Nutraferon NHCORT Injection

In primary adrenal crisis (Addisonian crisis), patients lack both glucocorticoid (cortisol) and mineralocorticoid (aldosterone) hormones, causing severe hypotension, hyponatremia, and hyperkalemia. Dexamethasone has zero mineralocorticoid activity, whereas Hydrocortisone at stress doses (100–200 mg/day) provides complete glucocorticoid AND mineralocorticoid replacement.

Intramuscular Epinephrine (Adrenaline) is always the mandatory first-line life-saving treatment in anaphylaxis. Hydrocortisone is administered as a secondary adjunct to blunt late-phase inflammatory cascades and prevent biphasic anaphylaxis recurrence 4 to 12 hours later.

Multi-day high-dose corticosteroid therapy suppresses the hypothalamic-pituitary-adrenal (HPA) axis; gradual tapering or step-down to maintenance oral hydrocortisone prevents rebound adrenal crisis.

High-dose systemic corticosteroids must NOT be used for Traumatic Brain Injury (TBI / acute head injury) (clinical trials such as the CRASH trial demonstrated increased mortality) or cerebral malaria, and are contraindicated in systemic fungal infections (unless treating life-threatening amphotericin B reactions or adrenal crisis) and with live-virus vaccines.

Monitor blood glucose (steroid-induced hyperglycemia), serum potassium (hypokalemia), serum sodium and fluid balance, blood pressure, and signs of stress ulceration or occult infection.