Here are some common questions about KHINDIVI
Still have questions? Call the Anovo® Specialty Pharmacy hotline at
1-833-343-2500,
Monday through Friday, 8 AM-5 PM CT.
How does this liquid hydrocortisone solution help simplify dosing?
KHINDIVI eliminates the need for compounding medicine (ingredients that are combined or mixed within a liquid by a pharmacy) and splitting or crushing tablets, offering a ready-to-use liquid to help accurately measure the prescribed dose every time.1
Can KHINDIVI help reduce the risks of inaccurate dosing?
When used as directed, the liquid solution eliminates some complexities of ensuring a precise dose when crushing or splitting a tablet in half or a quarter. With the syringe provided by Anovo® Specialty Pharmacy, doses of KHI️NDI️VI️ can be adjusted by as little as 0.5 mL to meet your child’s specific needs. Please see the Dosage and Administration section of the full Prescribing Information for dosing instructions for KHINDIVI.1
How is KHINDIVI different from the liquid hydrocortisone I get from my pharmacy?
If you currenty receive a liquid hydrocortisone from your pharmacy, most likely it is a compounded liquid suspension formulated by the pharmacy. Compounded medicines are made in smaller batches, so each batch might be a little different. These types of prescribed compounded medicines are not FDA-approved.2
As the only FDA-approved oral liquid hydrocortisone solution for children aged 5 years and older with adrenal insufficiency, KHINDIVI is designed to avoid the issue of potential inconsistencies of compounded medicines. KHINDIVI does not require refrigeration and can be stored for up to 120 days of receipt.1
What are the possible side effects of KHINDIVI?
The most common side effects of KHINDIVI include retaining fluids, changes in glucose tolerance, high blood pressure, behavioral and mood changes, increased appetite, and weight gain. There is also increased risk of gastrointestinal side effects in patients with certain gastrointestinal disorders. Please see additional Important Safety Information below for KHINDIVI.1
Why does FDA approval matter?
As the only FDA-approved oral liquid hydrocortisone solution for pediatric adrenal insufficiency, KHINDIVI has undergone testing and review by the FDA (the government agency responsible for medicines in the protection of public health) to ensure it is safe and effective for use under the conditions as prescribed and in accordance with the approved product labeling.1
Is KHINDIVI approved for use with a gastric tube (g-tube)?
Yes. To ensure proper delivery, KHINDIVI should be administered through the g-tube, followed by flushing with an adequate amount of water to ensure the entire dose reaches the stomach.1
What are the ingredients in KHINDIVI?
KHINDIVI is an oral liquid hydrocortisone solution. The inactive ingredients are berry flavor, butylated hydroxyanisole, ethyl maltol, glycerin, methylparaben, propylparaben, polyethylene glycol, propylene glycol, and sucralose.1
Does KHINDIVI contain any added sugars?
KHINDIVI contains sucralose (an artificial sweetener commonly known as Splenda®) and glycerin (a sugar alcohol commonly used in pharmaceuticals to help improve the smoothness and taste of medicines, such as cough syrup).1,3,4
Does a liquid hydrocortisone help with administration to younger children or those with swallowing difficulties?
The liquid solution is easy to swallow, making it a good choice for children who struggle with swallowing or with swallowing tablets.5
What does KHINDIVI taste like?
KHINDIVI has a berry-flavored taste designed to help patients take their medication as directed.1
Can I mix KHINDIVI with food or drinks?
KHINDIVI can be taken with or without food followed by water to ensure all of the medicine has been swallowed. Talk to your doctor before mixing with anything to ensure proper absorption.1
Can KHINDIVI be refrigerated?
Yes. KHINDIVI can be stored at room temperature (68°F to 77°F) or refrigerated (36°F to 46°F), if preferred. It is not necessary to refrigerate KHINDIVI. Each bottle of KHINDIVI should be used within 120 days of receipt. Throw away any KHINDIVI that has not been used within this time frame.1
Can my child be vaccinated while treated with KHINDIVI?
Administration of live vaccines may be acceptable in KHINDIVI-treated children with adrenal insufficiency who receive replacement corticosteroids. Always check with your doctor before having your child vaccinated.1
Is KHINDIVI safe to use during periods of stress or acute events?
KHINDIVI is not approved for increased dosing during periods of stress or acute events. Ask your doctor about using a different hydrocortisone-containing drug product for stress dosing.1
Tips for starting KHINDIVI
Set a routine
Keep your existing medication schedule and give KHINDIVI at the same time every day
Involve your child
Older children may appreciate understanding their new medication. Show them the liquid and explain how it works
Treat with confidence
The precise dosing of KHINDIVI eliminates pill manipulation and dosage uncertainty so you can focus on your child instead of medication accuracy
USE AND IMPORTANT SAFETY INFORMATION
USE
KHINDIVI is a prescription medicine used in children 5 years of age and older as replacement therapy when the adrenal gland is not making enough cortisol.
Limitation of Use: KHINDIVI is not approved for increased dosing during periods of stress or acute events. Use a different hydrocortisone-containing drug product for stress dosing.
IMPORTANT SAFETY INFORMATION
Always give KHINDIVI exactly as your doctor has directed.
Do not take KHINDIVI if you are allergic to hydrocortisone or any of its other ingredients.
Adrenal Crisis: Giving too low a dose or stopping medication can cause low levels of cortisol, which can result in serious illness or death. Treatment with intravenous hydrocortisone should be started immediately. When switching from another type of hydrocortisone to KHINDIVI, watch your child closely for any changes. During periods of stress such as infections or after surgery, your doctor should switch to another oral hydrocortisone product and increase the dose.
Systemic Adverse Reactions Due to Inactive Ingredients
Hyperosmolarity: KHINDIVI is not approved in children less than 5 years of age. The inactive ingredients in KHINDIVI can cause dangerous fluid imbalances.
Metabolic Acidosis and Other Adverse Reactions: Some ingredients in KHINDIVI may cause a build-up of acid in the body, low blood sugar, or injuries to the liver, kidneys, or brain, that may increase the risk of adrenal crisis.
Laxative Effects Due to Inactive Ingredients: Some ingredients in KHINDIVI may cause stomach upset resulting in vomiting and/or diarrhea and could increase the risk of adrenal crises in patients.
Immunosuppression and Increased Risk of Infection With Use of a Dosage Greater Than Replacement: Use of a greater than replacement dosage can suppress the immune system and increase the risks of new infections. Contact your health care provider if any infections develop.
Growth Retardation: The long-term use of corticosteroids in high doses may cause growth retardation in children.
Decrease in Bone Density: Corticosteroids can affect your child’s bone growth and strength.
Cushing’s Syndrome Due to High Doses of Corticosteroids: Treatment with high doses of corticosteroids can cause Cushing’s Syndrome. Treatment should be limited to the smallest dose required, and your child’s growth and development monitored appropriately.
Psychiatric Changes: Corticosteroids can change your child’s behavior or mood. Tell your doctor if your child has periods of extreme happiness, extreme sadness, hallucinations, or depression.
Changes in Vision: Tell your doctor if your child has blurred vision or other vision problems during treatment with KHINDIVI.
Gastrointestinal Adverse Reactions: Tell the doctor if your child has stomach pain, upset stomach, black, tarry stools, or vomiting of blood. These could be signs of ulcers or tears in the stomach or intestines. Taking anti-inflammatory nonsteroidal drugs, like ibuprofen, naproxen, or aspirin, can increase the risk of ulcers or tears.
The most common side effects of KHINDIVI include retaining fluids, changes in glucose tolerance, high blood pressure, behavioral and mood changes, greater appetite, and weight gain.
Vaccination: Administration of live vaccines may be acceptable in KHINDIVI-treated pediatric patients with adrenocortical insufficiency who receive replacement corticosteroids.
Please visit KHINDIVI.com/patient for more information.
You are encouraged to report negative side effects of prescription drugs by contacting Eton Pharmaceuticals, Inc. at 1-855-224-0233 or the U.S. Food and Drug Administration (FDA) at www.fda.gov/safety/medwatch or call 1-800-FDA-1088.
Please see full Prescribing Information for more information.
USE AND IMPORTANT SAFETY INFORMATION
USE
KHINDIVI is a prescription medicine used in children 5 years of age and older as replacement therapy when the adrenal gland is not making enough cortisol.
Limitation of Use: KHINDIVI is not approved for increased dosing during periods of stress or acute events. Use a different hydrocortisone-containing drug product for stress dosing.
IMPORTANT SAFETY INFORMATION
Always give KHINDIVI exactly as your doctor has directed.
Do not take KHINDIVI if you are allergic to hydrocortisone or any of its other ingredients.
Adrenal Crisis: Giving too low a dose or stopping medication can cause low levels of cortisol, which can result in serious illness or death. Treatment with intravenous hydrocortisone should be started immediately. When switching from another type of hydrocortisone to KHINDIVI, watch your child closely for any changes. During periods of stress such as infections or after surgery, your doctor should switch to another oral hydrocortisone product and increase the dose.
Systemic Adverse Reactions Due to Inactive Ingredients
Hyperosmolarity: KHINDIVI is not approved in children less than 5 years of age. The inactive ingredients in KHINDIVI can cause dangerous fluid imbalances.
Metabolic Acidosis and Other Adverse Reactions: Some ingredients in KHINDIVI may cause a build-up of acid in the body, low blood sugar, or injuries to the liver, kidneys, or brain, that may increase the risk of adrenal crisis.
Laxative Effects Due to Inactive Ingredients: Some ingredients in KHINDIVI may cause stomach upset resulting in vomiting and/or diarrhea and could increase the risk of adrenal crises in patients.
Immunosuppression and Increased Risk of Infection With Use of a Dosage Greater Than Replacement: Use of a greater than replacement dosage can suppress the immune system and increase the risks of new infections. Contact your health care provider if any infections develop.
Growth Retardation: The long-term use of corticosteroids in high doses may cause growth retardation in children.
Decrease in Bone Density: Corticosteroids can affect your child’s bone growth and strength.
Cushing’s Syndrome Due to High Doses of Corticosteroids: Treatment with high doses of corticosteroids can cause Cushing’s Syndrome. Treatment should be limited to the smallest dose required, and your child’s growth and development monitored appropriately.
Psychiatric Changes: Corticosteroids can change your child’s behavior or mood. Tell your doctor if your child has periods of extreme happiness, extreme sadness, hallucinations, or depression.
Changes in Vision: Tell your doctor if your child has blurred vision or other vision problems during treatment with KHINDIVI.
Gastrointestinal Adverse Reactions: Tell the doctor if your child has stomach pain, upset stomach, black, tarry stools, or vomiting of blood. These could be signs of ulcers or tears in the stomach or intestines. Taking anti-inflammatory nonsteroidal drugs, like ibuprofen, naproxen, or aspirin, can increase the risk of ulcers or tears.
The most common side effects of KHINDIVI include retaining fluids, changes in glucose tolerance, high blood pressure, behavioral and mood changes, greater appetite, and weight gain.
Vaccination: Administration of live vaccines may be acceptable in KHINDIVI-treated pediatric patients with adrenocortical insufficiency who receive replacement corticosteroids.
Please visit KHINDIVI.com/patient for more information.
You are encouraged to report negative side effects of prescription drugs by contacting Eton Pharmaceuticals, Inc. at 1-855-224-0233 or the U.S. Food and Drug Administration (FDA) at www.fda.gov/safety/medwatch or call 1-800-FDA-1088.
Please see full Prescribing Information for more information.
References: 1. KHINDIVI Package Insert. Eton Pharmaceuticals, Inc; 2025. 2. FDA’s Human Drug Compounding Progress Report: Three Years After Enactment of the Drug Quality and Security Act. Published January 2017. Accessed September 8, 2025. https://www.fda.gov/drugs/human-drug-compounding/fdas-human-drug-compounding-progress-report-three-years-after-enactment-drug-quality-and-security 3. US Food and Drug Administration. Aspartame and Other Sweeteners in Food. Accessed September 8, 2025. https://www.fda.gov/food/food-additives-petitions/aspartame-and-other-sweeteners-food 4. Eccles R, Mallefet P. Soothing properties of glycerol in cough syrups for acute cough due to common cold. Pharmacy (Basel). 2017;5(1):4. doi:10.3390/pharmacy5010004 5. Liu F, Ranmal S, Batchelor HK, et al. Patient-centred pharmaceutical design to improve acceptability of medicines: similarities and differences in paediatric and geriatric populations. Drugs. 2014;74(16):1871-1889. doi:10.1007/s40265-014-0297-2