hydrocortisone + trilostane

Hydrocortisone + trilostane is a combination of two pharmaceutical agents used primarily in veterinary medicine and, less commonly, in human medicine. Hydrocortisone is a synthetic glucocorticoid that acts as an anti-inflammatory and immunosuppressive agent by binding to the glucocorticoid receptor, leading to inhibition of phospholipase A2, NF-kappa B, other inflammatory transcription factors, and promotion of anti-inflammatory genes[2]. Trilostane is a steroidogenesis inhibitor that blocks the enzyme 3β-hydroxysteroid dehydrogenase (3β-HSD), thereby inhibiting the synthesis of adrenal steroids including cortisol and aldosterone[1][5][7]. The combination may be used when trilostane’s suppression of endogenous corticosteroid production risks causing glucocorticoid deficiency; hydrocortisone supplementation can prevent or treat this deficiency[5]. This approach has been described particularly in the context of treating Cushing’s syndrome or postmenopausal breast cancer where trilostane suppresses steroidogenesis but exogenous corticosteroids are needed to maintain physiological function[5].