Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent. The side effects listed below are not experienced by everyone who takes Cortef (Hydrocortisone). If you are concerned about side effects, discuss the risks and benefits of Cortef (Hydrocortisone) with your doctor.

The following side effects have been reported by at least 1% of people taking Cortef (Hydrocortisone). Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• bloating
• changed sense of taste
• Diarrhea
• dry skin
• hair thinning
• heartburn
• hiccups
• increased appetite
• increased sweating
• itching
• redness of face or cheeks
• skin changes (discolouration, stretch marks, thinning)
• unusual hair growth
• upset stomach or stomach irritation
• vomiting

Although most of these side effects listed below don't happen very often, they could lead to serious problems if you do not check with your doctor or seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• abdominal or stomach pain
• Acne
• anxiety
• behaviour changes or mood swings
• bone fractures
• burning or tingling sensation of skin
• changes in vision
• confusion
• decreased or blurred vision
• decreased reflexes
• excitement
• false sense of well-being
• filling or rounding out of the face
• hallucinations
• high blood pressure
• irregular heartbeat
• joint pain
• menstrual problems
• muscle cramps or spasms
• muscle weakness
• pain in arms, back, hips, legs, ribs, or shoulders
• rash
• reddish-purple lines on arms, face, groin, legs, or trunk
• restlessness
• sensitivity of eyes to light
• signs of a blood clot in the arm or leg (tenderness, pain, swelling, warmth, or redness in the arm or leg) or lungs (difficulty breathing, sharp chest pain that is worst when breathing in, coughing, coughing up blood, sweating, or passing out)
• signs of heart problems (e.g., fast, irregular heartbeat or pulse, chest pain, sudden weight gain, difficulty breathing, leg swelling)
• signs of infections (e.g., fever or chills, severe diarrhea, shortness of breath, prolonged dizziness, headache, stiff neck, weight loss, or listlessness)
• skin infection or slowed healing of cuts or wounds
• spinning sensation
• swelling of the feet, ankles, or legs
• symptoms of Depression (e.g., poor concentration, changes in weight, changes in sleep, decreased interest in activities, thoughts of suicide)
• symptoms of high blood sugar (e.g., frequent urination, increased thirst, excessive eating, unexplained weight loss, poor wound healing, infections, fruity breath odour)
• symptoms of low potassium (e.g., tiredness, weakness, tingling or numbness, muscle cramps)
• symptoms of a stomach ulcer (e.g., persistent abdominal or stomach pain or burning, bloody or black, tarry stools)
• symptoms of Tuberculosis reactivation (e.g., coughing blood, chest pain)
• tendon rupture
• trouble sleeping
• unusual tiredness or weakness
• weight gain (rapid)

Stop taking the medication and seek immediate medical attention if any of the following occur:

• seizures
• signs of a Heart Attack (e.g., chest pain or pressure, pain extending through shoulder and arm, nausea and vomiting, sweating)
• signs of pancreatitis (e.g., abdominal pain on the upper left side, back pain, nausea, fever, chills, rapid heartbeat, swollen abdomen)
• signs of a Anaphylaxis (severe allergic reaction) (e.g., Hives; difficulty breathing; swelling of the face, tongue, or throat)
• thoughts of self-harm

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking Cortef (Hydrocortisone).

10 mg
Each white, round, scored, compressed tablet, engraved "CORTEF 10", contains 10 mg of Cortef (Hydrocortisone). Nonmedicinal ingredients: calcium stearate, cornstarch, lactose, mineral oil, sorbic acid, sucrose, and trace amounts of sodium. Gluten- and tartrazine-free.

20 mg
Each white, round, scored, compressed tablet, engraved "CORTEF 20", contains 20 mg of Cortef (Hydrocortisone). Nonmedicinal ingredients: calcium stearate, cornstarch, lactose, mineral oil, sorbic acid, sucrose, and trace amounts of sodium. Gluten- and tartrazine-free.

Do not take Cortef (Hydrocortisone) tablets if you:

• are allergic to Cortef (Hydrocortisone) or to any of the ingredients of the medication
• have a fungal infection in the lungs or other organs within the body
• have herpes simplex of the eye, except as short-term or emergency therapy as in acute sensitivity reactions
• have vaccinia or varicella, except when used for short-term or emergency therapy as in acute sensitivity reactions
• will be given a live virus vaccine (e.g., Measles, Mumps, rubella, yellow Fever, BCG) and are taking large immunosuppressive doses of Cortef (Hydrocortisone)

There may be an interaction between Cortef (Hydrocortisone) (tablets) and any of the following:

• Aldesleukin
• Amiodarone
• amphotericin B
• androgens (e.g., testosterone)
• antacids (e.g., aluminum hydroxide, calcium carbonate, magnesium hydroxide)
• anticholinesterases (e.g., edrophonium, neostigmine, pyridostigmine)
• Aprepitant
• "azole" antifungals (e.g., itraconazole, ketoconazole, Voriconazole)
• BCG vaccine
• Calcitriol
• calcium carbonate
• Carbamazepine
• Carvedilol
• Celecoxib
• Cholestyramine
• Cladribine
• Cobicistat
• Colestipol
• conivaptan
• Cyclosporine
• Deferasirox
• diabetes medications (e.g., chlorpropamide, Glyburide, insulin, Metformin, Rosiglitazone, Saxagliptin)
• Diltiazem
• diuretics (water pills; e.g., Furosemide, Hydrochlorothiazide)
• Donepezil
• Dronedarone
• echinacea
• Enzalutamide
• estrogens (e.g., conjugated estrogen, Estradiol, ethinyl estradiol; including estrogen-containing birth control pills)
• Fingolimod
• Galantamine
• grapefruit juice
• HIV protease inhibitors (e.g., atazanavir, darunavir, lopinavir, ritonavir)
• Indacaterol
• isoniazid
• Ivacaftor
• Lapatinib
• Leflunomide
• macrolide antibiotics (e.g., clarithromycin, erythromycin)
• mifepristone
• Mirabegron
• Mitotane
• Natalizumab
• nelfinavir
• neuromuscular blockers (e.g., atracurium, pancuronium, vecuronium)
• nonsteroidal anti-inflammatory medications (NSAIDs; e.g., Diclofenac, Ibuprofen, Ketorolac, Naproxen)
• Ocrelizumab
• Phenobarbital
• Phenytoin
• Pimecrolimus
• primidone
• quinidine
• quinine
• quinolone antibiotics (e.g., ciprofloxacin, Norfloxacin, Ofloxacin)
• rifampin
• Rivastigmine
• salicylates (e.g., acetylsalicylic acid [Asa])
• sodium bicarbonate
• Somatropin
• St. John's wort
• Tacrolimus
• Tofacitinib
• Trastuzumab
• vaccines (e.g., yellow fever, BCG, measles, mumps, rubella)
• velpatasvir
• Verapamil
• Warfarin

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with Cortef (Hydrocortisone). Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the Nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use Cortef (Hydrocortisone).

Blood pressure: Cortef (Hydrocortisone) can increase blood pressure, especially when high doses are used. Your doctor will monitor your blood pressure closely while you are taking Cortef (Hydrocortisone). Your doctor may suggest diet changes or other measures to keep your blood pressure under control. People with high blood pressure should discuss with their doctor how Cortef (Hydrocortisone) may affect their medical condition, how their medical condition may affect the dosing and effectiveness of Cortef (Hydrocortisone), and whether any special monitoring is needed.

Diabetes: Cortef (Hydrocortisone) may worsen blood sugar control for people with diabetes. If you have diabetes, discuss with your doctor how Cortef (Hydrocortisone) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Cortef (Hydrocortisone), and whether any special monitoring is needed.

Heart disease: Cortef (Hydrocortisone) may cause blood pressure to increase. Cortef (Hydrocortisone) may also cause cholesterol levels to increase.  If you have a heart condition or are at risk of developing heart problems, discuss with your doctor how Cortef (Hydrocortisone) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Cortef (Hydrocortisone), and whether any special monitoring is needed.

Illness and surgery: People who take Cortef (Hydrocortisone), or have taken other corticosteroids (e.g., Prednisone) in the last several months, may need additional corticosteroids (e.g., prednisone) during times of any unusual stress, such as trauma, surgery, or infection.

Infections: When taken by mouth, Cortef (Hydrocortisone) may mask some signs of infection and put people at increased risk for new infections. Viral infections such as Chickenpox, measles, or herpes can be more serious for people who are taking Cortef (Hydrocortisone). Children and adults who have not had these diseases should take particular care to avoid exposure. If you are exposed to these infections, contact your doctor.

Liver function: Liver disease or reduced liver function may cause Cortef (Hydrocortisone) to build up in the body, causing side effects. If you have liver problems, discuss with your doctor how Cortef (Hydrocortisone) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Cortef (Hydrocortisone), and whether any special monitoring is needed.

Medical records: Let all health professionals involved in your care know that you have been taking a corticosteroid.

Mental health: Like other corticosteroids, Cortef (Hydrocortisone) may cause behaviour and personality changes and mood swings. These reactions are most likely to occur when you first start taking Cortef (Hydrocortisone). If you experience these symptoms or notice them in a family member who is taking Cortef (Hydrocortisone), contact your doctor as soon as possible.

Myasthenia Gravis: Myasthenia gravis is a condition that causes specific muscle weakness. Cortef (Hydrocortisone) can cause muscle wasting, decreasing muscle. If you have myasthenia gravis, discuss with your doctor how Cortef (Hydrocortisone) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Cortef (Hydrocortisone), and whether any special monitoring is needed.

Osteoporosis: Cortef (Hydrocortisone) can increase the risk of osteoporosis (brittle bones). Talk to your doctor about ways to help prevent osteoporosis. Your doctor will monitor your bone density if you take Cortef (Hydrocortisone) for a long period of time.

Steroid medication use: If you have taken or are still taking an oral steroid medication (e.g., prednisone) during the last several months, consult your doctor before using Cortef (Hydrocortisone). If you experience symptoms such as tiredness, headache, nausea, or vomiting while taking Cortef (Hydrocortisone), contact your doctor.

Stomach and intestinal problems: If you have or have had a stomach or intestinal ulcer, or have ulcerative colitis, discuss with your doctor how Cortef (Hydrocortisone) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Cortef (Hydrocortisone), and whether any special monitoring is needed.

Stopping the medication: When stopping Cortef (Hydrocortisone) after having used it for a long time, reduce the dose slowly as prescribed by your doctor. Stopping the medication too quickly could lead to symptoms including fever, muscle, and joint pain, and a general feeling of being unwell.

Thyroid disease: Decreased thyroid function may affect how your body handles Cortef (Hydrocortisone). If you have a history of thyroid disease, discuss with your doctor how Cortef (Hydrocortisone) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Cortef (Hydrocortisone), and whether any special monitoring is needed.

Tuberculosis: Corticosteroids, such as Cortef (Hydrocortisone), can cause tuberculosis infection to flare up. If you have had tuberculosis, discuss with your doctor how Cortef (Hydrocortisone) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Cortef (Hydrocortisone), and whether any special monitoring is needed.

Vaccines: Live vaccines (e.g., BCG, yellow fever, measles, mumps, rubella) should not be given to people taking doses of Cortef (Hydrocortisone) that are enough to suppress the immune system. Killed or inactivated vaccines may not be as effective for people who are taking Cortef (Hydrocortisone).

Vision problems: Long-term use of Cortef (Hydrocortisone) can cause Glaucoma and Cataracts. If you notice changes in your vision, such as faded colours, halos around lights, or blurred vision, contact your doctor as soon as possible. Glaucoma can cause permanent vision loss and should be treated as early as possible.

Pregnancy: Cortef (Hydrocortisone) should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking Cortef (Hydrocortisone), contact your doctor immediately.

Breast-feeding: Cortef (Hydrocortisone) passes into breast milk. If you are a breast-feeding mother and are taking Cortef (Hydrocortisone), it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: Long-term treatment with Cortef (Hydrocortisone) may suppress growth and development in children. Your child's growth should be monitored while they are taking Cortef (Hydrocortisone).