Indications & Dose:

Suppression of inflammatory and allergic

disorders

Congenital adrenal hyperplasia

• BY MOUTH

Adult: Usual dose 0.5–5 mg daily

• BY INTRAMUSCULAR INJECTION, OR BY SLOW INTRAVENOUS INJECTION, OR BY INTRAVENOUS INFUSION

Adult: 4–20 mg, repeated up to 4 times in 24 hours

Contraindications:

 Systemic fungal infection, live virus immunization.

Children

• BY SLOW INTRAVENOUS INJECTION,

up to 1 year 1 mg, 1-5 years 2 mg, 6-12 years 4 mg

Cautions:

Precautions:

 Psychosis, diabetes mellitus, glaucoma, osteoporosis, seizure disorders, ulcerative cobs (intestinal perforation), CHF, hypertension, myesthenia gravis (if used wit11 anticholinesterase agents), renal disuse, esophagitis, peptic ulcer, latent tuberculosis or amebiasis (reactivation of disease).

PREGNANCY & BREAST-FEEDING: Use with caution.

OLD AGE: May be used

Interaction:

Drugs

Aminoglutethamide: Enhanced elimination of corticosteroids; marked reduction in corticosteroid response; increased clearance of prednisone; doubling of dose may be necessary

Antidiabetics: Increased blood glucose

Barbiturates, carbamazepine: Reduced serum concentrations of corticosteroids; increased clearance of prednisone

Cholestyramine, colestipol: Possible reduced absorption of corticosteroids

Cyclosporine: Possible increased concentration of both drugs, seizures

Erythromycin, troleandomycin, clarithromycin, ketoconazole. Possible enhanced steroid effect

Estrogens, oral contraceptives: Enhanced effects of corticosteroids

Isoniazid: Reduced plasma concentrations of isoniazid

IUDs: Inhibition of inflammation may decrease contraceptive effect

NSAIDs: Increased risk GI ulceration

Rifampin: Reduced therapeutic effect of corticosteroids; may reduce hepatic clearance of prednisone

Salicylates: Subtherapeutic salicylate concentrations possible

Warnings:

Adverse Effects:

Lactations:

Special Precautions:

Counselling:

Side Effects Or Adverse Reactions:

CNS: Depression, headache, mood changes, seizures, vertigo

CV: CHF, hypertension, tachycardia, thromboembolism, thrombophlebitis

EENT: Blurred vision, cataracts, increased intraocular pressure

GI: Abdominal distention, diarrhea, hemorrhage, increased appetite, nausea, pancreatitis

METAB: Cushingoid state, decreased glucose tolerance, growth suppression in children, HPA suppression

MS: Aseptic necrosis of femoral and humeral heads, fractures, muscle .mass loss, osteoporosis, weakness

SKIN: Acne, allergic contact dermatitis, atrophy, bruising, burning, dryness, ecchymosis, folliculitis,. hypertrichosis, hypopigmentation, irritation, itching, miliaria, perioral dermatitis, petechiae, poor wound healing, secondary infection, striae, suppression of skin test reactions

Patient And Carer Advice: