Primary adrenal insufficiency (Addison’s disease)
Treatment of Addison’s disease
Hydrocortisone
Hydrocortisone 10mg tablets
Hydrocortisone 20mg tablets
Fludrocortisone
Fludrocortisone 100microgram tablets
Prescribing Notes:
- Patients deficient in glucocorticoids do not respond adequately to stress and should be advised to double the replacement dose of hydrocortisone for several days if significantly unwell.
- Provide Steroid Sick Day Rules information from the Society for Endocrinology. A one-month reserve of steroid medication is recommended for patients at risk of adrenal crisis.
- Fludrocortisone 100microgram tablets can be halved to allow dosing flexibility.
- Patients should be given a steroid card and a steroid emergency card. See the Healthcare Improvement Scotland website for details around the use of a Steroid Emergency Card.
History Notes
30/07/2026
Regional formulary chapter launched.
Treatment of Addison’s disease – emergency use
Hydrocortisone
Hydrocortisone sodium succinate 100mg powder and solvent for solution for injection vials
Hydrocortisone sodium succinate 100mg powder for solution for injection vials
Prescribing Notes:
- Patients should receive appropriate training and counselling on the reconstitution steps required.
- Ensure water for injection to reconstitute the powder for injection is also prescribed, if the product with diluent is unavailable.
- Patients should be given a steroid card and a steroid emergency card. See the Healthcare Improvement Scotland website for details around the use of a Steroid Emergency Card.
History Notes
30/07/2026
Regional formulary chapter launched.
Diagnosis of adrenocortical insufficiency
Tetracosactide
Tetracosactide 250micrograms/1ml solution for injection ampoules
History Notes
30/07/2026
Regional formulary chapter launched.