ATC Class:H02AB10

VA Class:HS051

AHFS Class:

• Adrenals 68:04

Generic Name(s):

• Cortisone Acetate

Cortisone is a glucocorticoid secreted by the adrenal cortex.

Cortisone (as the acetate) or hydrocortisone is usually the corticosteroid of choice for replacement therapy in patients with adrenocortical insufficiency, because these drugs have both glucocorticoid and mineralocorticoid properties. Concomitant administration of a more potent mineralocorticoid (fludrocortisone) may be required in some patients. For anti-inflammatory or immunosuppressive uses, synthetic glucocorticoids which have minimal mineralocorticoid activity are preferred.

Administration

Cortisone acetate is administered orally.

Dosage

Dosage for infants and children should be based on the severity of the disease and the response of the patient rather than on strict adherence to dosage indicated by age, body weight, or body surface area. After a satisfactory response is obtained, dosage should be decreased in small decrements to the lowest level that maintains an adequate clinical response. Patients should be continually monitored for signs that indicate dosage adjustment is necessary, such as remissions or exacerbations of the disease and stress (surgery, infection, trauma). If cortisone is used orally for prolonged anti-inflammatory therapy, an alternate-day dosage regimen should be considered. Following long-term therapy, cortisone should be withdrawn gradually. (See the Corticosteroids General Statement 68:04.)

The initial adult oral dosage of cortisone acetate may range from 25-300 mg daily depending on the disease being treated. Some clinicians state that children may be given an oral dosage of 0.7-10 mg/kg daily or 20-300 mg/m² daily in 4 divided doses.

Chemistry and Stability

Chemistry

Cortisone is a glucocorticoid secreted by the adrenal cortex. The drug is commercially available as the acetate ester. Cortisone acetate occurs as a white or practically white, crystalline powder and is insoluble in water and slightly soluble in alcohol.

Stability

Cortisone acetate tablets should be stored in well-closed containers at a temperature less than 40°C, preferably at 15-30°C.

Additional Information

For further information on chemistry, pharmacology, pharmacokinetics, uses, cautions, drug interactions, laboratory test interferences, and dosage and administration of cortisone, see the Corticosteroids General Statement 68:04. For EENT uses, see 52:08.08.