Indications

Allergic and inflammatory disorders.

Contraindication

Systemic infection (unless specific therapy is given). Concurrent admin of live virus vaccines in patients receiving immunosuppressive doses.

Special Precautions

Patient w/ infection, history of TB, cardiac disease or CHF (except in the presence of active rheumatic carditis), HTN, thromboembolic disorders, GI disorders (i.e. gastritis, diverticulitis, ulcerative colitis, peptic ulcer, pyogenic infections), DM (including family history), osteoporosis, myasthenia gravis, epilepsy, emotional instability, history of corticosteroid-induced myopathy, hypothyroidism, ocular herpes simplex. Avoid abrupt withdrawal after prolonged therapy. Renal and hepatic (including hepatic failure and cirrhosis) impairment. Childn. Pregnancy and lactation. Monitoring Parameters Monitor growth, height and wt esp in childn.

Side Effects

Wt gain, hypothalamic-pituitary-adrenal (HPA) axis suppression, amenorrhoea, Cushingoid facies, growth suppression (childn), increased appetite, opportunistic infections, candidiasis, osteoporosis, myopathy, menstrual irregularity, heart failure, headache, vertigo, restlessness, depression, labile mood, irritability, euphoria, mania, delusions, hallucinations, schizophrenia, behavioural disturbances, anxiety, sleep disturbances, cognitive dysfunction including confusion and amnesia, increased intra-ocular pressure, glaucoma, chorioretinopathy, corneal/scleral thinning, posterior subcapsular cataract, dyspepsia, peptic ulceration, haemorrhage, nausea, acute pancreatitis (childn), hirsutism, striae, acne, skin atrophy, telangiectasia, oedema, impaired healing, leukocytosis. Rarely, muscle wasting, bruising, benign intracranial HTN.

Drug Interactions

Decreased serum concentration when used w/ hepatic enzyme inducers (e.g. rifampicin, rifabutin, carbamazepine, phenobarbitone, phenytoin, primidone, aminoglutethimide). Increased serum concentration if concurrently used w/ hepatic enzyme inhibitors (e.g. ketoconazole). Antagonises the effect of hypoglycaemic agents, antihypertensive and diuretics. Enhances the hypokalaemic effect of acetazolamide, loop/thiazide diuretics, β2-agonists, xanthines and carbenoxolone. May increase the anticoagulant effect of coumarins. May prolong relaxation and acute myopathy when given w/ non-depolarising muscle relaxants. Increases the renal clearance of salicylates, steroid withdrawal may lead to salicylate intoxication. Increased serum concentrations w/ oral contraceptives. Reduced bioavailability w/ antacids. Increased risk of tendonitis and tendon rupture if concomitantly used w/ quinolones.

Route of Administration

Oral

Dosage

As directed by the physician