Source: Health Sciences Authority (SG) Publisher: SYNCO (H.K) LTD., Hong Kong
Patients on corticosteroid should not undergo immunisation.
Drug-induced secondary adrenocortical insufficiency may be minimized by gradual reduction of dosage.
Extreme caution in congestive heart failure diabetes mellitus, chronic renal failure, hypertension, recent intestinal anastomoses, infectious diseases, uremia, elderly persons, diverticulitis, myasthenia gravis, ocular herpes simplex and glaucoma.
History of peptic ulcer or psychotic tendencies, family history of diabetes mellitus, patients with previous tubercular infections, osteoporosis, rheumatoid arthritis.
Postmenopausal women, pregnancy lactation and children.
Hepatic cirrhosis and hypothyroidism may enhance corticosteroid effects.
Visual disturbance may be reported with systemic and topical corticosteroid use. If a patient presents with symptoms such as blurred vision or other visual disturbances, the patient should be considered for referral to an ophthalmologist for evaluation of possible causes which may include cataract, glaucoma or rare diseases such as central serous chorioretinopathy (CSCR) which have been reported after use of systemic and topical corticosteroids
Response to corticosteroid is reduced by concurrent administration of barbiturates phenylbutazone, phenytoin or rifampicin. Response to anticoagulant and salicylates is reduced by corticosteroid.
The use of this drug in pregnant and nursing mother or women of childbearing potential requires that the possible benefits of the drug be weighed against the potential hazards to the mother and embryo or fetus.
Fluid and electrolyte disturbances.
Musculoskeletal: Muscle weakness and osteoporosis.
Gastrointestinal: gastrointestinal disturbances, peptic ulcer with possible perforation and hemorrhage, pancreatitis, abdominal distention, ulcerative esophagitis.
Dermatological: impaired wound healing.
Neurological: convulsions, mental disturbances and euphoria.
Endocrine: menstrual irregularities; development of Cushingoid state; suppression of growth in children; secondary adrenocortical end pituitary unresponsiveness, manifestation of latent diabetes mellitus.
Ophthalmic: posterior subcapsular cataracts, increased intraocular pressure, glaucoma, exophthalmos.
Metabolic: negative nitrogen balance due to protein catabolism.
Vision, blurred
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