Side effects of cortisone

The side effects of cortisone must be checked before use.

Allergies
One should inform the doctor if there are hypersensitivity reactions, allergies to medicines of this group or to other drugs.
You should also tell your doctor if you have other forms of allergy, such as pets, preservatives or food dyes.

For non-prescription products, you should read the package leaflet and notes on the ingredients carefully.

Children
Corticosteroids are contraindicated in infections such as chickenpox or measles and can be dangerous for children taking them. Cortisone can also slow or stop the growth of children and adolescents, especially if taken for long periods of time.
Before this medication is given to children or adolescents, it is necessary to talk to the pediatrician and follow the doctor’s instructions carefully.

Elderly
Elderly patients are more likely to develop arterial hypertension (high blood pressure) or osteoporosis (bone disease) caused by cortisone. Women are at increased risk of developing the bone disease.

Pregnancy
Studies of birth defects when women took corticosteroids during pregnancy have not been conducted in humans.
However, studies in animals have shown that Medrol can lead to birth defects.

Breastfeeding
Cortisones are excreted in breast milk and can cause growth problems or other undesirable effects in children during lactation.
Depending on the amount of medication taken daily, it may be necessary to take another medicine or stop breastfeeding during treatment.

Contents

What are side effects and undesirable properties of cortisone?

The strong effect of cortisone can lead to strong side effects, similar to Cushing’s disease, which is characterized by a malfunction of the adrenal glands resulting in an overproduction of cortisol.

The list of potential side effects includes:

  • Increase appetite and body weight, so makes you fat
  • Water retention
  • Fat deposits in the chest, face, upper back and abdomen
  • Retention of water and sodium, leading to leg swelling
  • Arterial hypertension
  • Diabetes, because blood sugar increases
  • Black and blue spots on the skin
  • Slowed healing process for skin injuries
  • Women may experience a delay in the menstrual cycle
  • Osteoporosis
  • Visual disturbances, such as cataracts of the eyes
  • Skin changes, such as acne
  • Myasthenia
  • Thinning of the skin
  • Increased likelihood of developing infections
  • Ulcers of the stomach
  • Increased sweating
  • Nausea
  • Mood swings and insomnia
  • Mental health problems, such as depression
  • Crisis of the adrenal glands (Addision crisis)
  • Erythema, redness, urticaria and itching during prolonged exposure to the sun
  • Lymphocyte reduction in the blood
  • High doses of cortisone can cause damage to the liver because they lead to hepatotoxicity
  • Herpes simplex, unless they are combined with other medications under medical supervision

The undesirable properties can be reduced (but not avoided) by following the doctor’s instructions and maintaining the lowest possible dose.
It is important to choose the right dose by taking several doses or stopping the intake without planning.

To treat some inflammation, doctors prefer to prescribe nonsteroidal anti-inflammatory drugs (ibuprofen, naproxen, aspirin, etc.) because they have fewer side effects, even if they are less powerful than cortisone.

With regard to children, apart from the side effects of adults, there are some associated with the skeleton. In fact, prolonged intake of cortisone can lead to growth retardation, slow down skeletal maturation and lead to a reduction in calcium density in the bones (osteopenia).

Latest generation corticosteroids, such as deflazacort, have fewer side effects, but should always be taken under doctor’s supervision.

Tablets have a general effect on the body and provoke more side effects than topical products (creams or ointments), which are applied locally and less likely to enter the blood.
Also, cortisone-containing drugs that are inhaled are less harmful than those taken orally.
Rarely, cortisone is administered intravenously, except in the treatment of multiple sclerosis.

Interaction with other drugs

Before taking cortisone-containing medications, you must inform your doctor about any over-the-counter or prescribed medications you are already taking, in particular:

  1. Aspirin
  2. medicines for arthritis,
  3. anticoagulants (anticoagulants),
  4. Diuretics
  5. rifampicin,
  6. Phenobarbital
  7. estrogens (for example, the pill for pregnancy prevention),
  8. phenytoin,
  9. ketoconazole,
  10. Nonsteroidal anti-inflammatory drugs (NSAIDs) (Narita et al. – 2007).
  11. Medications for diabetes.

You should not take or stop taking over-the-counter or prescription medications without the consent of your doctor or pharmacist.

Prednisone interacts with the following types of drugs:

  • Anticoagulants (anticoagulants): cortisone may increase or decrease the anticoagulant effect
  • Medication for diabetes (sulfonylureas)
  • Macrolides
  • Antiepileptic drugs or barbiturates
  • diltiazem (calcium antagonist)
  • Nonsteroidal anti-inflammatory drugs (NSAIDs)

Interactions with betamethasone exist with the following drugs:

  • Oral anticoagulants
  • Anticholinesterases
  • Amphotericin B
  • NSAIDs
  • Diuretics
  • Contrast medium

Precautions

The doctor must follow the course of the disease during regular follow-up visits. In addition, the improvement of the clinical situation after discontinuation of the drug must be observed, as some effects may still persist.

For diabetics

This medication can affect the level of glucose (sugar) in the blood. If the test results change when examining the glucose content in blood or urine or if there is any doubt, a doctor must be consulted.

For patients who use cortisone-containing drugs by infiltration into joints when corticosteroids are injected into a joint, the joint must not be subjected to too much stress or too much stress for some time, even if it is already better.
You should ask the doctor when you can go back to work or exercise.

Doping

Cortisone is used as a doping agent because it has a strong anti-inflammatory and analgesic effect, increases aggression and fights fatigue.
Taking corticosteroids can improve athletic performance.

 Forgotten intake

If you take cortisone daily and accidentally miss a dose, you should take the tablet or granules as soon as you think about it. However, it should no longer be taken if the next intake is already pending.
If it is already time for the next dose, the previous dose must be omitted and the program must be proceeded normally.
Do not double the dose to make up for the delayed dose.
Another possibility: if you have skipped a dose, contact the doctor or pharmacist.
A change in cortisone intake may be necessary.

How are the cortisone-containing drugs discontinued?

Cortisone intake must be gradually reduced to allow the adrenal glands (located above the kidneys) to resume their own production of natural cortisol.

Do not stop taking the dose too quickly, as this can cause an adrenal crisis (with potentially fatal effects caused by insufficient cortisol levels).
Sometimes the dose is reduced by one milligram at a time to prevent recurrence of the disease, or you go from a whole tablet to half and then to a quarter.

If steroids are only taken for a short time, the tapering (gradual reduction) occurs much faster and the dose reduction may be
greater. Another possible complication of stopping the dose without a gradual reduction is steroid discontinuation syndrome. This is a violent reaction of the body to the discontinuation of the drug.
The withdrawal symptom can cause fever, muscle pain and joint pain, making it difficult for the doctor to distinguish between withdrawal symptoms and recurrence of the condition.

How long do the side effects last? When do they pass?

Some symptoms are temporary and end immediately after stopping therapy, such as nausea, weakness, high blood pressure, water retention and psychological symptoms (such as insomnia).
In certain cases, corticosteroids can cause long-lasting consequences, such as osteoporosis, cataracts and adrenal disorders.

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