Cortisone acetate

This article is about the medication. For the natural hormone, see Cortisone (hormone).
Cortisone acetate
Names
Trade namesAdreson, Cortison, Cortisone, Cortisone Acetate, Cortone, Cortistab, Cortisyl, others
Other namesCortisone 21-acetate; 17α,21-Dihydroxypregn-4-ene-3,11,20-trione 21-acetate
IUPAC name
  • [2-[(8S,9S,10R,13S,14S,17R)-17-hydroxy-10,13-dimethyl-3,11-dioxo-1,2,6,7,8,9,12,14,15,16-decahydrocyclopenta[a]phenanthren-17-yl]-2-oxoethyl] acetate
Clinical data
Drug classCorticosteroid (glucocorticoid, mineralocorticoid)[1]
Main usesAdrenal insufficiency, high blood calcium, autoimmune diseases, COPD, allergic reactions, tuberculosis[2][3]
Side effectsOsteoporosis, cataracts, weakness, thrush[2]
WHO AWaReUnlinkedWikibase error: ⧼unlinkedwikibase-error-statements-entity-not-set⧽
Typical dose25 to 300 mg/day[2]
External links
AHFS/Drugs.comMonograph
Chemical and physical data
FormulaC23H30O6
Molar mass402.487 g·mol−1
3D model (JSmol)
SMILES
  • CC(=O)OCC(=O)[C@]1(CC[C@@H]2[C@@]1(CC(=O)[C@H]3[C@H]2CCC4=CC(=O)CC[C@]34C)C)O
InChI
  • InChI=1S/C23H30O6/c1-13(24)29-12-19(27)23(28)9-7-17-16-5-4-14-10-15(25)6-8-21(14,2)20(16)18(26)11-22(17,23)3/h10,16-17,20,28H,4-9,11-12H2,1-3H3/t16-,17-,20+,21-,22-,23-/m0/s1
  • Key:ITRJWOMZKQRYTA-RFZYENFJSA-N

Cortisone acetate, sold under various brand names, is a corticosteroid used for a number of conditions.[2][4] Some of these include adrenal insufficiency, high blood calcium, autoimmune diseases, COPD, allergic reactions, and certain types of tuberculosis.[2][3] It is taken by mouth.[2] Effects generally last for 1 to 2 days.[2]

Commonly long term use results in osteoporosis, cataracts, weakness, and thrush.[2] Other side effects may include infection, adrenal insufficiency, swelling, and poor wound healing.[2] While short term use in the later part of pregnancy is safe, long term use may result in harm to the baby.[5] It is a manufactured steroid with both glucocorticoid and mineralocorticoid properties.[1]

Cortisone acetate was approved for medical use in the United States in 1950.[2] It is available as a generic medication.[2] In the United States 90 pills of 25 mg costs about 110 USD as of 2022.[6] It is marketed in many countries globally.[7]

Medical uses

A cortisone injection may provide short-term pain relief and may reduce the swelling from inflammation of a joint, tendon, or bursa in, for example, the joints of the knee, elbow and shoulder[8] and into a broken coccyx.[9]

Cortisone is also used by dermatologists to treat keloids,[10] relieve the symptoms of eczema and atopic dermatitis,[11] and stop the development of sarcoidosis.

Dosage

The typical dose in adults is 25 to 300 mg per day.[2]

Side effects

Oral use of cortisone has a number of potential systemic adverse effects, including asthma, hyperglycemia, insulin resistance, diabetes mellitus, osteoporosis, anxiety, depression, amenorrhoea, cataracts, glaucoma, Cushing's syndrome, increased risk of infections and impaired growth.[8][12][12] With topical application, it can lead to thinning of the skin, impaired wound healing, increased skin pigmentation, tendon rupture and skin infections (including abscesses).[13]

Mechanism of action

It is the C21 acetate ester of cortisone,[4][7] and acts as a prodrug of cortisone in the body.[14]

Addiction to cortisone was the subject of the 1956 motion picture Bigger Than Life, produced by and starring James Mason.

John F. Kennedy was regularly administered corticosteroids such as cortisone as a treatment for Addison's disease.[15]

References

  1. 1 2 I.K. Morton; Judith M. Hall (6 December 2012). Concise Dictionary of Pharmacological Agents: Properties and Synonyms. Springer Science & Business Media. pp. 85–. ISBN 978-94-011-4439-1.
  2. 1 2 3 4 5 6 7 8 9 10 11 12 "Cortisone Acetate Monograph for Professionals". Drugs.com. Archived from the original on 6 December 2021. Retrieved 7 January 2022.
  3. 1 2 "DailyMed - CORTISONE ACETATE tablet". dailymed.nlm.nih.gov. Archived from the original on 11 January 2022. Retrieved 7 January 2022.
  4. 1 2 J. Elks (14 November 2014). The Dictionary of Drugs: Chemical Data: Chemical Data, Structures and Bibliographies. Springer. pp. 317–. ISBN 978-1-4757-2085-3. Archived from the original on 17 October 2021. Retrieved 17 October 2021.
  5. ↑ "Cortisone (Cortone Acetate) Use During Pregnancy". Drugs.com. Archived from the original on 6 December 2021. Retrieved 7 January 2022.
  6. ↑ "Cortisone Prices, Coupons & Savings Tips - GoodRx". GoodRx. Archived from the original on 27 October 2016. Retrieved 7 January 2022.
  7. 1 2 Index Nominum 2000: International Drug Directory. Taylor & Francis. 2000. pp. 276–. ISBN 978-3-88763-075-1.
  8. 1 2 "Cortisone shots". MayoClinic.com. 2010-11-16. Archived from the original on 2013-09-01. Retrieved July 31, 2013.
  9. ↑ "injections and needles for coccyx pain". www.coccyx.org. Archived from the original on 2017-07-03. Retrieved 2022-01-07.
  10. ↑ Zanon, E; Jungwirth, W; Anderl, H (1992). "Cortisone jet injection as therapy of hypertrophic keloids". Handchirurgie, Mikrochirurgie, Plastische Chirurgie. 24 (2): 100–2. PMID 1582609.
  11. ↑ "All About Atopic Dermatitis". National Eczema Association. Archived from the original on 2012-01-30. Retrieved 2022-01-07.
  12. 1 2 "Prednisone and other corticosteroids: Balance the risks and benefits". MayoClinic.com. 2010-06-05. Archived from the original on 2013-12-13. Retrieved 2017-12-21.
  13. ↑ Cole, BJ; Schumacher (Jan–Feb 2005). "Injectable Corticosteroids in Modern Practice". Journal of the American Academy of Orthopaedic Surgeons. 13 (1): 37–46. CiteSeerX 10.1.1.562.1931. doi:10.5435/00124635-200501000-00006. PMID 15712981. S2CID 18658724.
  14. ↑ Løvås K, Husebye ES (2003). "Replacement therapy in Addison's disease". Expert Opin Pharmacother. 4 (12): 2145–9. doi:10.1517/14656566.4.12.2145. PMID 14640913. S2CID 37628998.
  15. ↑ Altman, Lawrence (October 6, 1992). "The doctor's world; Disturbing Issue of Kennedy's Secret Illness". The New York Times. Archived from the original on November 8, 2020. Retrieved January 7, 2022.
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