Comparative Pharmacology
Head-to-head clinical analysis: HYDROCORTISONE versus ILUVIEN.
Peer-Reviewed Evidence
Head-to-head clinical analysis: HYDROCORTISONE versus ILUVIEN.
HYDROCORTISONE vs ILUVIEN
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Hydrocortisone is a glucocorticoid that binds to the glucocorticoid receptor (GR), leading to altered gene expression. This results in anti-inflammatory, immunosuppressive, anti-proliferative, and vasoconstrictive effects. It also modulates carbohydrate, protein, and lipid metabolism.
Fluocinolone acetonide, a corticosteroid, suppresses inflammation by inhibiting phospholipase A2, reducing arachidonic acid release and subsequent prostaglandin and leukotriene synthesis. It also inhibits cytokine production and endothelial cell adhesion molecule expression.
Oral: 10-20 mg every 6-8 hours; IV/IM: 100-500 mg every 2-6 hours for acute conditions; typical maintenance: 20-240 mg/day divided every 8-12 hours.
Intravitreal implant containing 0.19 mg fluocinolone acetonide, designed to release drug over approximately 36 months. Administered as a single injection into the vitreous cavity of the eye.
None Documented
None Documented
Clinical Note
moderateHydrocortisone + Gatifloxacin
"The risk or severity of adverse effects can be increased when Hydrocortisone is combined with Gatifloxacin."
Clinical Note
moderateHydrocortisone + Rosoxacin
"The risk or severity of adverse effects can be increased when Hydrocortisone is combined with Rosoxacin."
Clinical Note
moderateHydrocortisone + Levofloxacin
"The risk or severity of adverse effects can be increased when Hydrocortisone is combined with Levofloxacin."
Clinical Note
moderateTerminal half-life: 1.5–2 hours (plasma). In tissues, biologic half-life is 8–12 hours due to intracellular activity. Half-life prolonged in hepatic impairment.
Intravitreal terminal half-life of fluocinolone acetonide from the Iluvien implant is approximately 30 months (range 18-36 months), providing sustained release over 36 months in the vitreous cavity.
Renal: primarily as inactive metabolites (cortisone, tetrahydrocortisone) and unchanged drug (<1%). Biliary/fecal: minimal (<5%).
Fluocinolone acetonide is primarily eliminated via hepatic metabolism and subsequent fecal/biliary excretion. Approximately 50-70% of a dose is excreted in feces as metabolites, with less than 20% recovered in urine as unchanged drug or metabolites.
Category D/X
Category C
Corticosteroid
Corticosteroid
Hydrocortisone + Trovafloxacin
"The risk or severity of adverse effects can be increased when Hydrocortisone is combined with Trovafloxacin."