Liquid Hydrocortisone Discontinued

In May 2025, we were warned by the Department of Health and Social Care (DHSC) of a shortage of liquid hydrocortisone (hydrocortisone sodium phosphate), used for the prevention and treatment of adrenal crisis, with supply expected to resume in May 2026.

We share here the news that it has now been permanently discontinued - read on for more information.

• What does this mean for people with adrenal insufficiency
• How to use Hydrocortisone Powder & Water for injections
• Why aren't there other forms of hydrocortisone available?
• The Future of Emergency Injections
• Injection Training
• Managing anxiety around adrenal crisis and emergency injections
• What can I do to help drive change?

Liquid hydrocortisone has been historically available in small 1mg glass vials and has been prescribed to patients with all types of adrenal insufficiency for use in their emergency hydrocortisone kits.  Advanz Pharma, who manufactured this liquid hydrocortisone in the UK, shared in May last year that they were moving manufacturing facilities and, as such, there would be a temporary pause in production.   

What does this mean for people with adrenal insufficiency, including Addison's disease?

The alternative injection medication, hydrocortisone sodium succinate 100mg powder for solution for injection or infusion 1x2ml - vial with diluent, continues to be available and will work in the same way in your body. 

Full details of this medication, including EAN and PIP codes can be found below.  Many of you will be familiar with it already, and most of you will currently have this on your repeat prescription since last year, when the manufacture of the liquid hydrocortisone was first stopped.   

Provision of hydrocortisone emergency injection medication is standard practice for the prevention of an acute adrenal crisis. It is the advice given in the NICE Guidance: Adrenal insufficiency: identification and management, by the ADSHG Clinical Advisory Panel, Society for Endocrinology, and on the NHS page for Addison's disease, 

Guidance for getting this medication from your GP 

Hydrocortisone sodium succinate powder is currently the only medication available in the UK for prescription for your emergency injections.  The PIP and EAN codes below will help your GP / pharmacist find the right medication for you

Full title: Hydrocortisone sodium succinate 100mg powder for solution for injection or infusion 1x2ml - vial with diluent (previously known as solu-cortef)

EAN code: 5415062387238

PIP code: 540 0718

How to use Hydrocortisone Sodium Succinate

This powder form of hydrocortisone is prescribed in two parts: one is the powder, and the other is a vial of water (diluent). These need to be mixed together by drawing up 2ml water from the vial and injecting it into the vial with the powder. They are then gently agitated to mix them together before drawing up the mixture for injection.  

For step-by-step instructions on how to administer an emergency injection, please see our instruction sheet below or our video on YouTube

Emergency Injection Video using Hydrocortisone Powder & Water

First-time users

1. Ask your GP, practice nurse or Endocrine healthcare team to show you how to use the hydrocortisone sodium succinate powder injection.
2. Bring a loved one or colleague to your training session so they can also learn. Some people need to ask for help in preparing the hydrocortisone injection syringe when they are unwell and, if needed, that person can support you in self-injecting or inject you themselves, and then ring 999.
3. If a training session cannot be provided, don't worry, this is not uncommon and is due to limited NHS resource. Whilst it is the recommendation in the NICE Guidelines, many people in our community learn through watching our online injection videos with their loved ones, following along with our 'How To' picture leaflets, and then practise on an orange at home!

Remember:

• If you think you are heading into adrenal crisis, don't delay - prepare an injection and be ready to inject. 
• If you think you may not be able to prepare the injection yourself because of how you feel, call someone to help you. 
• If you need an injection and are not able to self-administer or get someone to inject you, ring 999 and use the keyword, adrenal crisis.

Why aren't other forms of hydrocortisone available in the UK?

Following the news of the discontinuation, we initiated conversations with the Medicine Supply Team at the Department of Health and Social Care to highlight the change in the market and the resulting gap. We have asked them to investigate whether there are any other ways to bring alternative adrenal crisis treatment options such as ACT-O-VIAL® to the UK market. 

We were hoping to be able to give you updates on that now, at the same time as you learning about the discontinuation, but unfortunately none are available as yet.  However, we will keep you posted with any developments through our member emails (Join Us to become a member) and will continue to push for the improvements that we know are needed.

Whilst we are actively working towards different scenarios, you must be prepared for the eventuality of needing to use the medication and supplies that are currently available, so...

Time to get practising with powder & water!

Injection Training

Research shows that regular practice of injection training can help you feel more confident and increase the chance of you successfully self-injecting in an emergency. 

We are here to support your practice with:

• Injection Training Kits
• Promoting 2 'Practice Days' a year: 1 March and 1 September
• Running regional face-to-face training events in collaboration with a hospital near you (dependent upon input from endocrine nurses)
• Online video on injection technique
• Step-by-step injection instructions for hydrocortisone sodium succinate. 

Read more about Injection Training

Managing anxiety around adrenal crisis and emergency injections

Worrying about having low cortisol, not knowing your symptoms of adrenal crisis, or whether you'll be able to give an emergency injection if needed is completely normal. These concerns are an added stress to your everyday life and are part of your ‘invisible’ condition. But for some people, these worries become more intense, harder to control and result in anxiety. 

You don’t have to face this anxiety alone, and with the right support, it can become more manageable. Our online community platform is always there for you to speak with others who understand, ask questions, and share your lived experience. We have a forum which focuses on Medication, including supply & availability - please visit to join the conversation (member log-in required). If you aren't already a charity member, please join our community to log on to this online forum and explore this further with others. 

On our Coping with Psychological Stress webpage, we have a specific adrenal crisis anxiety section, as well as signposting you to further professional support.

What can I do to help drive change?

Directly influencing politicians and policymakers is essential for improving services. Your voice matters, and you sharing your thoughts and experiences can really help drive change.

We have put together a letter template for you to use if you want to contact your local MP to let them know how you feel about this news.

MP Letter Templates

Healthcare Professionals

The DHSC's Medicine Supply Notification is available via the Specialist Pharmacy Services Medicines Supply tool, accessible to colleagues in the NHS. Enquiries in the first instance should be directed to your Specialist Pharmacy Service Regional Pharmacy Procurement Team, who will escalate to national teams if required. 

Whether you're newly diagnosed or have lived with the condition for years - please join our community and support our cause! You'll receive the latest expert advice, guidance and ADSHG news, whilst being part of our inspiring and supportive community. 

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