Hydrocortisone VS Prednisone: Is there a difference?

Hi I am Tammy. When i first was diagnosed with Addisons I was given prednisone and florinef. Then when I was having stress problems they decided to switch to hydro, saying it was a more "natural" drug. First is this true and 2nd has anyone noticed a difference between the two? I have considered going back to the pred. Would LOVE some input on this one!!!

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Hi Tammy,

Yes, hydrocortisone is identical to cortisol, the hormone steroid which would be produced by the adrenal glands. Prednisone is another compound that acts like cortisol. The difference is it is slower acting and slower to purge from the body, thus often preferred to "smooth out" the daily curve of the steroid levels. Also, some prople do better on hydrocortisone, others on prednisone, for reasons unknown. The key criteria in the choice is how do you feel on the average on each one? The majority of Addison's are treated with hydrocortisone. Also, because HC is faster acting it is easier to stress-dose if necessary.

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I think Duane did a great job summing up! The only thing I would add, as something to consider with your doc, is the possibility of taking both medications. My son takes Prednisone (2.5 mg, 2x/day) as his basic treatment and then uses HC for stress dosing. This was recommended by his Endo as a way to "stress dose" for athletics, but now he is not competing and still finds he needs to add HC sometimes when he is feeling low. This seems to work for him and allows him to have some tools to work with as his needs fluctuate. The doc keeps an eye on him for signs of too much cortisol, but he has never displayed any symptoms of overdose, so the doctor has simply advised him to keep his doses as low as possible.

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Thanks for the reply to both of you! This is so awesome being able to talk to others who relate to me. It is already making me feel better due to not feeling so alone with this, as I have never, ever known another with this disease.

Another question: Is "hydrocort" another brand for hydro? Is it the same? I was given this when I got out of the hospital for a surgery for extra dosing and just found it in the cabinet as I was getting a little low of the other, long story - sorry, but: i have been doing better....also I have been really trying hard to handle my stress better so this could be the reason as well.

Thanks everyone!


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Hi Tammy, here's a link on hydrocort: http://www.drugs.com/pro/a-hydrocort.html

It's supposed to be taken intravenously as it comes as a powder. I'm surprised they gave it to you to bring home. It's usually used in hospitals. How are you taking it? Apparently, it does have the same dosing properties as hydrocortisone, but if you're just bumping up a little to help with your stress, I would think it would be hard to inject only 5 or 10 mg into yourself. It's generally for stress dosing.

You might want to ask your doctor for some extra 5 mg tablets for bumping up. I'm not sure this is the best way to go.

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I take prednisone and it is longer lasting. I am a secondary. I have tried hydrocortisone in replacement of the prednisone 3 times and it doesnt do a thing for me. However as Addisonmom said I use the HC for stress dosing. It does not give the horrible side effects of the prednisone like the talkies, nastiness, and inability to sleep but allows me to get through what I have to do. I believe it's half life is 4 hours so it is out of my system more quickly.

Just an FYI Hydrocort does come in pill form. I believe it is just made by another manufactur than Hydrocortisone.

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oh, okay. Thanks Jancy. I really just looked it up on the internet.

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Just wanted you to know that the Hydrocort they gave me was in pill form. Is it true that prednisone is longer lasting...i am getting confused now as to what really is the best one for me!

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Only you can determine which one is best for you. Both the hydrocortisone and the prednisone will do the job, however, as mentioned in the above posts, a bit differently. What you need to do is stay on one or the other for a while and make sure you have your dose right. Stay on it for a month. If you are not feeling well talk to your doctor about changing to the other. Don't be confused, three-quarters of the Addisonians are on hydrocortisone, split dose more in the morning and less in the afternoon. (say, 15mg upon waking and 5mg around 2pm). One Florinef tablet a day (0.1mg). And, add salt to your diet. (The salt is quite important, I met a retired endrocrinologist and he told me they used to keep Addison's patients going for quite a while with salt tablets alone. ) Just stick with whatever your daily dose is and don't worry about if there is a "best" one. There isn't.

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