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# IV Hydrocortisone for Acute Asthma ## Overview Intravenous (IV) hydrocortisone is a systemic corticosteroid used as adjunctive therapy in moderate to severe acute asthma exacerbations that do not respond adequately to initial bronchodilator therapy. It works by reducing airway inflammation. ## Primary Indications Adjunctive treatment for moderate to severe acute asthma exacerbations in patients requiring hospitalization or intensive care. ## Adult Dosing * **Loading Dose:** 100 mg IV every 6 to 8 hours. * **Maintenance Dose:** Continued at 100 mg IV every 6 to 8 hours until the patient can tolerate oral intake, at which point therapy should be transitioned to an equivalent oral corticosteroid dose. * **Alternatively:** Some protocols may use higher doses, e.g., 200 mg IV once followed by 100 mg IV every 4-6 hours, or continuous infusion at 2 mg/kg/hr. **Consult local protocol.** ## Pediatric Dosing * **Children > 12 years:** 100 mg IV every 6 to 8 hours.