A1,
A2,
B,
C1,
C2,
D,
E,
F,
G-H,
I-K,
L,
M,
N,
O,
P1,
P2,
Q-R,
S,
T,
U-V,
W-Z
Prednisone Side Effects, and Drug Interactions - Prednisone
Prednisone Side Effects, and Drug Interactions - Prednisone
SIDE EFFECTS
Fluid and Electrolyte Disturbances: Sodium retention,
fluid retention, congestive heart
failure in susceptible
patients, potassium loss, hypokalemic alkalosis, and hypertension.
Musculoskeletal: Muscle weakness, steriod myopathy,
loss of muscle mass,
osteoporosis, tendon
rupture, particularly of the Achilles tendon, vertebral
compression fractures,
aseptic necrosis of
femoral and humeral
heads, and pathologic
fracture of long bones.
Gastrointestinal: Peptic ulcer
with possible perforation and hemorrhage; pancreatitis; abdominal
distention; ulcerative
esophagitis; Increases in alanine
transaminase (ALT,
SGPT), aspartate transaminase
(AST, SGOT) and alkaline
phosphatase have
been observed following corticosteroid treatment. These changes
are usually small, not associated with any clinical syndrome and
are reversible upon
discontinuation.
Dermatologic: Impaired wound
healing, thin fragile skin, petechiae and ecchymoses, facial
erythema, increased sweating, and may suppress reactions to skin
tests.
Metabolic: Negative nitrogen
balance due to protein
catabolism.
Neurological: Increased intracranial
pressure with papilledema
(pseudo-tumor cerebri) usually after treatment, convulsions, vertigo,
and headache.
Endocrine: Menstrual irregularities; development
of Cushingoid state; secondary adrenocortical
and pituitary unresponsiveness, particularly in times of stress,
as in trauma, surgery or illness; suppression
of growth of children; decreased carbohydrate
tolerance; manifestations of latent diabetes mellitus; increased
requirements for insulin
or oral hypoglycemic agents
in diabetics.
Ophthalmic: Posterior subcapsular
cataracts, increased intraocular pressure, glaucoma, and exophthalmos.
Additional Reactions: Urticaria and other allergic,
anaphylactic or hypersensitivity reactions.
DRUG INTERACTIONS
The pharmacokinetic interactions listed below are potentially clinically
important. Drugs that induce hepatic
enzymes such as phenobarbital, phenytoin and rifampin
may increase the clearance
of corticosteroids and may require increases in corticosteroid
dose to achieve the desired
response. Drugs such as troleandomycin
and ketoconazole may inhibit the metabolism
of corticosteroids and thus decrease their clearance. Therefore,
the dose of corticosteroid
should be titrated to avoid steroid
toxicity. Corticosteroids may increase the clearance
of chronic high dose
aspirin. This could lead
to decreased salicylate serum
levels or increase the risk
of salicylate toxicity
when corticosteroid is withdrawn. Aspirin should be used cautiously
in conjunction with corticosteroids in patients suffering from hypoprothrombinemia.
The effect of corticosteroids on oral
anticoagulants is variable. There are reports of enhanced as well
as diminished effects of anticoagulants when given concurrently
with corticosteroids. Therefore, coagulation indices should be monitored
to maintain the desired anticoagulant
effect.
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