How to give an injection of hydrocortisone

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Act-O-Vial Instructions (Solu-Cortef) Act-O-Vial (Solu-Cortef) is a medicine used to treat many diseases such adrenal insufficiency in emergency situations. This medicine is given if you cannot take steroid hormone by mouth. It is also ordered if you: have a fever over 101 F are vomiting have diarrhea live far away from medical help are directed to do so by your doctor The Act-O-Vial contains 100 mg of hydrocortisone (Solu-Cortef). It is injected through the skin. This medicine can be life-saving because it works fast. Call your doctor if you have any questions about this medicine. Important: Always carry the package with you during travel or activities that put you at risk for physical injury (hiking, biking, or skiing). Contact your doctor before and after you use the Act-O-Vial. How to give an injection of hydrocortisone 1. Wash your hands. 2. Assemble your equipment. Revised 09/2015 Patient Education 2683 Page 1 of 5

3. Mix the medication vial by pushing down on top of the vial to release the cork. 4. Shake the vial to mix the medication solution well. 5. Use alcohol to clean the rubber stopper on the vial. 6. Take the cap off the syringe needle. Insert the needle into the vial. 7. Draw up the medication. Adults should use all the medication in the vial. For a child, use the dose prescribed by a doctor. 8. Replace the needle cap. Revised 09/2015 Patient Education 2683 Page 2 of 5

9. Select your injection site. To inject yourself safely, become familiar with your body. Uncover your thigh and look at it. Now, draw an imaginary line in the middle of your thigh to divide it in half lengthwise. The outer portion is where you will be injecting. Now, imagine your thigh divided into three equal portions, from the knee to the hip. The outer portion of the inner third of your thigh is where you will do the injection. 10. Use alcohol to cleanse the injection site on your skin. 11. Remove the cap from the needle. Hold the syringe like a dart. 12. Using your thumb and first two fingers, spread your skin while pushing down lightly. Revised 09/2015 Patient Education 2683 Page 3 of 5

13. Dart the needle into the thigh injection site, going straight in at a 90-degree angle. 14. Hold the syringe in place. Pull back the plunger to make sure you are not injecting into a large blood vessel. If blood appears in the syringe, withdraw the syringe and discard it. If this is the only dose of medication you have, inject the medication anyway. If you have another vial of medication, prepare another syringe with medication and inject yourself in a slightly different place. 15. After injecting the medication, put tissue or gauze near the needle and pull the needle out quickly. 16. Massage the injection site gently. 17. Place the syringe and needle in a hard, unbreakable container (such as an empty coffee can with a lid) before disposing of it. 18. Call your local doctor. Revised 09/2015 Patient Education 2683 Page 4 of 5

Contact your doctor before taking Act-O-Vial if: You are taking any blood thinners Your condition persists or worsens Storage Do not keep the Act-O-Vial past the expiration date. Store at room temperature and away from light. Do not use if the solution is cloudy. Resources for Patients and Families: Endocrine Center Monday through Friday, 8 a.m.-5 p.m. 713-563-7600 Internal Medicine Center Monday through Friday, 8 a.m.-5p.m. 713-792-2340 Emergency Center Main Building, Floor 1 Monday through Friday after 5 p.m. Saturday, Sunday and Holidays 713-792-3722 After business hours and weekends, you may call the hospital page operator at 713-792-7090 and ask for the on-call endocrinology fellow. Reference National Institute of Health www.cc.nih.gov/ccc/patient_education/pepubs/mngadrins.pdf Revised 09/2015 Patient Education 2683 Page 5 of 5