Last update April 18, 2022

Hydrocortisone, systemic use

Very Low Risk

Safe. Compatible. Minimal risk for breastfeeding and infant.

Hydrocortisone or cortisol is a natural steroid produced in the adrenal cortex. It has glucocorticoid and, to a lesser extent, mineralocorticoid effects. Its esters are used as anti-inflammatories orally, intramuscularly, intravenously, intraarticularly and topically (dermatological, intestinal, ophthalmic and otic).

At the date of the last update we did not find any published data on its excretion in breast milk.

Its pharmacokinetic data (high percentage of protein binding, wide volume of distribution and short half-life) make it highly unlikely that significant quantities will pass into breast milk.

Cortisol is a normal component of breast milk. Its concentration, 7 mcg/L (0.2 - 32) (Kulski 1981), has a circadian rhythm (Italianer 2020) and can increase in situations of maternal stress. (Aparicio 2020)

Intra-articular administration of depot prednisone derivatives may be a cause of transient decrease of milk production (Smuin 2016, McGuire 2012, Babwah 2013)

Until more published data is known about this drug in relation to breastfeeding, known safer alternatives are preferable, especially during the neonatal period and in the event of prematurity.

Eleventh WHO Model List of Essential Drugs 2002: Compatible with breastfeeding in single dose. No data available about prolonged usage. (WHO 2002)


See below the information of this related product:

Alternatives

  • Methylprednisolone ( Safe. Compatible. Minimal risk for breastfeeding and infant.)
  • Prednisolone ( Safe. Compatible. Minimal risk for breastfeeding and infant.)
  • Prednisone ( Safe. Compatible. Minimal risk for breastfeeding and infant.)

Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

Other names

Hydrocortisone, systemic use is also known as


Hydrocortisone, systemic use in other languages or writings:

Tradenames

Main tradenames from several countries containing Hydrocortisone, systemic use in its composition:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 96 %
Molecular weight 363 daltons
Protein Binding 90 %
VD 0.48 - 1 l/Kg
pKa 12.59 -
Tmax 1 hours
1 - 2 hours

References

  1. Middleton PG, Gade EJ, Aguilera C, MacKillop L, Button BM, Coleman C, Johnson B, Albrechtsen C, Edenborough F, Rigau D, Gibson PG, Backer V. ERS/TSANZ Task Force Statement on the management of reproduction and pregnancy in women with airways diseases. Eur Respir J. 2020 Feb 6;55(2). pii: 1901208. Abstract Full text (link to original source) Full text (in our servers)
  2. Italianer MF, Naninck EFG, Roelants JA, van der Horst GTJ, Reiss IKM, Goudoever JBV, Joosten KFM, Chaves I, Vermeulen MJ. Circadian Variation in Human Milk Composition, a Systematic Review. Nutrients. 2020 Aug 4;12(8). pii: E2328. Abstract
  3. Aparicio M, Browne PD, Hechler C, Beijers R, Rodríguez JM, de Weerth C, Fernández L. Human milk cortisol and immune factors over the first three postnatal months: Relations to maternal psychosocial distress. PLoS One. 2020 May 21;15(5):e0233554. Abstract
  4. Smuin DM, Seidenberg PH, Sirlin EA, Phillips SF, Silvis ML. Rare Adverse Events Associated with Corticosteroid Injections: A Case Series and Literature Review. Curr Sports Med Rep. 2016 May-Jun;15(3):171-6. Abstract
  5. Babwah TJ, Nunes P, Maharaj RG. An unexpected temporary suppression of lactation after a local corticosteroid injection for tenosynovitis. Eur J Gen Pract. 2013 Dec;19(4):248-50. Abstract
  6. McGuire E. Sudden loss of milk supply following high-dose triamcinolone (Kenacort) injection. Breastfeed Rev. 2012 Mar;20(1):32-4. Review. Abstract
  7. Henderson JJ, Hartmann PE, Newnham JP, Simmer K. Effect of preterm birth and antenatal corticosteroid treatment on lactogenesis II in women. Pediatrics. 2008 Abstract Full text (link to original source) Full text (in our servers)
  8. WHO / UNICEF. BREASTFEEDING AND MATERNAL MEDICATION Recommendations for Drugs in the Eleventh WHO Model List of Essential Drugs. Department of Child and Adolescent Health and Development (WHO/UNICEF) 2002 Full text (link to original source) Full text (in our servers)
  9. Kulski JK, Hartmann PE. Changes in the concentration of cortisol in milk during different stages of human lactation. Aust J Exp Biol Med Sci. 1981 Dec;59(Pt 6):769-78. Abstract

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