Deflazacort interactions
Full monograph for DeflazacortCheck it against another medicine
Medicines
329 documented
| Medicine | Severity | Mechanism | Effect | Sources |
|---|---|---|---|---|
| Adalimumab | Major | Synergy | The use of tumor necrosis factor (TNF) blockers with other immunosuppressive or myelosuppressive agents may increase the risk of infections. Serious infections… | 6 sources — open the full entry |
| Apalutamide | Major | Metabolism | Coadministration with potent or moderate inducers of CYP450 3A4 may significantly decrease the plasma concentrations of 21-desdeflazacort, the active… | 6 sources — open the full entry |
| Aprepitant | Major | Metabolism | Coadministration with potent or moderate inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of 21-desdeflazacort, the active… | 3 sources — open the full entry |
| Baricitinib | Major | Others | Coadministration of baricitinib or tofacitinib with other immuno- or myelosuppressive agents may potentiate the risk of infections as well as lymphoma and… | 6 sources — open the full entry |
| Bempedoic acid | Major | Synergy | Concomitant administration of bempedoic acid may potentiate the risk of tendon rupture or injury associated with fluoroquinolones and corticosteroids. The… | 2 sources — open the full entry |
| Bempedoic acid + Ezetimibe | Major | Synergy | Concomitant administration of bempedoic acid may potentiate the risk of tendon rupture or injury associated with fluoroquinolones and corticosteroids. The… | 2 sources — open the full entry |
| Bosentan Monohydrate | Major | Metabolism | Coadministration with potent or moderate inducers of CYP450 3A4 may significantly decrease the plasma concentrations of 21-desdeflazacort, the active… | 6 sources — open the full entry |
| Bupropion Hydrochloride | Major | Synergy | The use of bupropion is associated with a dose-related risk of seizures. The risk may be further increased when coadministered with selective serotonin… | 19 sources — open the full entry |
| Calcium Dobesilate + Lidocaine + Dexamethasone | Major | Metabolism | Coadministration with potent or moderate inducers of CYP450 3A4 may significantly decrease the plasma concentrations of 21-desdeflazacort, the active… | 6 sources — open the full entry |
| Carbamazepine | Major | Metabolism | Coadministration with potent or moderate inducers of CYP450 3A4 may significantly decrease the plasma concentrations of 21-desdeflazacort, the active… | 6 sources — open the full entry |
| Cenobamate | Major | Metabolism | Coadministration with potent or moderate inducers of CYP450 3A4 may significantly decrease the plasma concentrations of 21-desdeflazacort, the active… | 6 sources — open the full entry |
| Ceritinib | Major | Metabolism | Coadministration with potent or moderate inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of 21-desdeflazacort, the active… | 3 sources — open the full entry |
| CiprofloxacinbaseOphthalmic | Major | Synergy | Concomitant administration of corticosteroids may potentiate the risk of tendinitis and tendon rupture associated with fluoroquinolone treatment. The mechanism… | 7 sources — open the full entry |
| Ciprofloxacin + Dexamethasone | Major | Metabolism · Synergy | Coadministration with potent or moderate inducers of CYP450 3A4 may significantly decrease the plasma concentrations of 21-desdeflazacort, the active…2 documented mechanisms | 13 sources — open the full entry |
| Ciprofloxacin + Hydrocortisone Acetate | Major | Synergy | Concomitant administration of corticosteroids may potentiate the risk of tendinitis and tendon rupture associated with fluoroquinolone treatment. The mechanism… | 7 sources — open the full entry |
| Clarithromycin | Major | Metabolism | Coadministration with potent or moderate inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of 21-desdeflazacort, the active… | 3 sources — open the full entry |
| Clobetasol Propionate + Ofloxacin + Ornidazole + Terbinafine | Major | Synergy | Concomitant administration of corticosteroids may potentiate the risk of tendinitis and tendon rupture associated with fluoroquinolone treatment. The mechanism… | 7 sources — open the full entry |
| Crizotinib | Major | Metabolism | Coadministration with potent or moderate inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of 21-desdeflazacort, the active… | 3 sources — open the full entry |
| Deferasirox | Major | Synergy | Coadministration with drugs that have known ulcerogenic or hemorrhagic potential may increase the risk of gastrointestinal bleeding associated with the use of… | 3 sources — open the full entry |
| Delafloxacin | Major | Synergy | Concomitant administration of corticosteroids may potentiate the risk of tendinitis and tendon rupture associated with fluoroquinolone treatment. The mechanism… | 7 sources — open the full entry |
| Desmopressin Acetate | Major | Synergy | Coadministration of desmopressin with loop diuretics or systemic or inhaled corticosteroids may increase the risk of severe hyponatremia. Loop diuretics and… | 9 sources — open the full entry |
| Dexamethasone | Major | Metabolism | Coadministration with potent or moderate inducers of CYP450 3A4 may significantly decrease the plasma concentrations of 21-desdeflazacort, the active… | 6 sources — open the full entry |
| Dexamethasone + Chloramphenicol | Major | Metabolism | Coadministration with potent or moderate inducers of CYP450 3A4 may significantly decrease the plasma concentrations of 21-desdeflazacort, the active… | 6 sources — open the full entry |
| Dexamethasone + Levofloxacin | Major | Metabolism · Synergy | Coadministration with potent or moderate inducers of CYP450 3A4 may significantly decrease the plasma concentrations of 21-desdeflazacort, the active…2 documented mechanisms | 13 sources — open the full entry |
| Dexamethasone + Neomycin + Glacial Acetic Acid | Major | Metabolism | Coadministration with potent or moderate inducers of CYP450 3A4 may significantly decrease the plasma concentrations of 21-desdeflazacort, the active… | 6 sources — open the full entry |
| Dexamethasone + Neomycin Sulphate + Polymyxin B Sulphate | Major | Metabolism | Coadministration with potent or moderate inducers of CYP450 3A4 may significantly decrease the plasma concentrations of 21-desdeflazacort, the active… | 6 sources — open the full entry |
| Dexamethasone + Tobramycin | Major | Metabolism | Coadministration with potent or moderate inducers of CYP450 3A4 may significantly decrease the plasma concentrations of 21-desdeflazacort, the active… | 6 sources — open the full entry |
| Dextromethorphan + Bupropion | Major | Synergy | The use of bupropion is associated with a dose-related risk of seizures. The risk may be further increased when coadministered with selective serotonin… | 19 sources — open the full entry |
| Diltiazem Hydrochloride | Major | Metabolism | Coadministration with potent or moderate inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of 21-desdeflazacort, the active… | 3 sources — open the full entry |
| Efavirenz | Major | Metabolism | Coadministration with potent or moderate inducers of CYP450 3A4 may significantly decrease the plasma concentrations of 21-desdeflazacort, the active… | 6 sources — open the full entry |
| Enzalutamide | Major | Metabolism | Coadministration with potent or moderate inducers of CYP450 3A4 may significantly decrease the plasma concentrations of 21-desdeflazacort, the active… | 6 sources — open the full entry |
| ErythromycinLotionOral | Major | Metabolism | Coadministration with potent or moderate inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of 21-desdeflazacort, the active… | 3 sources — open the full entry |
| Esomeprazole + Amoxicillin + Clarithromycin | Major | Metabolism | Coadministration with potent or moderate inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of 21-desdeflazacort, the active… | 3 sources — open the full entry |
| Etanercept | Major | Synergy | The use of tumor necrosis factor (TNF) blockers with other immunosuppressive or myelosuppressive agents may increase the risk of infections. Serious infections… | 6 sources — open the full entry |
| FluconazolebaseOphthalmic | Major | Metabolism | Coadministration with potent or moderate inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of 21-desdeflazacort, the active… | 3 sources — open the full entry |
| Fosphenytoin Sodium | Major | Metabolism | Coadministration with potent or moderate inducers of CYP450 3A4 may significantly decrease the plasma concentrations of 21-desdeflazacort, the active… | 6 sources — open the full entry |
| Gatifloxacin | Major | Synergy | Concomitant administration of corticosteroids may potentiate the risk of tendinitis and tendon rupture associated with fluoroquinolone treatment. The mechanism… | 7 sources — open the full entry |
| Gatifloxacin + Dexamethasone | Major | Metabolism · Synergy | Coadministration with potent or moderate inducers of CYP450 3A4 may significantly decrease the plasma concentrations of 21-desdeflazacort, the active…2 documented mechanisms | 13 sources — open the full entry |
| Gemifloxacin | Major | Synergy | Concomitant administration of corticosteroids may potentiate the risk of tendinitis and tendon rupture associated with fluoroquinolone treatment. The mechanism… | 7 sources — open the full entry |
| Golimumab | Major | Synergy | The use of tumor necrosis factor (TNF) blockers with other immunosuppressive or myelosuppressive agents may increase the risk of infections. Serious infections… | 6 sources — open the full entry |
| Imatinib Mesylate | Major | Metabolism | Coadministration with potent or moderate inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of 21-desdeflazacort, the active… | 3 sources — open the full entry |
| Infliximab | Major | Synergy | The use of tumor necrosis factor (TNF) blockers with other immunosuppressive or myelosuppressive agents may increase the risk of infections. Serious infections… | 6 sources — open the full entry |
| Itraconazole | Major | Metabolism | Coadministration with potent or moderate inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of 21-desdeflazacort, the active… | 3 sources — open the full entry |
| Ketoconazole | Major | Metabolism | Coadministration with potent or moderate inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of 21-desdeflazacort, the active… | 3 sources — open the full entry |
| Ketoconazole + Zinc Pyrithione + Aleovera | Major | Metabolism | Coadministration with potent or moderate inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of 21-desdeflazacort, the active… | 3 sources — open the full entry |
| Lamivudine + Zidovudine + Nevirapine | Major | Metabolism | Coadministration with potent or moderate inducers of CYP450 3A4 may significantly decrease the plasma concentrations of 21-desdeflazacort, the active… | 6 sources — open the full entry |
| Lansoprazole + Amoxicillin + Clarithromycin | Major | Metabolism | Coadministration with potent or moderate inhibitors of CYP450 3A4 may significantly increase the plasma concentrations of 21-desdeflazacort, the active… | 3 sources — open the full entry |
| Leflunomide | Major | Synergy | The use of leflunomide with other immunosuppressive or myelosuppressive agents may increase the risk of infections. The risk is thought to extend to… | 2 sources — open the full entry |
| Levofloxacin (Eye/Ear) | Major | Synergy | Concomitant administration of corticosteroids may potentiate the risk of tendinitis and tendon rupture associated with fluoroquinolone treatment. The mechanism… | 7 sources — open the full entry |
| Levofloxacin Hemihydrate | Major | Synergy | Concomitant administration of corticosteroids may potentiate the risk of tendinitis and tendon rupture associated with fluoroquinolone treatment. The mechanism… | 7 sources — open the full entry |
Food & lifestyle
grapefruit juice
ModerateMetabolism
Grapefruit juice may increase the plasma concentrations of 21-desdeflazacort, the active metabolite of deflazacort that is formed by esterases after oral administration and further metabolized by CYP450 3A4 to several inactive metabolites. The proposed mechanism is inhibition of CYP450 3A4-mediated metabolism in the gut wall by certain compounds present in grapefruit. In general, the effect of grapefruit juice is concentration-, dose- and preparation-dependent, and can vary widely among brands.
What to do: Deflazacort should not be administered with grapefruit juice.
1 source
- Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
Conditions
Conditions in which Deflazacort needs care, as documented in this source.
Cushing Syndrome
ModerateCorticosteroids mimic the effects of endogenous cortisol and aldosterone. Use of these agents may aggravate conditions of hyperadrenocorticalism in a dose-dependent manner.
10 sources
- "Product Information. Hydeltrasol (prednisolone)." Merck & Co., Inc (2001):
- "Product Information. Deltasone (prednisone)." Pharmacia and Upjohn (2001):
- "Product Information. Decadron (dexamethasone)." Merck & Co., Inc (2001):
- "Product Information. Hydrocortone (hydrocortisone)." Merck & Co., Inc (2001):
- "Product Information. Medrol (methylprednisolone)." Pharmacia and Upjohn (2001):
- "Product Information. Florinef Acetate (fludrocortisone)." Bristol-Myers Squibb (2001):
- "Product Information. Cortone Acetate (cortisone)." Merck & Co., Inc (2001):
- "Product Information. Kenalog (triamcinolone)." Bristol-Myers Squibb (2001):
Show all 10 sourcesShow fewer sources
- "Product Information. Celestone (betamethasone)." Schering Corporation (2001):
- "Product Information. Emflaza (deflazacort)." PTC Therapeutics, Inc. (2021):
Diabetes Mellitus
ModerateCorticosteroids can raise blood glucose level by antagonizing the action and suppressing the secretion of insulin, which results in inhibition of peripheral glucose uptake and increased gluconeogenesis. Therapy with corticosteroids should be administered cautiously in patients with diabetes mellitus, glucose intolerance, or a predisposition to hyperglycemia. Patients with diabetes mellitus should be monitored more closely during corticosteroid therapy, and their antidiabetic regimen adjusted accordingly.
10 sources
- "Product Information. Hydeltrasol (prednisolone)." Merck & Co., Inc (2001):
- "Product Information. Deltasone (prednisone)." Pharmacia and Upjohn (2001):
- "Product Information. Decadron (dexamethasone)." Merck & Co., Inc (2001):
- "Product Information. Hydrocortone (hydrocortisone)." Merck & Co., Inc (2001):
- "Product Information. Medrol (methylprednisolone)." Pharmacia and Upjohn (2001):
- "Product Information. Florinef Acetate (fludrocortisone)." Bristol-Myers Squibb (2001):
- "Product Information. Cortone Acetate (cortisone)." Merck & Co., Inc (2001):
- "Product Information. Kenalog (triamcinolone)." Bristol-Myers Squibb (2001):
Show all 10 sourcesShow fewer sources
- "Product Information. Celestone (betamethasone)." Schering Corporation (2001):
- "Product Information. Emflaza (deflazacort)." PTC Therapeutics, Inc. (2021):
Hepatic Insufficiency
ModerateNo dose adjustment of deflazacort is required for patients with mild or moderate liver dysfunction. Care is recommended when using deflazacort in patients with severe liver dysfunction; a dosing recommendation cannot be provided as there is no clinical experience in these patients.
1 source
- "Product Information. Emflaza (deflazacort)." PTC Therapeutics, Inc. (2021):
Hypothyroidism
ModerateCorticosteroids may have enhanced effects in hypothyroidism due to decreased metabolism of these agents. Patients with hypothyroidism should be monitored more closely for excessive cortisol effects. Dosage adjustments may be required secondary to changes in their thyroid condition.
10 sources
- "Product Information. Hydeltrasol (prednisolone)." Merck & Co., Inc (2001):
- "Product Information. Deltasone (prednisone)." Pharmacia and Upjohn (2001):
- "Product Information. Decadron (dexamethasone)." Merck & Co., Inc (2001):
- "Product Information. Hydrocortone (hydrocortisone)." Merck & Co., Inc (2001):
- "Product Information. Medrol (methylprednisolone)." Pharmacia and Upjohn (2001):
- "Product Information. Florinef Acetate (fludrocortisone)." Bristol-Myers Squibb (2001):
- "Product Information. Cortone Acetate (cortisone)." Merck & Co., Inc (2001):
- "Product Information. Kenalog (triamcinolone)." Bristol-Myers Squibb (2001):
Show all 10 sourcesShow fewer sources
- "Product Information. Celestone (betamethasone)." Schering Corporation (2001):
- "Product Information. Emflaza (deflazacort)." PTC Therapeutics, Inc. (2021):
Infections
ModerateCorticosteroids (including deflazacort) suppress the immune system and increase the risk of infection with any pathogen (including viral, bacterial, fungal, protozoan, or helminthic). Corticosteroids mask some signs of infection, decrease resistance to new infections, exacerbate existing infections, and increase the risk of disseminated infections; these infections can be severe and sometimes fatal. The degree to which the dose, route, and duration of corticosteroid therapy correlates with the specific risks of infection is not well described; however, the rate of occurrence of infectious complications increases with increasing corticosteroid doses. Patients should be monitored for infection and dose reduction or discontinuation of corticosteroids should be considered as needed.
1 source
- "Product Information. Emflaza (deflazacort)." PTC Therapeutics, Inc. (2021):
Keratitis, Herpetic
ModeratePharmacologic dosages of corticosteroids should be used cautiously in patients with ocular herpes simplex because of the risk of corneal perforation. Corticosteroids are not recommended for patients with active ocular herpes simplex.
10 sources
- "Product Information. Hydeltrasol (prednisolone)." Merck & Co., Inc (2001):
- "Product Information. Deltasone (prednisone)." Pharmacia and Upjohn (2001):
- "Product Information. Decadron (dexamethasone)." Merck & Co., Inc (2001):
- "Product Information. Hydrocortone (hydrocortisone)." Merck & Co., Inc (2001):
- "Product Information. Medrol (methylprednisolone)." Pharmacia and Upjohn (2001):
- "Product Information. Florinef Acetate (fludrocortisone)." Bristol-Myers Squibb (2001):
- "Product Information. Cortone Acetate (cortisone)." Merck & Co., Inc (2001):
- "Product Information. Kenalog (triamcinolone)." Bristol-Myers Squibb (2001):
Show all 10 sourcesShow fewer sources
- "Product Information. Celestone (betamethasone)." Schering Corporation (2001):
- "Product Information. Emflaza (deflazacort)." PTC Therapeutics, Inc. (2021):
Latent Tuberculosis
ModerateIn patients with latent tuberculosis or tuberculin reactivity, the use of pharmacologic dosages of corticosteroids may cause a reactivation of the disease. Close monitoring for signs and symptoms of tuberculosis is recommended if corticosteroid therapy is administered to patients with a history of tuberculosis or tuberculin reactivity. During prolonged corticosteroid therapy, tuberculosis chemoprophylaxis may be considered.
9 sources
- "Product Information. Hydeltrasol (prednisolone)." Merck & Co., Inc (2001):
- "Product Information. Deltasone (prednisone)." Pharmacia and Upjohn (2001):
- "Product Information. Decadron (dexamethasone)." Merck & Co., Inc (2001):
- "Product Information. Hydrocortone (hydrocortisone)." Merck & Co., Inc (2001):
- "Product Information. Medrol (methylprednisolone)." Pharmacia and Upjohn (2001):
- "Product Information. Florinef Acetate (fludrocortisone)." Bristol-Myers Squibb (2001):
- "Product Information. Cortone Acetate (cortisone)." Merck & Co., Inc (2001):
- "Product Information. Kenalog (triamcinolone)." Bristol-Myers Squibb (2001):
Show all 9 sourcesShow fewer sources
- "Product Information. Celestone (betamethasone)." Schering Corporation (2001):
Muscular Diseases
ModerateToxic myopathy has been observed with the chronic use or the administration of large doses of corticosteroids, often in patients with disorders of neuromuscular transmission such as myasthenia gravis or in patients receiving neuromuscular blocking agents. Fluorinated corticosteroids such as betamethasone, dexamethasone, and triamcinolone appear to cause more severe muscle atrophy and weakness than the nonfluorinated agents. Moreover, multiple-daily doses are more toxic than once-daily or, preferably, alternate-day morning doses. Steroid myopathy is generalized and sometimes accompanied by respiratory weakness and dyspnea. In some cases, it has resulted in quadriparesis. Elevations of creatine kinase (CK) may also occur, albeit infrequently. After withdrawal of corticosteroid therapy, recovery may be slow and incomplete. Therapy with corticosteroids should be administered cautiously in patients with preexisting myopathy or myoneural disorders since these conditions may confound the diagnosis of steroid-induced myopathy. The presence of a normal serum CK level, minimal/no changes of myopathy on electromyography, and type 2 muscle fiber atrophy on biopsy are helpful in suggesting steroid-induced weakness. If steroid myopathy is suspected, a dosage reduction or discontinuation of the steroid should be considered.
10 sources
- "Product Information. Hydeltrasol (prednisolone)." Merck & Co., Inc (2001):
- "Product Information. Deltasone (prednisone)." Pharmacia and Upjohn (2001):
- "Product Information. Decadron (dexamethasone)." Merck & Co., Inc (2001):
- "Product Information. Hydrocortone (hydrocortisone)." Merck & Co., Inc (2001):
- "Product Information. Medrol (methylprednisolone)." Pharmacia and Upjohn (2001):
- "Product Information. Florinef Acetate (fludrocortisone)." Bristol-Myers Squibb (2001):
- "Product Information. Cortone Acetate (cortisone)." Merck & Co., Inc (2001):
- "Product Information. Kenalog (triamcinolone)." Bristol-Myers Squibb (2001):
Show all 10 sourcesShow fewer sources
- "Product Information. Celestone (betamethasone)." Schering Corporation (2001):
- "Product Information. Emflaza (deflazacort)." PTC Therapeutics, Inc. (2021):
Myocardial Infarction
ModerateThe use of corticosteroids may be associated with left ventricular free-wall rupture in patients who have had a recent myocardial infarction. Pharmacologic dosages of corticosteroids should be administered with great caution in such patients.
10 sources
- "Product Information. Hydeltrasol (prednisolone)." Merck & Co., Inc (2001):
- "Product Information. Deltasone (prednisone)." Pharmacia and Upjohn (2001):
- "Product Information. Decadron (dexamethasone)." Merck & Co., Inc (2001):
- "Product Information. Hydrocortone (hydrocortisone)." Merck & Co., Inc (2001):
- "Product Information. Medrol (methylprednisolone)." Pharmacia and Upjohn (2001):
- "Product Information. Florinef Acetate (fludrocortisone)." Bristol-Myers Squibb (2001):
- "Product Information. Cortone Acetate (cortisone)." Merck & Co., Inc (2001):
- "Product Information. Kenalog (triamcinolone)." Bristol-Myers Squibb (2001):
Show all 10 sourcesShow fewer sources
- "Product Information. Celestone (betamethasone)." Schering Corporation (2001):
- "Product Information. Emflaza (deflazacort)." PTC Therapeutics, Inc. (2021):
Osteoporosis
ModerateCorticosteroids reduce osteoblastic function and inhibit the absorption of intestinal calcium, which can result in bone resorption and bone loss during prolonged therapy. In addition, bone matrix may be affected by the protein-catabolic effects of corticosteroids, especially when given in high dosages or for prolonged periods, leading to aseptic necrosis and fractures. Long-term or high-dose corticosteroid therapy should be administered cautiously and only if necessary in patients with or at risk for osteoporosis. Adverse skeletal effects may be minimized by alternate-day or intermittent administration. Any patient receiving prolonged therapy with the equivalent of 7.5 mg prednisone/day or more are at risk for glucocorticoid-induced osteoporosis and should be managed according to The American College of Rheumatology (ACR) guidelines.
10 sources
- "Product Information. Hydeltrasol (prednisolone)." Merck & Co., Inc (2001):
- "Product Information. Deltasone (prednisone)." Pharmacia and Upjohn (2001):
- "Product Information. Decadron (dexamethasone)." Merck & Co., Inc (2001):
- "Product Information. Hydrocortone (hydrocortisone)." Merck & Co., Inc (2001):
- "Product Information. Medrol (methylprednisolone)." Pharmacia and Upjohn (2001):
- "Product Information. Florinef Acetate (fludrocortisone)." Bristol-Myers Squibb (2001):
- "Product Information. Cortone Acetate (cortisone)." Merck & Co., Inc (2001):
- "Product Information. Kenalog (triamcinolone)." Bristol-Myers Squibb (2001):
Show all 10 sourcesShow fewer sources
- "Product Information. Celestone (betamethasone)." Schering Corporation (2001):
- "Product Information. Emflaza (deflazacort)." PTC Therapeutics, Inc. (2021):
Peptic Ulcer
ModerateCorticosteroids may cause peptic ulcer disease and gastrointestinal (GI) hemorrhage, usually when given in high dosages or for prolonged periods. However, even conventional dosages may aggravate symptoms in patients with a history of peptic ulcers. Delayed healing of ulcers has also been reported. Therapy with corticosteroids should be avoided or administered cautiously in patients with active or latent peptic ulcers or other risk factors for GI bleeding. Some clinicians recommend the use of prophylactic antacids or H2-antagonists between meals when large doses of corticosteroids are necessary.
10 sources
- "Product Information. Hydeltrasol (prednisolone)." Merck & Co., Inc (2001):
- "Product Information. Deltasone (prednisone)." Pharmacia and Upjohn (2001):
- "Product Information. Decadron (dexamethasone)." Merck & Co., Inc (2001):
- "Product Information. Hydrocortone (hydrocortisone)." Merck & Co., Inc (2001):
- "Product Information. Medrol (methylprednisolone)." Pharmacia and Upjohn (2001):
- "Product Information. Florinef Acetate (fludrocortisone)." Bristol-Myers Squibb (2001):
- "Product Information. Cortone Acetate (cortisone)." Merck & Co., Inc (2001):
- "Product Information. Kenalog (triamcinolone)." Bristol-Myers Squibb (2001):
Show all 10 sourcesShow fewer sources
- "Product Information. Celestone (betamethasone)." Schering Corporation (2001):
- "Product Information. Emflaza (deflazacort)." PTC Therapeutics, Inc. (2021):
Peptic Ulcer Perforation
ModerateCorticosteroids may cause gastrointestinal perforation and hemorrhage, usually when given in high dosages or for prolonged periods. They may also mask symptoms of complications such as peritonitis or intraabdominal sepsis. Therapy with corticosteroids should be avoided or administered cautiously in patients with diverticulitis, nonspecific ulcerative colitis (if there is a probability of impending perforation, abscess, or other pyogenic infection), or recent intestinal anastomoses.
10 sources
- "Product Information. Hydeltrasol (prednisolone)." Merck & Co., Inc (2001):
- "Product Information. Deltasone (prednisone)." Pharmacia and Upjohn (2001):
- "Product Information. Decadron (dexamethasone)." Merck & Co., Inc (2001):
- "Product Information. Hydrocortone (hydrocortisone)." Merck & Co., Inc (2001):
- "Product Information. Medrol (methylprednisolone)." Pharmacia and Upjohn (2001):
- "Product Information. Florinef Acetate (fludrocortisone)." Bristol-Myers Squibb (2001):
- "Product Information. Cortone Acetate (cortisone)." Merck & Co., Inc (2001):
- "Product Information. Kenalog (triamcinolone)." Bristol-Myers Squibb (2001):
Show all 10 sourcesShow fewer sources
- "Product Information. Celestone (betamethasone)." Schering Corporation (2001):
- "Product Information. Emflaza (deflazacort)." PTC Therapeutics, Inc. (2021):
Psychotic Disorders
ModerateCorticosteroids may aggravate the symptoms of psychosis and emotional instability. Patients with these conditions should be monitored for increased or worsened symptoms during corticosteroid therapy.
10 sources
- "Product Information. Hydeltrasol (prednisolone)." Merck & Co., Inc (2001):
- "Product Information. Deltasone (prednisone)." Pharmacia and Upjohn (2001):
- "Product Information. Decadron (dexamethasone)." Merck & Co., Inc (2001):
- "Product Information. Hydrocortone (hydrocortisone)." Merck & Co., Inc (2001):
- "Product Information. Medrol (methylprednisolone)." Pharmacia and Upjohn (2001):
- "Product Information. Florinef Acetate (fludrocortisone)." Bristol-Myers Squibb (2001):
- "Product Information. Cortone Acetate (cortisone)." Merck & Co., Inc (2001):
- "Product Information. Kenalog (triamcinolone)." Bristol-Myers Squibb (2001):
Show all 10 sourcesShow fewer sources
- "Product Information. Celestone (betamethasone)." Schering Corporation (2001):
- "Product Information. Emflaza (deflazacort)." PTC Therapeutics, Inc. (2021):
Strongyloidiasis
ModerateUnlike most helminths, Strongyloides stercoralis has the ability to replicate in the human host. In patients with strongyloidiasis, the use of pharmacologic or immunosuppressive dosages of corticosteroids may result in Strongyloides hyperinfection and dissemination with widespread larval migration, often accompanied by severe enterocolitis and potentially fatal gram-negative septicemia. Therapy with corticosteroids should be administered with extreme caution, if at all, in these patients. For patients on corticosteroids who develop known or suspected Strongyloides infestation, withdrawal of corticosteroids or reduction of the dose of corticosteroids is recommended.
10 sources
- "Product Information. Hydeltrasol (prednisolone)." Merck & Co., Inc (2001):
- "Product Information. Deltasone (prednisone)." Pharmacia and Upjohn (2001):
- "Product Information. Decadron (dexamethasone)." Merck & Co., Inc (2001):
- "Product Information. Hydrocortone (hydrocortisone)." Merck & Co., Inc (2001):
- "Product Information. Medrol (methylprednisolone)." Pharmacia and Upjohn (2001):
- "Product Information. Florinef Acetate (fludrocortisone)." Bristol-Myers Squibb (2001):
- "Product Information. Cortone Acetate (cortisone)." Merck & Co., Inc (2001):
- "Product Information. Kenalog (triamcinolone)." Bristol-Myers Squibb (2001):
Show all 10 sourcesShow fewer sources
- "Product Information. Celestone (betamethasone)." Schering Corporation (2001):
- "Product Information. Emflaza (deflazacort)." PTC Therapeutics, Inc. (2021):
Thromboembolism
ModerateCorticosteroids may increase blood coagulability and have rarely been associated with the development of intravascular thrombosis, thromboembolism, and thrombophlebitis. Therapy with corticosteroids should be administered cautiously in patients who have or may be predisposed to thrombotic or thromboembolic disorders.
10 sources
- "Product Information. Hydeltrasol (prednisolone)." Merck & Co., Inc (2001):
- "Product Information. Deltasone (prednisone)." Pharmacia and Upjohn (2001):
- "Product Information. Decadron (dexamethasone)." Merck & Co., Inc (2001):
- "Product Information. Hydrocortone (hydrocortisone)." Merck & Co., Inc (2001):
- "Product Information. Medrol (methylprednisolone)." Pharmacia and Upjohn (2001):
- "Product Information. Florinef Acetate (fludrocortisone)." Bristol-Myers Squibb (2001):
- "Product Information. Cortone Acetate (cortisone)." Merck & Co., Inc (2001):
- "Product Information. Kenalog (triamcinolone)." Bristol-Myers Squibb (2001):
Show all 10 sourcesShow fewer sources
- "Product Information. Celestone (betamethasone)." Schering Corporation (2001):
- "Product Information. Emflaza (deflazacort)." PTC Therapeutics, Inc. (2021):
Toxic Optic Neuropathy
ModerateProlonged use of corticosteroids may cause posterior subcapsular cataracts and elevated intraocular pressure, the latter of which may lead to glaucoma and/or damage to the optic nerves. Long-term therapy with corticosteroids should be administered cautiously in patients with a history of cataracts, glaucoma, or increased intraocular pressure.
10 sources
- "Product Information. Hydeltrasol (prednisolone)." Merck & Co., Inc (2001):
- "Product Information. Deltasone (prednisone)." Pharmacia and Upjohn (2001):
- "Product Information. Decadron (dexamethasone)." Merck & Co., Inc (2001):
- "Product Information. Hydrocortone (hydrocortisone)." Merck & Co., Inc (2001):
- "Product Information. Medrol (methylprednisolone)." Pharmacia and Upjohn (2001):
- "Product Information. Florinef Acetate (fludrocortisone)." Bristol-Myers Squibb (2001):
- "Product Information. Cortone Acetate (cortisone)." Merck & Co., Inc (2001):
- "Product Information. Kenalog (triamcinolone)." Bristol-Myers Squibb (2001):
Show all 10 sourcesShow fewer sources
- "Product Information. Celestone (betamethasone)." Schering Corporation (2001):
- "Product Information. Emflaza (deflazacort)." PTC Therapeutics, Inc. (2021):
Water-Electrolyte Imbalance
ModerateCorticosteroids can cause hypernatremia, hypokalemia, and fluid retention. These mineralocorticoid effects are most significant with fludrocortisone, followed by hydrocortisone and cortisone, then by prednisone and prednisolone. The remaining corticosteroids, betamethasone, dexamethasone, methylprednisolone, and triamcinolone, have little mineralocorticoid activities. However, large doses of any corticosteroid can demonstrate these effects, particularly if given for longer than brief periods. All corticosteroids also increase excretion of calcium and can cause hypocalcemia. Therapy with corticosteroids should be administered cautiously in patients with preexisting electrolyte disturbances. Caution is also advised when treating patients with seizure disorders, since electrolyte disturbances may trigger seizure activity.
10 sources
- "Product Information. Hydeltrasol (prednisolone)." Merck & Co., Inc (2001):
- "Product Information. Deltasone (prednisone)." Pharmacia and Upjohn (2001):
- "Product Information. Decadron (dexamethasone)." Merck & Co., Inc (2001):
- "Product Information. Hydrocortone (hydrocortisone)." Merck & Co., Inc (2001):
- "Product Information. Medrol (methylprednisolone)." Pharmacia and Upjohn (2001):
- "Product Information. Florinef Acetate (fludrocortisone)." Bristol-Myers Squibb (2001):
- "Product Information. Cortone Acetate (cortisone)." Merck & Co., Inc (2001):
- "Product Information. Kenalog (triamcinolone)." Bristol-Myers Squibb (2001):
Show all 10 sourcesShow fewer sources
- "Product Information. Celestone (betamethasone)." Schering Corporation (2001):
- "Product Information. Emflaza (deflazacort)." PTC Therapeutics, Inc. (2021):
Water-Electrolyte Imbalance
ModerateCorticosteroids may cause hypernatremia, hypokalemia, fluid retention, and elevation in blood pressure. These mineralocorticoid effects are most significant with fludrocortisone, followed by hydrocortisone and cortisone, then by prednisone and prednisolone. The remaining corticosteroids, betamethasone, dexamethasone, methylprednisolone, and triamcinolone, have little mineralocorticoid activities. However, large doses of any corticosteroid can demonstrate these effects, particularly if given for longer than brief periods. Therapy with corticosteroids should be administered cautiously in patients with preexisting fluid retention, hypertension, congestive heart failure, and/or renal dysfunction. Dietary sodium restriction and potassium supplementation may be advisable.
10 sources
- "Product Information. Hydeltrasol (prednisolone)." Merck & Co., Inc (2001):
- "Product Information. Deltasone (prednisone)." Pharmacia and Upjohn (2001):
- "Product Information. Decadron (dexamethasone)." Merck & Co., Inc (2001):
- "Product Information. Hydrocortone (hydrocortisone)." Merck & Co., Inc (2001):
- "Product Information. Medrol (methylprednisolone)." Pharmacia and Upjohn (2001):
- "Product Information. Florinef Acetate (fludrocortisone)." Bristol-Myers Squibb (2001):
- "Product Information. Cortone Acetate (cortisone)." Merck & Co., Inc (2001):
- "Product Information. Kenalog (triamcinolone)." Bristol-Myers Squibb (2001):
Show all 10 sourcesShow fewer sources
- "Product Information. Celestone (betamethasone)." Schering Corporation (2001):
- "Product Information. Emflaza (deflazacort)." PTC Therapeutics, Inc. (2021):