Carol M.Hi Lisa,Don’t sell yourself short...your math is just fine! I agree with you that if you gave your son 0.25 ml of the reconstituted solution (1/8 of a 2 ml vial), he would only get 12.5 mg of Solu-Cortef ( 1/8 of 100 mg).However, I bet your doctor was really trying to prescribe 25 mg, rather than 12.5 mg. and probably just got confused thinking the vial contained only 1 ml of liquid, rather than 2 ml, when reconstituted. (I’ve had a doctor make the same mistake before.) On the other hand, if he really DID mean to prescribe only 12.5 mg, you can always show him this excerpt from the Johns Hopkins booklet on CAH.As an aside, this excerpt also clearly shows that the injection lasts only about 6 hours (what everyone else has said), rather than the 24 hours that he suggested.Best wishes!************************************************************4. Glucocorticoids in conditions of repeated vomiting
If a person with CAH vomits their oral medicine, an increased oral dose should be administered 30 minutes after vomiting. If this in turn is vomited, a cortisol injection is needed. Other circumstances in which affected individuals may need to receive their treatment via injection is if they are unconscious, have severe diarrhea, or are unable to take anything by mouth prior to surgery.
Injectable hydrocortisone is sold as Solu-Cortef (Acti-Vial) and should be kept in the home for emergency use. Your nurse or doctor will show you how to mix the vial of Solu-Cortef and give it as a shot. Give 25 to 100 mg Solu-Cortef via intramuscular injection. This provides a window of approximately 6 hours to get to an Emergency Room.