Hydrocortisone - Adrenal crisis

The Surrey Heartlands Area Prescribing Committee have agreed that primary care prescribers may prescribe replacement hydrocortisone injection for the hydrocortisone rescue kits for patients at risk of adrenal crisis when:

- the patient has been provided with clear instructions
- a management plan has been provided to the GP and the patient
- the previous supply of hydrocortisone injection has been used or has expired

Advice on the safe use of adrenal crisis emergency kits can be found at the link below.
Secondary care will prescribe the initial supply of the appropriate formulation of hydrocortisone 

NOTES for prescribing:
- hydrocortisone sodium succinate is licensed for adrenal crisis but comes in a powder that does require reconstitution. Max of 2ml water for injection is required for reconstitution.
- DO NOT USE hydrocortisone acetate injection to treat adrenal crisis