If stocks run out, prescribers are advised to consider switching patients to hydrocortisone sodium succinate 100mg powder for injection
Pharmacists are being notified of a limited supply of hydrocortisone sodium phosphate 100mg/1ml solution for injection ampoules, with stock expected to be exhausted by late March 2025.
The Department of Health and Social Care (DHSC) has issued a medicine supply notification, indicating that resupply is not anticipated until May 2026.
NHS provider Trust pharmacy procurement and clinical teams are advised to collaborate in reserving existing stock of the solution for injection, specifically for patients who require hydrocortisone sodium phosphate during an adrenal crisis.
The DHSC added that this stock has an expiry date of June 2025.
Hydrocortisone is used to replace steroids in individuals with adrenal insufficiency, such as those with Congenital Adrenal Hyperplasia (CAH) or Addison's disease, where the adrenal glands produce insufficient natural steroids.
People with adrenal insufficiency or anyone who is “steroid-dependent” require a hydrocortisone emergency injection kit to prevent an acute adrenal crisis, which can be life-threatening.
Symptoms of an adrenal crisis include extreme weakness, significant blood pressure drops, drowsiness, and confusion.
An emergency hydrocortisone injection, which can be administered by the patient or a friend or family member, can be life-saving until the patient receives further medical care.
Alternative option
In cases where stock is exhausted, prescribers are advised to consider switching patients to hydrocortisone sodium succinate 100mg powder for injection, keeping in mind the difference in concentration after reconstitution.
“After reconstitution with 2ml diluent, the final concentration is approximately 50mg/ml,” the DHSC noted.
Prescribers should inform patients and/or carers who are used to administering the medication on how to reconstitute the hydrocortisone sodium succinate vial, making them aware of the concentration difference of the reconstituted solution to ensure the correct dose.
The DHSC has asked pharmacists to ensure that prescription for hydrocortisone sodium succinate powder for injection includes water for injection, unless the product with diluent is prescribed.
Furthermore, it is critical that wards, clinics, and emergency departments are informed of any changes in formulation and issue reconstitution advice, highlighting difference in concentration of the reconstituted solution.
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