Hydrocortisone interactions

Full monograph for Hydrocortisone Check it against another medicine

Medicines

682 documented

Severity

Mechanism

Medicines documented to interact with Hydrocortisone, worst severity first.
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
Amiodarone Hydrochloride	Major	Synergy	Amiodarone can cause dose-related prolongation of the QT interval. Theoretically, coadministration with agents that can produce hypokalemia and/or…	5 sources — open the full entry
Arsenic Trioxide	Major	Synergy	Arsenic trioxide can cause QT interval prolongation and complete atrioventricular block. Since hypokalemia and hypomagnesemia are known risk factors for…	2 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 · Unknown	Concomitant administration of bempedoic acid may potentiate the risk of tendon rupture or injury associated with fluoroquinolones and corticosteroids. The…2 documented mechanisms	2 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
Ciprofloxacinbase Ophthalmic	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	Synergy · Unknown	Concomitant administration of corticosteroids may potentiate the risk of tendinitis and tendon rupture associated with fluoroquinolone treatment. The mechanism…2 documented mechanisms	7 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
Clobetasol Propionate + Ofloxacin + Ornidazole + Terbinafine	Major	Synergy · Unknown	Concomitant administration of corticosteroids may potentiate the risk of tendinitis and tendon rupture associated with fluoroquinolone treatment. The mechanism…3 documented mechanisms	7 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 + Levofloxacin	Major	Synergy · Unknown	Concomitant administration of corticosteroids may potentiate the risk of tendinitis and tendon rupture associated with fluoroquinolone treatment. The mechanism…2 documented mechanisms	7 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
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
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	Synergy · Unknown	Concomitant administration of corticosteroids may potentiate the risk of tendinitis and tendon rupture associated with fluoroquinolone treatment. The mechanism…2 documented mechanisms	7 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
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
Iohexol	Major	Others	Coadministration of corticosteroids with iodinated contrast media by the intrathecal route may be associated with a high incidence of radiographic…	5 sources — open the full entry
Iopamidol	Major	Others	Coadministration of corticosteroids with iodinated contrast media by the intrathecal route may be associated with a high incidence of radiographic…	5 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
Lomefloxacin	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
Loteprednol Etabonate + 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
Mifepristone	Major	Antagonism · Metabolism	Mifepristone is a potent antiglucocorticoid and may antagonize the effects of corticosteroids. Pharmacokinetically, mifepristone may increase the plasma…	4 sources — open the full entry
Mifepristone + Misoprostol	Major	Antagonism · Metabolism	Mifepristone is a potent antiglucocorticoid and may antagonize the effects of corticosteroids. Pharmacokinetically, mifepristone may increase the plasma…	4 sources — open the full entry
Moxifloxacin HydrochlorideInjection Ophthalmic Tablet	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
Moxifloxacin Hydrochloride + Dexamethasone	Major	Synergy · Unknown	Concomitant administration of corticosteroids may potentiate the risk of tendinitis and tendon rupture associated with fluoroquinolone treatment. The mechanism…2 documented mechanisms	7 sources — open the full entry
Moxifloxacin Hydrochloride + Xanthan Gum	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
Nalidixic Acid	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
Ofloxacin	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
Ofloxacin + Clotrimazole + Beclomethasone + Lidocaine	Major	Synergy · Unknown	Concomitant administration of corticosteroids may potentiate the risk of tendinitis and tendon rupture associated with fluoroquinolone treatment. The mechanism…3 documented mechanisms	7 sources — open the full entry
Rotavirus Vaccine	Major	Others	The administration of live, attenuated viral or bacterial vaccines during immunosuppressant or intense antineoplastic therapy may be associated with a risk of…	9 sources — open the full entry
Sparfloxacin	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
Thalidomide	Major	Synergy	Coadministration of thalidomide with glucocorticoids and/or antineoplastic agents in the treatment of malignancy may potentiate the risk of thromboembolism…	20 sources — open the full entry
Tofacitinib	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
Upadacitinib	Major	Others	Coadministration of upadacitinib with other immuno- or myelosuppressive agents may potentiate the risk of infections as well as lymphoma and other malignancies.	1 sources — open the full entry
Yellow Fever Vaccine	Major	Others	The administration of live, attenuated viral or bacterial vaccines during immunosuppressant or intense antineoplastic therapy may be associated with a risk of…2 documented mechanisms	19 sources — open the full entry
Ziprasidone	Major	Synergy	Ziprasidone can cause dose-related prolongation of the QT interval. While clinical data are lacking, the coadministration of ziprasidone and agents that can…	5 sources — open the full entry
Abametapir	Moderate	Metabolism	Based on in vitro inhibition data, a single topical application of abametapir lotion may increase plasma concentrations of drugs that are substrates of CYP450…	1 sources — open the full entry
Acarbose	Moderate	Antagonism	The efficacy of insulin and other antidiabetic agents may be diminished by certain drugs, including atypical antipsychotics, corticosteroids, diuretics…	95 sources — open the full entry
Acetazolamide	Moderate	Synergy	The concomitant use of corticosteroids and agents that deplete potassium (e.g., potassium-wasting diuretics, amphotericin B, cation exchange resins) may result…	8 sources — open the full entry
Alogliptin Benzoate	Moderate	Antagonism	The efficacy of insulin and other antidiabetic agents may be diminished by certain drugs, including atypical antipsychotics, corticosteroids, diuretics…	95 sources — open the full entry
Aluminium Hydroxide + Magnesium Hydroxide	Moderate	Absorption · Antagonism	The overuse or abuse of laxatives can cause significant loss of electrolytes and potentiate the risk of hypokalemia associated with corticosteroid therapy…2 documented mechanisms	10 sources — open the full entry
Aluminium Hydroxide + Magnesium Hydroxide + Simethicone	Moderate	Absorption · Antagonism	The overuse or abuse of laxatives can cause significant loss of electrolytes and potentiate the risk of hypokalemia associated with corticosteroid therapy…2 documented mechanisms	10 sources — open the full entry

Conditions

Conditions in which Hydrocortisone needs care, as documented in this source.

Infections
Major
The immunosuppressant and anti-inflammatory effects of corticosteroids, particularly in higher dosages, may decrease host resistance to infectious agents, decrease the ability to localize infections, and mask the symptoms of infection. Secondary infections may be more likely to develop. In general, corticosteroids should not be used in patients with active infections, especially systemic fungal infections, unless they are medically necessary and effective antimicrobial therapy or other appropriate treatment has been instituted. However, for corticosteroid-dependent patients who develop a severe or life-threatening infection, continuation of corticosteroid therapy with at least physiologic replacement dosages should be considered, since these patients may have secondary adrenocortical insufficiency. Removal of external steroid during periods of stress may be detrimental to these patients.
9 sources
1. "Product Information. Hydeltrasol (prednisolone)." Merck & Co., Inc (2001):
2. "Product Information. Deltasone (prednisone)." Pharmacia and Upjohn (2001):
3. "Product Information. Decadron (dexamethasone)." Merck & Co., Inc (2001):
4. "Product Information. Hydrocortone (hydrocortisone)." Merck & Co., Inc (2001):
5. "Product Information. Medrol (methylprednisolone)." Pharmacia and Upjohn (2001):
6. "Product Information. Florinef Acetate (fludrocortisone)." Bristol-Myers Squibb (2001):
7. "Product Information. Cortone Acetate (cortisone)." Merck & Co., Inc (2001):
8. "Product Information. Kenalog (triamcinolone)." Bristol-Myers Squibb (2001):
Show all 9 sourcesShow fewer sources
1. "Product Information. Celestone (betamethasone)." Schering Corporation (2001):
Premature Birth
Major
The use of certain parenteral formulations of dexamethasone, hydrocortisone, methylprednisolone, prednisolone and triamcinolone is considered by the drug manufacturers to be contraindicated in neonates, particularly premature infants and infants of low birth weight. Some formulations of these drugs contain benzyl alcohol which, when used in bacteriostatic saline intravascular flush and endotracheal tube lavage solutions, has been associated with fatalities and severe respiratory and metabolic complications in low-birth-weight premature infants. However, many experts feel that, in the absence of benzyl alcohol-free equivalents, the amount of the preservative present in these formulations should not necessarily preclude their use if they are clearly indicated. The American Academy of Pediatrics considers benzyl alcohol in low doses (such as when used as a preservative in some medications) to be safe for newborns. Continuous infusions of high dosages of medications containing benzyl alcohol may, however, cause toxicity and should be avoided if possible.
10 sources
1. "Product Information. Hydeltrasol (prednisolone)." Merck & Co., Inc (2001):
2. "Product Information. Deltasone (prednisone)." Pharmacia and Upjohn (2001):
3. "Product Information. Decadron (dexamethasone)." Merck & Co., Inc (2001):
4. "Product Information. Hydrocortone (hydrocortisone)." Merck & Co., Inc (2001):
5. "Product Information. Medrol (methylprednisolone)." Pharmacia and Upjohn (2001):
6. "Product Information. Florinef Acetate (fludrocortisone)." Bristol-Myers Squibb (2001):
7. "Product Information. Cortone Acetate (cortisone)." Merck & Co., Inc (2001):
8. "Product Information. Kenalog (triamcinolone)." Bristol-Myers Squibb (2001):
Show all 10 sourcesShow fewer sources
1. "Product Information. Celestone (betamethasone)." Schering Corporation (2001):
2. ""Inactive" ingredients in pharmaceutical products: update (subject review). American Academy of Pediatrics Committee on Drugs. Available from: URL: http://www.aap.org/policy/re9706.html." Pediatrics 99 (1997): 268-78
Cushing Syndrome
Moderate
Corticosteroids mimic the effects of endogenous cortisol and aldosterone. Use of these agents may aggravate conditions of hyperadrenocorticalism in a dose-dependent manner.
10 sources
1. "Product Information. Hydeltrasol (prednisolone)." Merck & Co., Inc (2001):
2. "Product Information. Deltasone (prednisone)." Pharmacia and Upjohn (2001):
3. "Product Information. Decadron (dexamethasone)." Merck & Co., Inc (2001):
4. "Product Information. Hydrocortone (hydrocortisone)." Merck & Co., Inc (2001):
5. "Product Information. Medrol (methylprednisolone)." Pharmacia and Upjohn (2001):
6. "Product Information. Florinef Acetate (fludrocortisone)." Bristol-Myers Squibb (2001):
7. "Product Information. Cortone Acetate (cortisone)." Merck & Co., Inc (2001):
8. "Product Information. Kenalog (triamcinolone)." Bristol-Myers Squibb (2001):
Show all 10 sourcesShow fewer sources
1. "Product Information. Celestone (betamethasone)." Schering Corporation (2001):
2. "Product Information. Emflaza (deflazacort)." PTC Therapeutics, Inc. (2021):
Diabetes Mellitus
Moderate
Corticosteroids 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
1. "Product Information. Hydeltrasol (prednisolone)." Merck & Co., Inc (2001):
2. "Product Information. Deltasone (prednisone)." Pharmacia and Upjohn (2001):
3. "Product Information. Decadron (dexamethasone)." Merck & Co., Inc (2001):
4. "Product Information. Hydrocortone (hydrocortisone)." Merck & Co., Inc (2001):
5. "Product Information. Medrol (methylprednisolone)." Pharmacia and Upjohn (2001):
6. "Product Information. Florinef Acetate (fludrocortisone)." Bristol-Myers Squibb (2001):
7. "Product Information. Cortone Acetate (cortisone)." Merck & Co., Inc (2001):
8. "Product Information. Kenalog (triamcinolone)." Bristol-Myers Squibb (2001):
Show all 10 sourcesShow fewer sources
1. "Product Information. Celestone (betamethasone)." Schering Corporation (2001):
2. "Product Information. Emflaza (deflazacort)." PTC Therapeutics, Inc. (2021):
Fibrosis
Moderate
Corticosteroids may have enhanced effects on patients with cirrhosis due to decreased metabolism of these agents. Patients with cirrhosis should be monitored more closely for excessive cortisol effects. Dosage adjustments may be required in these patients.
9 sources
1. "Product Information. Hydeltrasol (prednisolone)." Merck & Co., Inc (2001):
2. "Product Information. Deltasone (prednisone)." Pharmacia and Upjohn (2001):
3. "Product Information. Decadron (dexamethasone)." Merck & Co., Inc (2001):
4. "Product Information. Hydrocortone (hydrocortisone)." Merck & Co., Inc (2001):
5. "Product Information. Medrol (methylprednisolone)." Pharmacia and Upjohn (2001):
6. "Product Information. Florinef Acetate (fludrocortisone)." Bristol-Myers Squibb (2001):
7. "Product Information. Cortone Acetate (cortisone)." Merck & Co., Inc (2001):
8. "Product Information. Kenalog (triamcinolone)." Bristol-Myers Squibb (2001):
Show all 9 sourcesShow fewer sources
1. "Product Information. Celestone (betamethasone)." Schering Corporation (2001):
Hyperlipidemias
Moderate
Corticosteroids may elevate serum triglyceride and LDL cholesterol levels if used for longer than brief periods. Patients with preexisting hyperlipidemia may require closer monitoring during prolonged corticosteroid therapy, and adjustments made accordingly in their lipid-lowering regimen.
10 sources
1. Seale JP, Compton MR "Side-effects of corticosteroid agents." Med J Aust 144 (1986): 139-42
2. "Product Information. Hydeltrasol (prednisolone)." Merck & Co., Inc (2001):
3. "Product Information. Deltasone (prednisone)." Pharmacia and Upjohn (2001):
4. "Product Information. Decadron (dexamethasone)." Merck & Co., Inc (2001):
5. "Product Information. Hydrocortone (hydrocortisone)." Merck & Co., Inc (2001):
6. "Product Information. Medrol (methylprednisolone)." Pharmacia and Upjohn (2001):
7. "Product Information. Florinef Acetate (fludrocortisone)." Bristol-Myers Squibb (2001):
8. "Product Information. Cortone Acetate (cortisone)." Merck & Co., Inc (2001):
Show all 10 sourcesShow fewer sources
1. "Product Information. Kenalog (triamcinolone)." Bristol-Myers Squibb (2001):
2. "Product Information. Celestone (betamethasone)." Schering Corporation (2001):
Hypothyroidism
Moderate
Corticosteroids 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
1. "Product Information. Hydeltrasol (prednisolone)." Merck & Co., Inc (2001):
2. "Product Information. Deltasone (prednisone)." Pharmacia and Upjohn (2001):
3. "Product Information. Decadron (dexamethasone)." Merck & Co., Inc (2001):
4. "Product Information. Hydrocortone (hydrocortisone)." Merck & Co., Inc (2001):
5. "Product Information. Medrol (methylprednisolone)." Pharmacia and Upjohn (2001):
6. "Product Information. Florinef Acetate (fludrocortisone)." Bristol-Myers Squibb (2001):
7. "Product Information. Cortone Acetate (cortisone)." Merck & Co., Inc (2001):
8. "Product Information. Kenalog (triamcinolone)." Bristol-Myers Squibb (2001):
Show all 10 sourcesShow fewer sources
1. "Product Information. Celestone (betamethasone)." Schering Corporation (2001):
2. "Product Information. Emflaza (deflazacort)." PTC Therapeutics, Inc. (2021):
Keratitis, Herpetic
Moderate
Pharmacologic 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
1. "Product Information. Hydeltrasol (prednisolone)." Merck & Co., Inc (2001):
2. "Product Information. Deltasone (prednisone)." Pharmacia and Upjohn (2001):
3. "Product Information. Decadron (dexamethasone)." Merck & Co., Inc (2001):
4. "Product Information. Hydrocortone (hydrocortisone)." Merck & Co., Inc (2001):
5. "Product Information. Medrol (methylprednisolone)." Pharmacia and Upjohn (2001):
6. "Product Information. Florinef Acetate (fludrocortisone)." Bristol-Myers Squibb (2001):
7. "Product Information. Cortone Acetate (cortisone)." Merck & Co., Inc (2001):
8. "Product Information. Kenalog (triamcinolone)." Bristol-Myers Squibb (2001):
Show all 10 sourcesShow fewer sources
1. "Product Information. Celestone (betamethasone)." Schering Corporation (2001):
2. "Product Information. Emflaza (deflazacort)." PTC Therapeutics, Inc. (2021):
Latent Tuberculosis
Moderate
In 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
1. "Product Information. Hydeltrasol (prednisolone)." Merck & Co., Inc (2001):
2. "Product Information. Deltasone (prednisone)." Pharmacia and Upjohn (2001):
3. "Product Information. Decadron (dexamethasone)." Merck & Co., Inc (2001):
4. "Product Information. Hydrocortone (hydrocortisone)." Merck & Co., Inc (2001):
5. "Product Information. Medrol (methylprednisolone)." Pharmacia and Upjohn (2001):
6. "Product Information. Florinef Acetate (fludrocortisone)." Bristol-Myers Squibb (2001):
7. "Product Information. Cortone Acetate (cortisone)." Merck & Co., Inc (2001):
8. "Product Information. Kenalog (triamcinolone)." Bristol-Myers Squibb (2001):
Show all 9 sourcesShow fewer sources
1. "Product Information. Celestone (betamethasone)." Schering Corporation (2001):
Liver Diseases
Moderate
Corticosteroids are primarily metabolized by the liver and may have enhanced effects in patients with liver disease. Dosage adjustments may be necessary in these patients.
10 sources
1. "Product Information. Hydeltrasol (prednisolone)." Merck & Co., Inc (2001):
2. Cunliffe WJ, Burton JL, Holti G, Wright V "Hazards of steroid therapy in hepatic failure." Br J Dermatol 93 (1975): 183-5
3. "Product Information. Deltasone (prednisone)." Pharmacia and Upjohn (2001):
4. "Product Information. Decadron (dexamethasone)." Merck & Co., Inc (2001):
5. "Product Information. Hydrocortone (hydrocortisone)." Merck & Co., Inc (2001):
6. "Product Information. Medrol (methylprednisolone)." Pharmacia and Upjohn (2001):
7. "Product Information. Florinef Acetate (fludrocortisone)." Bristol-Myers Squibb (2001):
8. "Product Information. Cortone Acetate (cortisone)." Merck & Co., Inc (2001):
Show all 10 sourcesShow fewer sources
1. "Product Information. Kenalog (triamcinolone)." Bristol-Myers Squibb (2001):
2. "Product Information. Celestone (betamethasone)." Schering Corporation (2001):
Muscular Diseases
Moderate
Toxic 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
1. "Product Information. Hydeltrasol (prednisolone)." Merck & Co., Inc (2001):
2. "Product Information. Deltasone (prednisone)." Pharmacia and Upjohn (2001):
3. "Product Information. Decadron (dexamethasone)." Merck & Co., Inc (2001):
4. "Product Information. Hydrocortone (hydrocortisone)." Merck & Co., Inc (2001):
5. "Product Information. Medrol (methylprednisolone)." Pharmacia and Upjohn (2001):
6. "Product Information. Florinef Acetate (fludrocortisone)." Bristol-Myers Squibb (2001):
7. "Product Information. Cortone Acetate (cortisone)." Merck & Co., Inc (2001):
8. "Product Information. Kenalog (triamcinolone)." Bristol-Myers Squibb (2001):
Show all 10 sourcesShow fewer sources
1. "Product Information. Celestone (betamethasone)." Schering Corporation (2001):
2. "Product Information. Emflaza (deflazacort)." PTC Therapeutics, Inc. (2021):
Myasthenia Gravis
Moderate
Although corticosteroids are commonly used in the treatment of myasthenia gravis to increase muscle strength, these agents should nevertheless be administered with caution in such setting. Patients should be treated in an intensive care unit and receive respiratory support, since muscle strength may markedly decrease initially, particularly with high dosages. Preferably, therapy should begin with relatively low dosages (15 to 25 mg/day of prednisone or equivalent) and be increased stepwise as tolerated (approximately 5 mg/day of prednisone or equivalent at 2- to 3-day intervals until marked clinical improvement or a dosage of 50 mg/day is reached). Improvement may be delayed and gradual. Thus, it is important not to discontinue therapy prematurely.
1 source
1. Braunwald E, Hauser SL, Kasper DL, Fauci AS, Isselbacher KJ, Longo DL, Martin JB, eds., Wilson JD "Harrison's Principles of Internal Medicine." New York, NY: McGraw-Hill Health Professionals Division (1998):
Myocardial Infarction
Moderate
The 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
1. "Product Information. Hydeltrasol (prednisolone)." Merck & Co., Inc (2001):
2. "Product Information. Deltasone (prednisone)." Pharmacia and Upjohn (2001):
3. "Product Information. Decadron (dexamethasone)." Merck & Co., Inc (2001):
4. "Product Information. Hydrocortone (hydrocortisone)." Merck & Co., Inc (2001):
5. "Product Information. Medrol (methylprednisolone)." Pharmacia and Upjohn (2001):
6. "Product Information. Florinef Acetate (fludrocortisone)." Bristol-Myers Squibb (2001):
7. "Product Information. Cortone Acetate (cortisone)." Merck & Co., Inc (2001):
8. "Product Information. Kenalog (triamcinolone)." Bristol-Myers Squibb (2001):
Show all 10 sourcesShow fewer sources
1. "Product Information. Celestone (betamethasone)." Schering Corporation (2001):
2. "Product Information. Emflaza (deflazacort)." PTC Therapeutics, Inc. (2021):
Osteoporosis
Moderate
Corticosteroids 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
1. "Product Information. Hydeltrasol (prednisolone)." Merck & Co., Inc (2001):
2. "Product Information. Deltasone (prednisone)." Pharmacia and Upjohn (2001):
3. "Product Information. Decadron (dexamethasone)." Merck & Co., Inc (2001):
4. "Product Information. Hydrocortone (hydrocortisone)." Merck & Co., Inc (2001):
5. "Product Information. Medrol (methylprednisolone)." Pharmacia and Upjohn (2001):
6. "Product Information. Florinef Acetate (fludrocortisone)." Bristol-Myers Squibb (2001):
7. "Product Information. Cortone Acetate (cortisone)." Merck & Co., Inc (2001):
8. "Product Information. Kenalog (triamcinolone)." Bristol-Myers Squibb (2001):
Show all 10 sourcesShow fewer sources
1. "Product Information. Celestone (betamethasone)." Schering Corporation (2001):
2. "Product Information. Emflaza (deflazacort)." PTC Therapeutics, Inc. (2021):
Peptic Ulcer
Moderate
Corticosteroids 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
1. "Product Information. Hydeltrasol (prednisolone)." Merck & Co., Inc (2001):
2. "Product Information. Deltasone (prednisone)." Pharmacia and Upjohn (2001):
3. "Product Information. Decadron (dexamethasone)." Merck & Co., Inc (2001):
4. "Product Information. Hydrocortone (hydrocortisone)." Merck & Co., Inc (2001):
5. "Product Information. Medrol (methylprednisolone)." Pharmacia and Upjohn (2001):
6. "Product Information. Florinef Acetate (fludrocortisone)." Bristol-Myers Squibb (2001):
7. "Product Information. Cortone Acetate (cortisone)." Merck & Co., Inc (2001):
8. "Product Information. Kenalog (triamcinolone)." Bristol-Myers Squibb (2001):
Show all 10 sourcesShow fewer sources
1. "Product Information. Celestone (betamethasone)." Schering Corporation (2001):
2. "Product Information. Emflaza (deflazacort)." PTC Therapeutics, Inc. (2021):
Peptic Ulcer Perforation
Moderate
Corticosteroids 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
1. "Product Information. Hydeltrasol (prednisolone)." Merck & Co., Inc (2001):
2. "Product Information. Deltasone (prednisone)." Pharmacia and Upjohn (2001):
3. "Product Information. Decadron (dexamethasone)." Merck & Co., Inc (2001):
4. "Product Information. Hydrocortone (hydrocortisone)." Merck & Co., Inc (2001):
5. "Product Information. Medrol (methylprednisolone)." Pharmacia and Upjohn (2001):
6. "Product Information. Florinef Acetate (fludrocortisone)." Bristol-Myers Squibb (2001):
7. "Product Information. Cortone Acetate (cortisone)." Merck & Co., Inc (2001):
8. "Product Information. Kenalog (triamcinolone)." Bristol-Myers Squibb (2001):
Show all 10 sourcesShow fewer sources
1. "Product Information. Celestone (betamethasone)." Schering Corporation (2001):
2. "Product Information. Emflaza (deflazacort)." PTC Therapeutics, Inc. (2021):
Psychotic Disorders
Moderate
Corticosteroids 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
1. "Product Information. Hydeltrasol (prednisolone)." Merck & Co., Inc (2001):
2. "Product Information. Deltasone (prednisone)." Pharmacia and Upjohn (2001):
3. "Product Information. Decadron (dexamethasone)." Merck & Co., Inc (2001):
4. "Product Information. Hydrocortone (hydrocortisone)." Merck & Co., Inc (2001):
5. "Product Information. Medrol (methylprednisolone)." Pharmacia and Upjohn (2001):
6. "Product Information. Florinef Acetate (fludrocortisone)." Bristol-Myers Squibb (2001):
7. "Product Information. Cortone Acetate (cortisone)." Merck & Co., Inc (2001):
8. "Product Information. Kenalog (triamcinolone)." Bristol-Myers Squibb (2001):
Show all 10 sourcesShow fewer sources
1. "Product Information. Celestone (betamethasone)." Schering Corporation (2001):
2. "Product Information. Emflaza (deflazacort)." PTC Therapeutics, Inc. (2021):
Scleroderma, Localized
Moderate
In patients with scleroderma, corticosteroids may precipitate renal crisis with malignant hypertension, possibly via steroid-induced increases in renin substrate and angiotensin II levels and decreases in vasodilator prostaglandin production. Renal failure may ensue. Therapy with corticosteroids should be administered cautiously in patients with scleroderma. In addition, they should be limited to short-term use.
10 sources
1. "Product Information. Hydeltrasol (prednisolone)." Merck & Co., Inc (2001):
2. "Product Information. Deltasone (prednisone)." Pharmacia and Upjohn (2001):
3. "Product Information. Decadron (dexamethasone)." Merck & Co., Inc (2001):
4. "Product Information. Hydrocortone (hydrocortisone)." Merck & Co., Inc (2001):
5. "Product Information. Medrol (methylprednisolone)." Pharmacia and Upjohn (2001):
6. "Product Information. Florinef Acetate (fludrocortisone)." Bristol-Myers Squibb (2001):
7. "Product Information. Cortone Acetate (cortisone)." Merck & Co., Inc (2001):
8. "Product Information. Kenalog (triamcinolone)." Bristol-Myers Squibb (2001):
Show all 10 sourcesShow fewer sources
1. "Product Information. Celestone (betamethasone)." Schering Corporation (2001):
2. Braunwald E, Hauser SL, Kasper DL, Fauci AS, Isselbacher KJ, Longo DL, Martin JB, eds., Wilson JD "Harrison's Principles of Internal Medicine." New York, NY: McGraw-Hill Health Professionals Division (1998):
Strongyloidiasis
Moderate
Unlike 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
1. "Product Information. Hydeltrasol (prednisolone)." Merck & Co., Inc (2001):
2. "Product Information. Deltasone (prednisone)." Pharmacia and Upjohn (2001):
3. "Product Information. Decadron (dexamethasone)." Merck & Co., Inc (2001):
4. "Product Information. Hydrocortone (hydrocortisone)." Merck & Co., Inc (2001):
5. "Product Information. Medrol (methylprednisolone)." Pharmacia and Upjohn (2001):
6. "Product Information. Florinef Acetate (fludrocortisone)." Bristol-Myers Squibb (2001):
7. "Product Information. Cortone Acetate (cortisone)." Merck & Co., Inc (2001):
8. "Product Information. Kenalog (triamcinolone)." Bristol-Myers Squibb (2001):
Show all 10 sourcesShow fewer sources
1. "Product Information. Celestone (betamethasone)." Schering Corporation (2001):
2. "Product Information. Emflaza (deflazacort)." PTC Therapeutics, Inc. (2021):
Thromboembolism
Moderate
Corticosteroids 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
1. "Product Information. Hydeltrasol (prednisolone)." Merck & Co., Inc (2001):
2. "Product Information. Deltasone (prednisone)." Pharmacia and Upjohn (2001):
3. "Product Information. Decadron (dexamethasone)." Merck & Co., Inc (2001):
4. "Product Information. Hydrocortone (hydrocortisone)." Merck & Co., Inc (2001):
5. "Product Information. Medrol (methylprednisolone)." Pharmacia and Upjohn (2001):
6. "Product Information. Florinef Acetate (fludrocortisone)." Bristol-Myers Squibb (2001):
7. "Product Information. Cortone Acetate (cortisone)." Merck & Co., Inc (2001):
8. "Product Information. Kenalog (triamcinolone)." Bristol-Myers Squibb (2001):
Show all 10 sourcesShow fewer sources
1. "Product Information. Celestone (betamethasone)." Schering Corporation (2001):
2. "Product Information. Emflaza (deflazacort)." PTC Therapeutics, Inc. (2021):
Toxic Optic Neuropathy
Moderate
Prolonged 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
1. "Product Information. Hydeltrasol (prednisolone)." Merck & Co., Inc (2001):
2. "Product Information. Deltasone (prednisone)." Pharmacia and Upjohn (2001):
3. "Product Information. Decadron (dexamethasone)." Merck & Co., Inc (2001):
4. "Product Information. Hydrocortone (hydrocortisone)." Merck & Co., Inc (2001):
5. "Product Information. Medrol (methylprednisolone)." Pharmacia and Upjohn (2001):
6. "Product Information. Florinef Acetate (fludrocortisone)." Bristol-Myers Squibb (2001):
7. "Product Information. Cortone Acetate (cortisone)." Merck & Co., Inc (2001):
8. "Product Information. Kenalog (triamcinolone)." Bristol-Myers Squibb (2001):
Show all 10 sourcesShow fewer sources
1. "Product Information. Celestone (betamethasone)." Schering Corporation (2001):
2. "Product Information. Emflaza (deflazacort)." PTC Therapeutics, Inc. (2021):
Water-Electrolyte Imbalance
Moderate
Corticosteroids 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
1. "Product Information. Hydeltrasol (prednisolone)." Merck & Co., Inc (2001):
2. "Product Information. Deltasone (prednisone)." Pharmacia and Upjohn (2001):
3. "Product Information. Decadron (dexamethasone)." Merck & Co., Inc (2001):
4. "Product Information. Hydrocortone (hydrocortisone)." Merck & Co., Inc (2001):
5. "Product Information. Medrol (methylprednisolone)." Pharmacia and Upjohn (2001):
6. "Product Information. Florinef Acetate (fludrocortisone)." Bristol-Myers Squibb (2001):
7. "Product Information. Cortone Acetate (cortisone)." Merck & Co., Inc (2001):
8. "Product Information. Kenalog (triamcinolone)." Bristol-Myers Squibb (2001):
Show all 10 sourcesShow fewer sources
1. "Product Information. Celestone (betamethasone)." Schering Corporation (2001):
2. "Product Information. Emflaza (deflazacort)." PTC Therapeutics, Inc. (2021):
Water-Electrolyte Imbalance
Moderate
Corticosteroids 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
1. "Product Information. Hydeltrasol (prednisolone)." Merck & Co., Inc (2001):
2. "Product Information. Deltasone (prednisone)." Pharmacia and Upjohn (2001):
3. "Product Information. Decadron (dexamethasone)." Merck & Co., Inc (2001):
4. "Product Information. Hydrocortone (hydrocortisone)." Merck & Co., Inc (2001):
5. "Product Information. Medrol (methylprednisolone)." Pharmacia and Upjohn (2001):
6. "Product Information. Florinef Acetate (fludrocortisone)." Bristol-Myers Squibb (2001):
7. "Product Information. Cortone Acetate (cortisone)." Merck & Co., Inc (2001):
8. "Product Information. Kenalog (triamcinolone)." Bristol-Myers Squibb (2001):
Show all 10 sourcesShow fewer sources
1. "Product Information. Celestone (betamethasone)." Schering Corporation (2001):
2. "Product Information. Emflaza (deflazacort)." PTC Therapeutics, Inc. (2021):

Therapeutic duplication

Drug classes that overlap with Hydrocortisone, so taking both doubles up the same effect. This source publishes no per-row citations for duplication.

cortisones
The recommended maximum number of medicines in the 'cortisones' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'cortisones' category.
Example product in the source data (US market): Wixela inhub
cortisones
The recommended maximum number of medicines in the 'cortisones' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'cortisones' category.
Example product in the source data (US market): Formoterol/mometasone
cortisones
The recommended maximum number of medicines in the 'cortisones' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'cortisones' category.
Example product in the source data (US market): Trelegy ellipta
cortisones
The recommended maximum number of medicines in the 'cortisones' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'cortisones' category.
Example product in the source data (US market): Fluticasone/vilanterol
cortisones
The recommended maximum number of medicines in the 'cortisones' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'cortisones' category.
Example product in the source data (US market): Symbicort
cortisones
The recommended maximum number of medicines in the 'cortisones' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'cortisones' category.
Example product in the source data (US market): Budesonide/formoterol/glycopyrrolate
cortisones
The recommended maximum number of medicines in the 'cortisones' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'cortisones' category.
Example product in the source data (US market): Albuterol/budesonide

Medicines

Conditions

Infections

Premature Birth

Cushing Syndrome

Diabetes Mellitus

Fibrosis

Hyperlipidemias

Hypothyroidism

Keratitis, Herpetic

Latent Tuberculosis

Liver Diseases

Muscular Diseases

Myasthenia Gravis

Myocardial Infarction

Osteoporosis

Peptic Ulcer

Peptic Ulcer Perforation

Psychotic Disorders

Scleroderma, Localized

Strongyloidiasis

Thromboembolism

Toxic Optic Neuropathy

Water-Electrolyte Imbalance

Water-Electrolyte Imbalance

Therapeutic duplication

cortisones

cortisones

cortisones

cortisones

cortisones

cortisones

cortisones