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Side effects of cortisone

The side effects of cortisone should be considered before administration.

 


Allergy to cortisone

You should tell your doctor if hypersensitivity reactions, allergies to the medicines in this group or any other medication occur . 
You should tell your doctor if you suffer from other types of allergies, for example:

  • The hair of animals,
  • A preservatives or dyes.

For over-the-counter products, carefully read the package leaflet or the ingredients.

 

Side effects in children

Cortisone may be more dangerous for children who take it if they have 
infections such as chickenpox or measles (Richards – 2008). 
Cortisone may also slow the growth of children and adolescents, especially if taken for a long time. 
Before giving this medicine to a child or adolescent, it is necessary to talk to your pediatrician and follow his or her instructions.

 

Side effects in the elderly

Older patients are more likely to develop high blood pressure or osteoporosis because of cortisone. 
Women are particularly at risk.

 

Side Effects in Pregnancy

No human studies on birth defects have been performed if the mother takes  corticosteroids during pregnancy. 
However, animal studies have shown that depomedrol may cause defects in newborns.

 

Side effects on breastfeeding

Cortisone passes through breast milk and can cause growth problems or side effects in children during lactation . 
Based on the amount of medicine the pregnant woman takes every day, it may be necessary to take another medicine or stop breastfeeding during treatment.

 

What are the side effects and adverse reactions?

The powerful effect of cortisone can cause serious side effects, such as Cushing’s disease (Stewart et al. – 2011) which is characterized by a malfunction of the adrenal glands, which results in excess cortisol.

The list of possible side effects includes:

Side effects can be reduced (but can not be avoided). Follow the doctor’s recommendations and keep the dose as low as possible. 
It is important to choose the right dosage.

To treat an inflammation , doctors prefer to prescribe non-steroidal anti-inflammatory drugs (ibuprofen, naproxen, aspirin, etc.) because they have fewer side effects, although they are less effective than cortisone.

In children, in addition to the side effects of adults, there are some effects related to the skeleton, in fact taking cortisone for long periods can:

  • To cause delay of growth,
  • Delay skeletal maturation,
  • Causing decreased bone calcium  (osteopenia).

Tablets have a general effect on the body and cause more side effects than topical products (creams or ointments) that apply locally and penetrate less in the blood. 
Cortisone taken by inhalation is less harmful than that taken orally (Busse et al. – 2012). 
Cortisone is rarely taken by intravenous injection.

 

Drug interactions

Before taking this medication, the patient should inform his doctor of any medication without a prescription or prescription, especially:

  • Aspirin,
  • Medicines for arthritis,
  • Anticoagulants,
  • Diuretics,
  • Rifampin,
  • Phenobarbital,
  • Estrogen (eg, birth control pill ),
  • Phenytoin,
  • Ketoconazole,
  • Non-steroidal anti-inflammatory drugs (NSAIDs).
  • Medications for diabetes.

Do not start or stop taking any medication without your doctor’s approval. 
In the case of meticorten , the interactions are with the following types of drugs:

  • Anticoagulants: Cortisone may increase or decrease the anticoagulant action
  • Medications for diabetes ( sulfonylureas )
  • Macrolídeos
  • Antiepileptic drugs or barbiturates
  • Diltiazem (calcium channel blocker)
  • Non-steroidal anti-inflammatory drugs (NSAIDs).

The interactions of betamethasone are as follows:

  • Oral Anticoagulants
  • Anticolinesterases
  • Amphotericin B
  • The substances
  • Diuretics
  • Means of contrast.

 

Precautions

The doctor should periodically check the progress of the disease.

For patients with diabetes
This medicine may affect blood sugar (sugar) levels. If you notice a change in your glucose and urine test results or if there is any doubt, you should see a doctor.

For patients who are taking these medicines with infiltration of the joints. 
If cortisone is injected into a joint, care must be taken not to put too much strain on the joint for a while, even if you are already better. Ask your doctor when you can go back to work or sports activities.

 

Doping

Cortisone is considered to be doping because it causes excitement and reduces the sensation of fatigue (Dvorak et al., 2006). 
The administration of cortisone may improve athletic performance.

 

Forgotten dose

If you are taking cortisone daily and skip a dose, take the tablet when you remember.

However, it is not necessary to take if it is almost time to take the next dose.

If it is almost time for your next dose, skip the  missed dose  and resume your usual dosing schedule. 
Do not double the dose to catch up.

 

How to stop taking the medication?

The administration of cortisone should be gradually reduced to allow the adrenal glands (which are located above the kidneys) to resume production of cortisol, naturally. 
It is not possible to stop taking cortisone  very quickly because it can cause adrenal crisis (a potentially lethal effect caused by an insufficient level of cortisol).

Generally, your doctor recommends stopping in two ways :

  • Doses are decreased by one milligram to prevent acute exacerbation of the disease,
  • If you start taking a whole tablet, half the tablet and then a quarter.

When steroids are administered for short periods of time, dose reduction is faster. 
Another possible complication of stopping cortisone without dosing doses is corticosteroid withdrawal syndrome, which is the body’s exaggerated response to drug withdrawal (Stanbury et al., 1998). 
The disruption effect can cause fever , muscle aches and joint pains, making it difficult to distinguish between:

  • Symptoms of withdrawal,
  • Acute exacerbation of the disease.

 

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

Some symptoms are temporary and end immediately after discontinuation of therapy, such as nausea, weakness, high blood pressure, fluid retention and insomnia. 
In some cases cortisone may cause long-term consequences, for example, osteoporosis, cataracts and disorders of the adrenal gland.

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