Withdrawal of corticosteroids can result in increased plasma concentrations of salicylate and possible toxicity. Because of its potent anti-inflammatory and immune-suppressing effects, it is used to treat conditions such as asthma, allergies, and croup, juvenile rheumatoid arthritis (JRA) , acute demyelinating encephalomyelitis (ADEM) , and others. Endocrine Disorders Primary or secondary adrenocortical insufficiency (hydrocortisone or cortisone is the first choice; synthetic analogs may be used in conjunction with mineralocorticoids where applicable; in infancy mineralocorticoid supplementation is of particular importance) Congenital adrenal hyperplasia Hypercalcemia . Systemic and inhaled corticosteroids are known to increase blood glucose and worsen glycemic control in patients taking antidiabetic agents. Concurrent use may increase the risk of acute myopathy. Corticosteroids, such as beclomethasone and prednisolone, whose concentrations are less affected by strong CYP3A4 inhibitors, should be considered, especially for long-term use. Tolazamide: (Moderate) Monitor patients receiving antidiabetic agents closely for worsening glycemic control when corticosteroids are instituted and for signs of hypoglycemia when corticosteroids are discontinued. Prednisolone is formed through the 11b-hydroxydehydrogenase enzyme, which is not part of the CYP system, but then prednisolone is metabolized by the CYP3A4-mediated 6b-hydroxylase enzyme to inactive compounds. Mannitol: (Moderate) Corticosteroids may accentuate the electrolyte loss associated with diuretic therapy resulting in hypokalemia. Keep taking this medicine (prednisone tablets) as you have been told by your doctor or other health care provider, even if you feel well. Rocuronium: (Moderate) Caution and close monitoring are advised if corticosteroids and neuromuscular blockers are used together, particularly for long periods, due to enhanced neuromuscular blocking effects. Simeprevir: (Minor) Simeprevir, a P-glycoprotein (P-gp) inhibitor and a mild intestinal CYP3A4 inhibitor, may increase the side effects of prednisone, which is a P-gp and CYP3A4 substrate. Dosage not established. Prednisone is a CYP3A4 substrate; darunavir is a strong inhibitor of CYP3A4. After the disease is controlled, reduce the dose by 10% every 5 to 7 days; a more rapid reduction may result in relapse. Carmustine, BCNU: (Minor) Because systemically administered corticosteroids exhibit immunosuppressive effects when given in high doses and/or for extended periods, additive effects may be seen with other immunosuppressives or antineoplastic agents. Assess sodium chloride intake from all sources, including intake from sodium-containing intravenous fluids and antibiotic admixtures. Titrate to response. For other situations where corticosteroids are used for treating non-life threatening conditions, mifepristone may lead to reduced corticosteroid efficacy and exacerbation or deterioration of such conditions. (Moderate) Salicylates or NSAIDs should be used cautiously in patients receiving corticosteroids. Clinical improvement or recovery after stopping corticosteroids may require weeks to years. Psychiatric derangements may appear when corticosteroids are used, ranging from euphoria, insomnia, mood swings, personality changes, and severe depression, to frank psychosis. Isotretinoin: (Minor) Both isotretinoin and corticosteroids can cause osteoporosis during chronic use. You may have more of a chance of getting an infection. Tell your PDR.net is to be used only as a reference aid. Decreased insulin production may occur in the pancreas due to a direct effect on pancreatic beta cells. Warfarin: (Moderate) The effect of corticosteroids on oral anticoagulants (e.g., warfarin) is variable. Because serum cortisol levels remain elevated and may even increase during treatment with mifepristone, serum cortisol levels do not provide an accurate assessment of hypoadrenalism. Bisoprolol; Hydrochlorothiazide, HCTZ: (Moderate) Additive hypokalemia may occur when non-potassium sparing diuretics, including thiazide diuretics, are coadministered with other drugs with a significant risk of hypokalemia, such as corticosteroids. Prednisone tablets are indicated in the following conditions: Endocrine disorders: primary or secondary adrenocortical insufficiency (hydrocortisone or cortisone is the first choice; synthetic analogs may be used in conjunction with mineralocorticoids where applicable; in infancy mineralocorticoid supplementation is of particular importance); congenital adrenal . Prednisone binds extensively to the plasma proteins albumin and transcortin, with only the unbound portion of a dose active. Titrate to response. Isoniazid, INH; Pyrazinamide, PZA; Rifampin: (Moderate) A dose adjustment of prednisone may be necessary when administered concurrently with rifamycins, due to the potential for decreased exposure of prednisone. The rate of absorption was similar for both formulations. In such patients, a peripheral nerve stimulator may be of value in monitoring the response. In such patients, a peripheral nerve stimulator may be of value in monitoring the response. Short-Term Prednisone Use. Systemic and inhaled corticosteroids are known to increase blood glucose and worsen glycemic control in patients taking antidiabetic agents. Tell all of your health care providers that you take this medicine (prednisone tablets). Sodium Phosphate Monobasic Monohydrate; Sodium Phosphate Dibasic Anhydrous: (Moderate) Use sodium phosphate cautiously with corticosteroids, especially mineralocorticoids or corticotropin, ACTH, as concurrent use can cause hypernatremia. Vemurafenib: (Minor) Concomitant use of vemurafenib and prednisone may result in altered concentrations of prednisone or its active metabolite, prednisolone. After a 3-day oral aprepitant regimen, the AUC of midazolam (given on days 1, 4, 8, and 15) increased by 25% on day 4, and then decreased by 19% and 4% on days 8 and 15, respectively. Ertugliflozin; Sitagliptin: (Moderate) Monitor patients receiving antidiabetic agents closely for worsening glycemic control when corticosteroids are instituted and for signs of hypoglycemia when corticosteroids are discontinued. Rifapentine: (Moderate) A dose adjustment of prednisone may be necessary when administered concurrently with rifamycins, due to the potential for decreased exposure of prednisone. Is sunburn a side effect of prednisone? Vinblastine is metabolized by CYP3A4 and dexamethasone may decrease vinblastine plasma concentrations. Tuberculin Purified Protein Derivative, PPD: (Moderate) Immunosuppressives may decrease the immunological response to tuberculin purified protein derivative, PPD. Acute intravascular hemolysis and hemoglobinuria was seen in a healthy volunteer during infusion of micafungin (200 mg) and oral prednisolone (20 mg). Amphotericin B lipid complex (ABLC): (Moderate) The potassium-wasting effects of corticosteroid therapy can be exacerbated by concomitant administration of other potassium-depleting drugs including amphotericin B. Serum potassium levels should be monitored in patients receiving these drugs concomitantly. Found inside – Page 185Patients with hepatic dysfunction should be treated with prednisolone rather than prednisone. Dosage and Indications The antitumor dosage of prednisone is 2 ... Growth and development of pediatric patients on prolonged corticosteroid therapy should be carefully observed. 40 mg PO once daily for 5 days is the most commonly recommended regimen. Prednisone is used to treat conditions such as arthritis, blood disorders, breathing problems, severe allergies, skin diseases, cancer, eye problems, and immune system disorders.Prednisone belongs . This effect may be more pronounced in infants and young children. Close monitoring of electrolytes should occur in patients receiving these drugs concomitantly. After symptoms controlled, decrease dose slowly every 5 to 7 days. In another study, patients aged 75 years and older received melphalan (0.2 mg/kg PO daily) for 4 days and prednisone 2 mg/kg PO once daily for 4 days and repeated every 6 weeks for 12 cycles plus thalidomide 100 mg/day PO at bedtime. Indications and Recommendations on Prednisone Use Anti-inflammatory properties of Prednisone work well for the therapy of thyroid gland inflammation, COPD, arthritis, hives, and laryngitis. Liraglutide: (Moderate) Monitor patients receiving antidiabetic agents closely for worsening glycemic control when corticosteroids are instituted and for signs of hypoglycemia when corticosteroids are discontinued. Clinical improvement or recovery after stopping corticosteroids may require weeks to years. Caution and close monitoring for adverse effects, such as corticosteroid-related side effects, are advised if these drugs are used together. This acute myopathy is generalized, may involve ocular and respiratory muscles, and may result in quadriparesis. Amifampridine: (Moderate) Carefully consider the need for concomitant treatment with systemic corticosteroids and amifampridine, as coadministration may increase the risk of seizures. Atazanavir; Cobicistat: (Moderate) Coadministration of prednisone with atazanavir may cause elevated prednisone serum concentrations, potentially resulting in Cushing's syndrome and adrenal suppression. Withdrawal of corticosteroids can result in increased plasma concentrations of salicylate and possible toxicity. Systemic and inhaled corticosteroids are known to increase blood glucose and worsen glycemic control in patients taking antidiabetic agents. Ondansetron: (Moderate) Concomitant use of systemic sodium chloride, especially at high doses, and corticosteroids may result in sodium and fluid retention. Salicylates: (Moderate) Salicylates or NSAIDs should be used cautiously in patients receiving corticosteroids. The main risk factors for impaired glucose tolerance due to corticosteroids are the dose of steroid and duration of treatment. Some Systemic and inhaled corticosteroids are known to increase blood glucose and worsen glycemic control in patients taking antidiabetic agents. Corticosteroids are not indicated as initial treatment for anaphylaxis, but can be given as adjunctive therapy after the administration of epinephrine. Decreased insulin production may occur in the pancreas due to a direct effect on pancreatic beta cells. Concomitant use of corticosteroids may increase the risk of adverse GI events due to NSAIDs. Desmopressin: (Major) Desmopressin, when used in the treatment of nocturia is contraindicated with corticosteroids because of the risk of severe hyponatremia. NOTE: Hydrocortisone and cortisone are the preferred agents; prednisone has little to no mineralocorticoid properties. Food was shown to significantly affect the absorption of delayed-release tablets during a study in 24 heathy subjects. Phenobarbital is a CYP3A4 inducer; prednisone is a CYP3A4 substrate. Digoxin: (Moderate) Hypokalemia, hypomagnesemia, or hypercalcemia increase digoxin's effect. Patients with urea cycle disorders being treated with sodium phenylbutyrate usually should not receive regular treatment with corticosteroids. Withdrawal of corticosteroids can result in increased plasma concentrations of salicylate and possible toxicity. Prednisone Intensol™ solution is a concentrated liquid. Plasma concentrations and efficacy of prednisolone may be reduced if these drugs are administered concurrently. 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