1. About hydrocortisone buccal tablets
Hydrocortisone buccal tablets stick gently to the inside of your mouth and release hydrocortisone as they dissolve.
They relieve the soreness of mouth ulcers and speed up healing.
Hydrocortisone buccal tablets are available on prescription. You can also buy them from pharmacies.
Hydrocortisone is a type of medicine known as a steroid (or corticosteroid). Corticosteroids are not the same as anabolic steroids.
Other types of hydrocortisone
There are different types of hydrocortisone, including tablets you swallow, skin treatments and injections.
2. Key facts
- You put hydrocortisone buccal tablets directly on top of your mouth ulcer. It's usual to use 4 hydrocortisone buccal tablets a day for up to 5 days.
- Leave the tablet to dissolve slowly against the ulcer. If you swallow or suck buccal tablets they will not work.
- If you have more than 1 ulcer, move the tablet around your mouth so the medicine can dissolve on each ulcer. Do not use more than 1 tablet at a time and do not use more than 4 in a day.
- Do not use buccal tablets for mouth ulcers which are caused by dentures (false teeth), an injury or an infection – they could make these ulcers worse.
3. Who can and cannot take hydrocortisone
Hydrocortisone buccal tablets can be used by most adults and children aged 1 month and over.
Children under 12 years old should only use these tablets if their doctor prescribes them.
Hydrocortisone buccal tablets are not suitable for some people. Tell your doctor before starting the medicine if you:
- have ever had an allergic reaction to hydrocortisone or any other medicine
- cannot digest a sugar called lactose (lactose intolerance)
- have a mouth infection or injury
- wear dentures (false teeth)
- keep getting mouth ulcers or they get worse
- have ulcers on other parts of your body
- are pregnant or trying to get pregnant
If your dentures are making your mouth sore or you think you might have a mouth injury or infection, do not use hydrocortisone buccal tablets. They could make the problem worse. It's best to see a doctor or dentist.
4. How and when to use hydrocortisone buccal tablets
Each hydrocortisone buccal tablet contains 2.5mg of hydrocortisone.
It's usual to use 4 tablets a day for up to 5 days. Try to leave a gap of 3 to 4 hours between tablets.
If the ulcer heals in less than 5 days, you can stop using the tablets.
See your doctor if the ulcer has not healed after 5 days, or if it heals but comes back again.
How to use buccal tablets
Put the buccal tablet in your mouth against the ulcer and let it dissolve there.
Do not chew or swallow the tablet. If you do this, the tablet will not work and you may get side effects.
If you have more than 1 mouth ulcer, move the tablet around your mouth, sharing it between each ulcer. Do not use more than 1 tablet at a time and do not use more than 4 in a day.
What if I forget a dose?
If you forget a tablet use it as soon as you remember, unless it’s less than an hour until the next one is due. In this case just skip the missed dose and go back to your usual routine.
What if I use too many?
Buccal tablets contain a very low dose of hydrocortisone. Using too many is unlikely to harm you. Talk to a pharmacist if you're worried.
5. Side effects
Most people do not have any side effects when they use hydrocortisone buccal tablets for a few days.
Some people feel a sharp pain while the tablet dissolves on the ulcer. This usually only lasts for a few minutes and stops happening after you've been using the tablets for a few days.
It may help if you avoid spicy, salty foods and acidic drinks (like fruit juice) while you're using this medicine. It may also help if you drink cold drinks through a straw. Do not use a straw for hot drinks as you could burn yourself.
Serious side effects
Buccal tablets contain a very small dose of hydrocortisone so it's rare to have a serious side effect.
Side effects in your mouth
If you have a mouth infection, using hydrocortisone buccal tablets can make it worse and cause it to spread.
The tablets can also occasionally cause oral thrush. This is a fungal infection which causes soreness and white patches in the mouth. To help prevent oral thrush, rinse your mouth out with cold water or a mouthwash after the buccal tablet has fully dissolved.
Tell your doctor straight away if your mouth becomes red and sore or if you develop white furry patches on your tongue or inside your mouth. These can be signs of a mouth infection.
Side effects in the rest of your body
Occasionally, hydrocortisone from buccal tablets gets into the bloodstream and can cause side effects in other parts of your body.
Urgent advice: Contact a doctor if:
- you are being sick (vomiting), feel very tired or dizzy, pass out or have a very upset stomach, muscle weakness, mood changes, loss of appetite or weight loss – these can be signs of adrenal gland problems
- you are confused, sleepy, more hungry or thirsty than usual, peeing more than usual, breathing quickly or have breath that smells like fruit – these can be signs of diabetes or complications of diabetes
Serious allergic reaction
It's extremely rare to have an allergic reaction (anaphylaxis) to a hydrocortisone buccal tablet but if this happens to you, contact a doctor straight away.
Immediate action required: Call 999 or go to A&E now if:
- you get a skin rash that may include itchy, red, swollen, blistered or peeling skin
- you're wheezing
- you get tightness in the chest or throat
- you have trouble breathing or talking
- your mouth, face, lips, tongue or throat start swelling
You could be having a serious allergic reaction and may need immediate treatment in hospital.
These are not all the side effects of hydrocortisone buccal tablets. For a full list see the leaflet inside your medicine packet.
You can report any suspected side effect using the Yellow Card safety scheme.
6. Pregnancy and breastfeeding
Hydrocortisone buccal tablets can be used in pregnancy and breastfeeding.
Only very small amounts will get into your blood and reach your baby or breastmilk.
For safety, tell your pharmacist or doctor if you're trying to get pregnant, are already pregnant or if you're breastfeeding.
For more information about using hydrocortisone during pregnancy, read this leaflet on steroids on the Best Use of Medicines in Pregnancy (BUMPs) website.
7. Cautions with other medicines
Taking other medicines, either prescribed or ones you buy from a pharmacy or shop, will not affect the way hydrocortisone buccal tablets work.
Mixing hydrocortisone buccal tablets with herbal remedies and supplements
There's very little information about taking herbal remedies and supplements with hydrocortisone buccal tablets. They are not tested in the same way as other medicines.
Important: Medicine safety
Tell your doctor or pharmacist if you're taking any other medicines, including herbal medicines, vitamins or supplements.
8. Common questions about hydrocortisone
How do hydrocortisone buccal tablets work?
Hydrocortisone buccal tablets contain the active ingredient hydrocortisone. This is a steroid (or corticosteroid).
Like other steroids, they work by calming down your immune system. If you have mouth ulcers this reduces pain and swelling and helps the ulcers heal.
How long will they take to work?
Usually, mouth ulcers will feel less sore within a few days of starting treatment.
Mouth ulcers should heal within 5 days of using hydrocortisone buccal tablets. If they are not better within 5 days, talk to your doctor.
Can I still have vaccinations?
Yes. Using hydrocortisone buccal tablets does not stop you having vaccinations.
Can I drink alcohol with it?
Yes, you can drink alcohol while using buccal tablets. However, drinking spirits may make your ulcer heal more slowly.
Is there any food or drink I need to avoid?
You can eat and drink normally while using hydrocortisone buccal tablets.
However, eating spicy or salty foods and having acidic drinks like fruit juice can irritate mouth ulcers and make the pain worse.
Drinking strong alcohol (spirits) may also make your ulcer heal more slowly.
Will it affect my fertility?
There’s no clear evidence to suggest that taking hydrocortisone will reduce fertility in either men or women.
Will it affect my contraception?
But if you’re sick (vomit), your contraceptive pills may not protect you from pregnancy. Look on the pill packet to find out what to do.