Hydrocortisone compound

Revised September 17, 2018
Section 1.1

Midwives may independently prescribe, order and administer this drug.

Hydrocortisone compounds contain topical corticosteroids that decrease inflammation by suppressing leukocyte production and reducing capillary permeability. They are available in cream, lotion, ointment and suppository form.

Indications and Clinical Use:

Hemorrhoids: Low to mid potency creams or ointments, In combination with pramoxine hydrochloride 1% and zinc sulfate, may be prescribed for adults for anorectal therapy for treatment of hemorrhoids (examples include Anusol HC®, Procotzone®, Proctodan®, Proctofoam®).

PEP: Low to mid-potency creams, lotions and ointments may be prescribed to treat symptoms associated with polymorphic eruption of pregnancy (PEP), formerly known as pruritic urticarial papules and plaques of pregnancy (PUPP).

APNO: Low-potency betamethasone ointment may be prescribed as a component of All-Purpose Nipple Ointment (APNO).


Hypersensitivity to any component of the formulation.

Warnings and Precautions:

Use with caution in patients with GI disease, hepatic impairment, hypertension, osteoporosis, thyroid disease. Discontinue use if redness or irritation occurs.

Do not apply to nipples unless as a component of APNO.


Comptaible – The lowest effective potency should be used over the smallest possible area for the shortest possible time.


Category L2 – No Data – Probably Compatible
Topical use to small area is not associated with problems

Adverse Reactions:

Burning, dryness, irritation, itching, skin maceration, dermatitis and secondary skin infection.

Dosage and Administration:

Hemorrhoids: Topical: 0.5%-1% hydrocortisone acetate (cream or ointment + pramoxine hydrochloride + zinc sulfate): Apply thin layer of to the affected area two to four times daily.
Suppository:1% hydrocortisone acetate (foam or cream + pramoxine hydrochloride 1% + zinc sulfate): One suppository twice daily for two weeks.

PEP/PUPP: Topical: 1% hydrocortisone butyrate (lotion, cream or ointment) OR 0.1% betamethasone (lotion, cream or ointment):
Apply thin film to affected area twice daily for up to seven days.

APNO: Topical: 0.1% betamethasone ointment, in combination with mupirocin ointment and miconazole powder (refer to entry for APNO).