What Is the Treatment of Central Adrenal Insufficiency?
Central adrenal insufficiency requires structured glucocorticoid replacement therapy. Treatment is guided by evidence-based recommendations and is individualised according to each patient's circumstances and tolerability.
Treatment Approach
The cornerstone of management is oral glucocorticoid replacement. Hydrocortisone is the principal agent; its administration involves specific considerations around daily dosing structure and the timing of doses throughout the day. In selected patients, alternative longer-acting glucocorticoids may be appropriate.
The complete regimen — including dosing schedule, dose-distribution strategy, and guidance on when to consider alternatives — is available in the full protocol.
References
DOI: 10.1210/jc.2016-2118
- We recommend using HC, usually 15–20 mg total daily dose in single or divided doses. Patients using divided doses should take the highest dose in the morning at awakening and the second in the afternoon (two-dose regime) or the second and third at lunch and late afternoon, respectively (three-dose regime).
- We suggest using longer-acting GCs in selected cases (eg, nonavailability, poor compliance, convenience).
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