BNF for Children (BNFC) 2018-2019

lSIDE-EFFECTS
▶Uncommon
▶With rectal useSkin discolouration
▶Frequency not known
▶With oral useDyslipidaemia.fatigue.hypotension.malaise
▶With parenteral useExophthalmos.hiccups.Kaposi’s
sarcoma.lipomatosis.malaise

lDIRECTIONS FOR ADMINISTRATION
▶With intravenous useForintravenous administration, dilute
with Glucose 5 % or Sodium Chloride 0. 9 %. Forintermittent
infusiongive over 20 – 30 minutes.
▶With oral useFor administrationby mouth, injection
solution may be swallowed [unlicensed use] but consider
phosphate content.

lPRESCRIBING AND DISPENSING INFORMATIONThe RCPCH
and NPPG recommend that, when a liquid special of
hydrocortisone is required, the following strength is used:
5 mg/ 5 mL.

lPATIENT AND CARER ADVICEPatient counselling is advised
for hydrocortisone tablets and injections (steroid card).
lLESS SUITABLE FOR PRESCRIBING
▶With intravenous useHydrocortisone as the sodium
phosphate is less suitable for prescribing as paraesthesia
and pain (particularly in the perineal region) may follow
intravenous injection.

lEXCEPTIONS TO LEGAL CATEGORY
▶With intramuscular use or intravenous usePrescription only
medicine restriction does not apply where administration
is for saving life in emergency.

lMEDICINAL FORMS
There can be variation in the licensing of different medicines
containing the same drug. Forms available from special-order
manufacturers include: capsule, oral suspension, oral solution
Tablet
CAUTIONARY AND ADVISORY LABELS10, 21
▶Hydrocortisone (Non-proprietary)
Hydrocortisone 10 mgHydrocortisone 10 mg tablets|
30 tabletP£ 101. 76 DT = £ 32. 79
Hydrocortisone 20 mgHydrocortisone 20 mg tablets|
30 tabletP£ 147. 26 DT = £ 83. 26
Powder for solution for injection
▶Solu-Cortef(Pfizer Ltd)
Hydrocortisone (as Hydrocortisone sodium succinate)
100 mgSolu-Cortef 100 mg powder for solution for injection vials|
10 vialP£ 9. 17
Powder and solvent for solution for injection
CAUTIONARY AND ADVISORY LABELS 10
▶Solu-Cortef(Pfizer Ltd)
Hydrocortisone (as Hydrocortisone sodium succinate)
100 mgSolu-Cortef 100 mg powder and solvent for solution for
injection vials| 1 vialP£ 1. 16 DT = £ 1. 16
Solution for injection
CAUTIONARY AND ADVISORY LABELS 10
▶Hydrocortisone (Non-proprietary)
Hydrocortisone (as Hydrocortisone sodium phosphate) 100 mg
per 1 mlHydrocortisone sodium phosphate 100 mg/ 1 ml solution for
injection ampoules| 5 ampouleP£ 8. 33 DT = £ 8. 33
Foam
EXCIPIENTS:May contain Cetostearyl alcohol (including cetyl and
stearyl alcohol), hydroxybenzoates (parabens), propylene glycol
▶Colifoam(Meda Pharmaceuticals Ltd)
Hydrocortisone acetate 100mg per 1 gramColifoam 10 % aerosol
| 14 doseP£ 9. 33 DT price = £ 9. 33

eiiiiF 436

Methylprednisolone 03-Nov-2017

lINDICATIONS AND DOSE

Inflammatory and allergic disorders

▶BY MOUTH, OR BY SLOW INTRAVENOUS INJECTION, OR BY

INTRAVENOUS INFUSION

▶Child: 0. 5 – 1. 7 mg/kg daily in 2 – 4 divided doses, divide

doses depending on condition and response

Treatment of graft rejection reactions

▶BY INTRAVENOUS INJECTION

▶Child: 10 – 20 mg/kg once daily for 3 days, alternatively

400 – 600 mg/m^2 once daily (max. per dose 1 g) for

3 days

Severe erythema multiforme|Lupus nephritis|Systemic

onset juvenile idiopathic arthritis

▶BY INTRAVENOUS INJECTION

▶Child: 10 – 30 mg/kg once daily or on alternate days

(max. per dose 1 g) for up to 3 doses

DEPO-MEDRONE®

Suppression of inflammatory and allergic disorders

▶BY DEEP INTRAMUSCULAR INJECTION

▶Child:Seek specialist advice, to be injected into the

gluteal muscle

IMPORTANT SAFETY INFORMATION

MHRA/CHM ADVICE: METHYLPREDNISOLONE INJECTABLE

MEDICINE CONTAINING LACTOSE (SOLU-MEDRONE®40 MG): DO

NOT USE IN PATIENTS WITH COWS’MILK ALLERGY (OCTOBER

2017)

An EU-wide review has concluded thatSolu-Medrone®

40 mg may contain trace amounts of milk proteins and

should not be used in patients with a known or

suspected allergy to cows’milk. Serious allergic

reactions, including bronchospasm and anaphylaxis,

have been reported in patients allergic to cows’milk

proteins. If a patient’s symptoms worsen or new allergic

symptoms occur, administration should be stopped and

the patient treated accordingly.

lCAUTIONSRapid intravenous administration of large

doses associated with cardiovascular collapse

lINTERACTIONS→Appendix 1 : corticosteroids

lSIDE-EFFECTSDiarrhoea.dizziness.dyslipidaemia.

exophthalmos.fatigue.hiccups.hypotension.Kaposi’s

sarcoma.lipomatosis.malaise

lDIRECTIONS FOR ADMINISTRATION

▶With intravenous useIntravenous injection given over

30 minutes. For intravenous infusion, may be diluted with

sodium chloride intravenous infusion 0. 9 %or 0. 45 %, or

glucose intravenous infusion 5 %or 10 %.

lPATIENT AND CARER ADVICEPatient counselling is advised

for methylprednisolone tablets and injections (steroid

card).

lMEDICINAL FORMS

There can be variation in the licensing of different medicines

containing the same drug. Forms available from special-order

manufacturers include: oral suspension

Powder and solvent for solution for injection

CAUTIONARY AND ADVISORY LABELS 10

▶Methylprednisolone (Non-proprietary)

Methylprednisolone (as Methylprednisolone sodium succinate)

500 mgMethylprednisolone sodium succinate 500 mg powder and

solvent for solution for injection vials| 1 vialP£ 9. 60

Methylprednisolone (as Methylprednisolone sodium succinate)

1 gramMethylprednisolone sodium succinate 1 g powder and solvent

for solution for injection vials| 1 vialP£ 17. 30

▶Solu-Medrone(Pfizer Ltd)

Methylprednisolone (as Methylprednisolone sodium succinate)

40 mgSolu-Medrone 40 mg powder and solvent for solution for

injection vials| 1 vialP£ 1. 58

BNFC 2018 – 2019 Corticosteroid responsive conditions 441

Endocrine system

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