| CORTISONE ACETATE
Classifications: hormone; synthetic adrenal corticosteroid; glucocorticoid; antiinflammatory; Therapeutic:antiinflammatory; corticosteroid replacement; immunosuppressant
Pregnancy Category: D
5 mg, 10 mg, 25 mg tablets; 50 mg/mL injection
Short-acting synthetic steroid with prominent glucocorticoid activity and minimal mineralocorticoid effects. Therapeutic
activity of cortisone results from its conversion in body to cortisol, resulting in metabolic effects including promotion
of protein, carbohydrate, and fat metabolism and interference with linear growth in children.
Has antiinflammatory and immunosuppressive actions. Glucocorticoids prevent or suppress inflammation caused by various events
including radiant, mechanical, chemical, and infectious stimuli. Also suppress immune responses in diseases caused by undesirable
immune reactions, such as in asthma, urticaria, or renal allograft.
Replacement therapy for primary or secondary adrenocortical insufficiency and inflammatory and allergic disorders.
Hypersensitivity to glucocorticoids; psychoses; viral, fungal, or bacterial diseases of skin; Cushing's syndrome, immunologic
procedures; pregnancy (category D), lactation.
Diabetes mellitus; hypertension, CHF; older adults; active or arrested tuberculosis; coagulopathy; hepatic disease; psychosis,
emotional instability; renal disease, seizure disorders; active or latent peptic ulcer.
Route & Dosage
|Replacement or Inflammatory Disorders
Adult: PO/IM 20300 mg/d in 1 or more divided doses, try to reduce periodically by 1025 mg/d to lowest effective dose
Child: PO 2.510 mg/kg/d divided q68h IM 15 mg/kg/d divided q1224h
- Administer cortisone (usually in a.m.) with food or fluid of patient's choice to reduce gastric irritation.
- Sodium chloride and a mineralocorticoid are usually given with cortisone as part of replacement therapy.
- Parenteral cortisone is a suspension (25 mg/mL) and therefore should not be used IV. Shake bottle well before withdrawing
- Give deep IM into a large muscle.
- Drug must be gradually tapered rather than withdrawn abruptly.
- Store at 15°30° C (59°86° F) in tightly closed container unless otherwise directed by manufacturer.
Protect from heat and freezing.
Adverse Effects (≥1%) CV:
CHF, hypertension, edema. GI: Nausea, peptic ulcer
Hyperglycemia. Hematologic: Thrombocytopenia
. Musculoskeletal: Compression fracture,
osteoporosis, muscle weakness. CNS:
, vertigo, nystagmus. Skin:
Impaired wound healing, petechiae, ecchymosis, acne
. Special Senses: Cataracts, glaucoma
, blurred vision.
, phenytoin, rifampin
decrease effects of cortisone.
Readily absorbed from GI tract. Onset:
Rapid PO; 2448 h IM. Peak:
2 h PO; 2448 h IM. Duration:
1.251.5 d. Distribution:
Concentrated in many tissues; crosses placenta; distributed into breast milk. Metabolism:
In liver. Elimination:
In urine. Half-Life:
0.5 h; HPA suppression: 812 h.
Assessment & Drug Effects
- Monitor for S&S of Cushing's syndrome (see Appendix F), especially in patients on long-term therapy.
- Lab tests: Periodic blood glucose and CBC with platelet count.
- Cortisone may mask some signs of infection, and new infections may appear.
- Be alert to clinical indications of infection: malaise, anorexia, depression, and evidence of delayed healing. (Classic signs
of inflammation are suppressed by cortisone.)
- Report ecchymotic areas, unexplained bleeding, and easy bruising.
Patient & Family Education
- Take drug exactly as prescribed. Do not alter dose intervals or stop therapy abruptly.
- Monitor weight and report a steady gain especially if it is accompanied by signs of fluid retention (e.g., edema of ankles
- Report changes in visual acuity, including blurring, promptly.
- Inform physician or dentist that cortisone is being taken. Carry identification card or jewelry that states drug being taken
and physician's name.