Plasma cortisol concentrations after oral substitution of cortisone in the fasting and non-fasting state

Nine corticosteroid-substituted patients received oral cortisone acetate in the fasting state and together with a breakfast meal. Plasma cortisol concentrations were determined before, after 30 min, and at 1-hour intervals until 6 hours after drug ingestion. There were great interindividual variations in the time to peak values (tmax), the peak concentrations (Cmax), and the areas under the time-concentration curves (AUC0--6h). The AUC and Cmax values were significantly increased when cortisone tablets were ingested with food compared to the values obtained in the fasting state (p less than 0.01 and p less than 0.05 respectively), whereas tmax values were not significantly different. The differences were minor and probably without clinical implications.