title: Contraindications - Neonatal Intensive Care Drug Manual
text: Use of hydrocortisone in preterm infants in the first week is associated with intestinal perforation, particularly when treating concurrently with indomethacin.
  Untreated systemic bacterial infections.
  Use with caution in patients with renal impairment, hypothyroidism or cardiac disease.
  Prolonged use of corticosteroids (> 14 days) may cause prolonged adrenal suppression requiring a tapering dose of hydrocortisone.[4-6]
  Caution should be used when using hydrocortisone for treatment of hyperinsulinaemic hypoglycaemia given the lack of evidence, potential for adrenal suppression and side effects.
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