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When to give an emergency injection


  • In an emergency, anyone who is steroid-dependent, whether from Addison's or from other causes, can experience symptoms of extreme weakness, a serious drop in blood pressure and mental confusion. In people with Addison's disease, this is usually called an adrenal crisis. This means they need extra steroid medication immediately, and are likely to need an emergency injection of intramuscular (IM) hydrocortisone 100mg.

The symptoms of needing injected steroids are:

  • vomiting
  • profound muscle weakness
  • dizziness
  • low blood pressure
  • extreme sleepiness
  • possibly headache, chills or fever
  • possibly hypovolaemic shock or coma.

As a general rule, the steroid-dependent person should give themselves an emergency injection of 100mg hydrocortisone as soon as they vomit. This will act to stabilise their condition so that further medical advice or treatment can be sought.

The injection buys time in the event of severe illness or injury. It can be given by a friend or family member if the person is too ill to inject themselves. Giving too much steroid during injury or illness will do no harm. Under-replacement in these circumstances is potentially life-threatening, or may have other severe outcomes due to circulatory/cardiovascular complications from low blood pressure.


Further explanation of when to inject can be found in the video interview given by Prof John Wass, Chair of the Addison's Clinical Advisory Panel:




It is important to check that the correct hydrocortisone injection brand has been supplied: hydrocortisone sodium phosphate or sodium succinate-based drug products. Any acetate-based hydrocortisone injection product should be discarded as it would not be effective.


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The Addison’s Disease Self-Help Group is the support group for people with Addison’s disease or adrenal insufficiency and their families in the UK and Ireland.The group was formed in 1984 and is a UK registered charity no. 1179825.

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