Generic Hydrocortisone, Revisited
Ten years ago, I made the bold claim that a generic form of my life sustaining medicine almost killed me. I had suffered a terrifying adrenal crisis at the hands of unprepared and inept medical professionals. Through much analysis, we realized that the main trigger of this nightmare was the switch to the generic brand of hydrocortisone called Qualitest.
I published my accusation online, and I was blown away with the number of people who joined in and said “Hey, this happened to me as well.” Just scroll through the comments on that original post.
However, many things have changed in the last decade. Generics have been bought and sold. Names have come and go. The information originally provided by that blog post is no longer accurate. Consider this post the update.
Things to Watch For
Do you have Adrenal Insufficiency and…
- Are constantly nauseated?
- Have a never ending headache?
- Still feel beyond miserable despite your doctors telling you that your dosage is correct?
- Are regularly blacking out not due to another medical diagnosis?
- Have an insurmountable amount of fatigue?
- Remain sick despite stress dosing?
- Feel worse 20-30 minutes after swallowing your medicine?
Check the manufacturer of your medicine here.
USA Hydrocortisone Brands
This information was compiled April 2023 and is subject to change. If you believe that I have missed something, or you discover that some of this information is out of date, please contact me. I want to give a special thank you and shutout to the MAGIC Foundation, and specifically Jenna, the CAH Division Consultant for bringing this information to my attention.
Cortef / Pfizer
- Brand History: Cortef is the brand name form of hydrocortisone. It is produced by Pfizer.
- Link (PDF)
- Dose Increments: 5mg, 10mg, 20mg
- Active Ingredients: Hydrocortisone (WI4X0X7BPJ)
- Inactive Ingredients: Calcium Stearate, Corn Starch, Lactose, Mineral Oil, Sorbic Acid, Sucrose
Viatris / Greenstone
- Brand History: Viatris is the name given to the Myla-Upjohn merger (merger effective November 2020), a division of Pfizer. This includes Pfizer’s generic hydrocortisone, Greenstone. In the past, if insurance forced you to have a generic, this was the preferred generic as it was as close to the name brand Cortef as possible.
- Link: Viatris, Greenstone
- Dose Increments: 5mg, 10mg, 20mg
- Active Ingredients: Hydrocortisone (WI4X0X7BPJ)
- Inactive Ingredients: Calcium Stearate, Corn Starch, Lactose, Mineral Oil, Sorbic Acid, Sucrose
Amneal Pharmaceuticals
- Brand History: Amneal purchased Lineage Therapeautics and Impax Laboratories (CorePharma was previous purhcased by Impax) in 2015.
- Link
- Dose Increments: 5mg, 10mg, 20mg
- Active Ingredients: Hydrocortisone (WI4X0X7BPJ)
- Inactive Ingredients: Lactose, Corn Starch, Cellulose Microcrystalline, Croscarmellose Sodium, Sodium Starch Glycolate Type A Potato, Magnesium Stearate
Strides Pharma
- Brand History: Vensun was purhcased by Strides in 2019.
- Link
- Dose Increments: 5mg, 10mg, 20mg
- Active Ingredients: Hydrocortisone (WI4X0X7BPJ)
- Inactive Ingredients: Lactose Monohydrate, Cellulose Microcrystalline, Silicon Dioxide, Magnesium Stearate
Chartwell RX
- Brand History: Chartwell only comes in 20mg doses, which is not ideal for our treatment.
- Link
- Dose Increments: 20mg
- Active Ingredients: Hydrocortisone (WI4X0X7BPJ)
- Inactive Ingredients: Calcium Stearate, Corn Starch, Lactose Monohydrate, Sucrose
My Thoughts, a Decade Later
Of the seven manufacturers that I had originally listed, online one remains name unchanged. That is the brand name Cortef. Everything else has gone through name changes and mergers. I am encouraged to see that the ingredient that I had initially reacted to (Sodium Lauryl Sulfate) seems to have been pulled from the market. However, there has been some research into Magnesium Stearate when compounded with hydrocortisone degrades the hydrocortisone.
What do you do if you cannot get brand name Cortef and are still reacting to your generic hydrocortisone? There are a couple of options. First, you could try switching to an alternate steroid such as dexamethasone or prednisone. If that does not work, explore treatment with solu-cortef. This can either be in the form of sub-cutaneous injections or the cortisol pump. I have now been on my cortisol pump for over nine years.
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