How to make an Adrenal Crisis Care kit

In the event of an adrenal crisis, a cortisol replacement injection must be administered. Do not ever hesitate to inject an adrenal insufficient patient with cortisol replacement medication if they are experiencing an adrenal crisis.

Items needed in an Adrenal Crisis Care Kit:

  • • Cortisol Replacement Medication Vial
  • • Alcohol Prep Wipes
  • • Intramuscular Syringes (It is recommended to have at least 2 just in case)
  • Instructions on how to administer cortisol replacement via injection. AAF’s QR code can be scanned to immediately access dosing instructions. (You can download this QR code at the link

How to Administer Solu-Cortef Acto-Vial Emergency Cortisol Injection

  1. Remove the two-chamber vial containing Solu-Cortef Act-O-Vial from the packaging.
    a. Press the colored cap down to mix solvent with the powder solution of hydrocortisone.
    b. Mix the contents until the powder is dissolved. The powder solution of hydrocortisone is completely dissolved once the solution is clear
  2. Remove the protective disc from the center of the plastic cap of the vial.
  3. Wipe top of vial with alcohol swab to sterilize it before inserting syringe into bottle.
  4. Insert the syringe into the vial. Turn the vial upside down and draw the solution into the syringe.
  5. Hold the syringe like a dart and push the needle for 2/3 of its length into the chosen injection site at a right angle to the skin.
  6. Give the injection into intramuscular tissue such as the buttock or in the upper thigh muscle.

What if my doctor refuses to prescribe an emergency cortisol injection?

Prescribing a cortisol replacement emergency injection is a documented, standard treatment protocol for patients with any form of cortisol deficiency. If your doctor refuses to prescribe an emergency injection, you can provide your physician with the informational links posted below regarding the importance of providing an emergency cortisol replacement injection to treat an acute adrenal crisis.

If they continue to refuse to provide you with this life saving prescription, they can be reported to the medical board. Ignorance on care protocols for rare disease treatments is common, which is why doctors must be willing to educate themselves with documented research. However, negligence and refusal to provide standard care is unacceptable and should be reported to the medical board in order to prevent harm from occurring.

Having an emergency adrenal crisis care kit is vital to the management of adrenal insufficiency. Please do not continue receiving care under a physician who is unwilling to properly manage cortisol deficiency.

Supporting links:,soon%20upon%20arrival%20in%20hospital

More information on managing adrenal disease can be found in our book, Adrenal Insufficiency 101: A Patient’s Guide to Managing Adrenal Insufficiency
Available at the link:

This information has been brought to you by the Adrenal Alternatives Foundation and is not to be used to provide medical care. Adrenal Alternatives is a nonprofit, patient advocacy organization dedicated to advocacy & access for all cortisol care.

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