A patient who has been taking 25 mg of hydrocortisone each morning for several months reports feeling fatigued late in the day each day. What will the nurse tell the patient to discuss with the provider?

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Patients generally take hydrocortisone once daily in the morning to mimic the body's natural cortisol release cycle. However, some patients develop fatigue late in the day. These patients may split the daily dose, taking two-thirds in the morning and one-third in the afternoon or early evening. Mineralocorticoids are given to maintain intravascular volume and regulate sodium, potassium, and hydrogen, so adding this drug would not help with fatigue. Fatigue is not a sign of steroid toxicity. Increasing the dose is not indicated.

A Patient Who Has Been Taking 25 Mg of Hydrocortisone