Corticosteroid side effects

Corticosteroids may interact with a variety of other medicines. When this happens, the effects of one or both of the drugs may change or the risk of side effects may be greater. Anyone who takes corticosteroids should let the physician know all other medicines he or she is taking. Among the drugs that may interact with corticosteroids are:

  • Insulin and diabetes medicines
  • Heart medicine such as digitalis
  • Diuretics (water pills)
  • Medicine containing potassium or sodium
  • Immunizations (vaccinations)
  • Cyclosporine (Sandimmune)
  • Blood thinners, such as warfarin (Coumadin)
  • Estrogen drugs, such as conjugated estrogens (Premarin) or oral contraceptives
  • Antacids (if taken frequently).
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An example of an acute hepatitis-like syndrome arising after pulse methylprednisolone therapy.  These episodes arise typically 2 to 4 weeks after a third or fourth cycle of pulse therapy, and range in severity from an asymptomatic and transient rise in serum aminotransferase levels to an acute hepatitis and even fulminant hepatic failure.  In this instance, the marked and persistent rise in serum enzymes coupled with liver histology suggesting chronic hepatitis led to a diagnosis of new-onset autoimmune hepatitis, despite the absence of serum autoantibodies or hypergammaglobulinemia.  Autoimmune hepatitis may initially present in this fashion, without the typical pattern of serum autoantibodies during the early, anicteric phase.  The diagnosis was further supported by the prompt improvements in serum enzymes with prednisone therapy.  The acute hepatitis-like syndrome that can occur after pulses of methylprednisolone is best explained as a triggering of an underlying chronic autoimmune hepatitis caused by the sudden and profound immunosuppression followed by rapid withdrawal.  This syndrome can be severe, and fatal instances have been reported.  Whether reinitiation of corticosteroid therapy with gradual tapering and withdrawal is effective in ameliorating the course of illness is unclear, but anecdotal reports such as this one suggest that they are beneficial and should be initiated promptly on appearance of this syndrome.  Long term follow up of such cases is also necessary to document that the autoimmune hepatitis does not relapse once corticosteroids are withdrawn again.

Addiction to cortisone was the subject of the 1956 motion picture, Bigger Than Life , produced by and starring James Mason . Though it was a box-office flop upon its initial release, [15] many modern critics hail it as a masterpiece and brilliant indictment of contemporary attitudes towards mental illness and addiction. [16] In 1963, Jean-Luc Godard named it one of the ten best American sound films ever made. [17] John F. Kennedy needed to regularly use corticosteroids such as cortisone as a treatment for Addison's disease . [18]

How often cortisone injections are given varies based on the reason for the injection. This is determined on a case-by-case basis by the health care practitioner. If a single cortisone injection is curative, then further injections are unnecessary. Sometimes, a series of injections might be necessary; for example, cortisone injections for a trigger finger may be given every three weeks, to a maximum of three times in one affected finger. In other instances, such as knee osteoarthritis, a second cortisone injection may be given approximately three months after the first injection, but the injections are not generally continued on a regular basis.

Corticosteroid side effects

corticosteroid side effects

How often cortisone injections are given varies based on the reason for the injection. This is determined on a case-by-case basis by the health care practitioner. If a single cortisone injection is curative, then further injections are unnecessary. Sometimes, a series of injections might be necessary; for example, cortisone injections for a trigger finger may be given every three weeks, to a maximum of three times in one affected finger. In other instances, such as knee osteoarthritis, a second cortisone injection may be given approximately three months after the first injection, but the injections are not generally continued on a regular basis.

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