Anyone know anything about hydrocortizone instead of prednisone for exacerbations?
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Hydrocortisone
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Hydrocortisone is about one-fifths as potent (per milligram) as methylprednisolone (e.g., IV Solu-Medrol) and has a shorter half-life (one-half to one third) than methylprednisolone. Although it is used systemically, its chemical characteristics make it less desirable for systemic use and more desirable for topical use or local injection (e.g., in an inflamed joint).
The intermediate- and even more potent long-acting corticosteroids are better suited for systemic use (oral or IV). In the high doses used for acute MS exacerbations -- and with better choices available -- there isn't a good reason to use hydrocortisone for MS.
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