Corticosteroids are well absorbed from the gut: plasma concentrations of prednisolone or hydrocortisone are at a maximum about 2 hours after a single oral dose.1 An intramuscular dose acts no more quickly. Intravenous corticosteroid acts at once and is required for severe acute adrenal failure, for example in the crises of Addison’s disease, after adrenalectomy, after sudden cessation of corticosteroid therapy and sometimes in severe hypopituitarism. A sudden increase in the requirement of patients who are taking or have taken corticosteroids may also demand intravenous therapy.
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