A Comprehensive Monograph on Hydrocortisone Succinate (DB14545): From Molecular Structure to Clinical Application

Executive Summary

Hydrocortisone succinate is a synthetic, water-soluble hemisuccinate ester of hydrocortisone, the pharmaceutical name for the endogenous glucocorticoid cortisol.[1] It is classified as a short-acting corticosteroid that possesses both potent glucocorticoid (anti-inflammatory) and significant mineralocorticoid (salt-retaining) properties.[3] The primary clinical utility of hydrocortisone succinate stems from its formulation as a sterile powder for rapid parenteral (intravenous or intramuscular) administration. This characteristic makes it a cornerstone therapy for a multitude of acute, often life-threatening, conditions that demand immediate and powerful anti-inflammatory, immunosuppressive, or physiologic hormone replacement effects.[2]

The molecule functions as a prodrug; upon administration, it is rapidly hydrolyzed in the body to release its active moiety, hydrocortisone. The active hormone then binds to intracellular glucocorticoid receptors, and the resulting complex translocates to the cell nucleus to modulate the transcription of a wide array of genes. This genomic action ultimately leads to the suppression of key inflammatory pathways, including the inhibition of phospholipase A2 and pro-inflammatory transcription factors such as NF-kappa B.[8]