Drug Interaction:
Glucorticoids include -
Short acting- Cortisone, Hydrocortisone
Intermediate acting - Prednisone, Prednisolone, Triamcinolone, Methylprednisolone
Long acting- Dexamethasone, Betamethasone
Refer- Dexamethasone
Interacting drugs - summary
+Corticosteroids
Aminoglutethimide + dexamethosone
possible loss of dexamethosone-induced adrenal suppression
Barbiturates
decreased pharmacolgic effects of the corticosteroids metabolism
through the induction of hepatic microsomal enzymes
Cholestyramine + Hydrocortisone
hydrocortisine AUC decreased
Contraceptives Oral
Hepatic metabolism decreased by OCs, resulting in
increased therapeutic effects or toxicity
Ephedrine + Dexamethasone
a decreased half-life and increased clearance of dexamethsone
may occur
Estrogens
estrogen coadministration reduce the clearance and
increase the elimination half-life of corticosteroids
Hydantoins
corticosteroids clearance decreased and the AUC increased
resulting in reduced therapeutic effects
Ketoconazole
corticosteroid clearance decreased and the AUC increased
Macrolide Antibiotics + Methyl prednisolone
significant decrease in methylprednisolone clearance has been used
to decrease methylprednisolone dose
Rifampicin
corticosteroid clearance increased resulting in decreased
therapeutic effects
Corticosteroids +
Anticholinesterases
anticholinesterase effect antagonised in myasthenia gravis
Anticoagulants oral
anticoagulant dose requirements reduced. Conversely,
corticosteroids may oppose the anticoagulant action.
Cyclosporine
although this combination is therapeutically beneficial for organ
transplant, toxicity may be enhanced
Digitalis glycosides
coadministratin enhance the possibility ofdigitalis toxicity
associated with hypokalemia
Isoniazid
isoniazid serum concentration decreased
Nondepolarising muscle relaxants
corticosteroids potentiate, counteract or have no effect on the
neuromuscular blocking action
Potassium depleting agents eg.diuretics
observe patients for hypokalemia
Salicylates
corticosteroids will reduce serum salicylate levels and decrease
their effectiveness
Somatrem
growth-promoting effect of somatrem inhibited
Theophyllines
alterations in the pharmacologic activity of either agent occur
Indication:
New Drugs Approved by (DCI) Drug Controller GENERAL - India For Marketing
(Ref- IDMA Publication)
Name of Drug Indication Date of Approval
Prednisolone Sodium Phosphate 26-11-2009
Orally disintegrating Tablet
10/15/30mg
Indicated For conditionsrequired Glucocorticoids activity including Collagen
Disease and Hypersensitive reaction
FIXED DOSE COMBINATIONS APPROVED BY DCG(I)
FROM JANUARY 1961 TILL NOVEMBER 2014
Name of Drug Indication Date of Approval
Prednisolone 10mg + 04-07-2003
Ofloxacin 3mg per ml eye drops
Endocrine disorders
Adverse Reaction:
Acute adrenal insufficiency precipated by infection, trauma, surgery in patients on long term
therapy.
Cushings syndrome and growth retardation in children, osteoporosis and vertebral
compression fractures.
Peptic ulceration haemorrhage and perforation. Glaucoma, hyper- glycaemia,
pancreatitis,
G.I.upsets, increased appetite, obesity, facial-rounding, fragility of skin,
behavioural and personality changes, hyperpaeoedema,
reduced plasma testostestosterone, increased excretion of uric acid,
calcium and phosphate.
Topical appln to skin:
Thinning and atrophy,sytemic absorption with prolonged use over large
surface, broken skin, occulsive dressing.
Intradermal/Intralesion: Local hypopigmentation of hyperpigmented lesions.
Sub conjuntival injection/eye drops/ointment: Thinning of cornea,corneal ulcer,raised
intraocular pressure and glaucoma, cataract (more after systemic use).
Ear drops: Stinging and blurring (especially with perforated ear drum)
Intra articular injection: Aseptic bone necrosis.
Contra-Indications:
Except when it is life saving C.I. in chronic nephritis,peptic ulcer, acute psychosis, Cushing syndrome, herpes simplex keratitis infections.
Special precaution:
Diabetes, hypertension, psychological disturbances, Osteoporosis,post menopausal women.
Dosages/ Overdosage Etc:
Indications:
Endocrine disorders, rheumatoid disorders, bronchial asthma.
Dosage:
Not for IV use. Initial - 4 to 60mg/mg/day. IM Multiple sclerosis- 200mg daily for a week, followed by 80mg every other day or 4 to 8mg dexamethasone every other day for I month.
Other Information:
For Availability/supplies
Contact -
1.Indian Drug Manufacturers Association (IDMA)
Phone- 022- 24944624/ 24974308
Fax- 022- 24950723
Email- idma@vsnl.com
Website: www.idma-assn.org
2.Bulk Drug Manufacturers Association (India)(BDMA)
Phone - 040-23703910/ 23706718
Fax- 040-23704804
Email- info@bdmai.org
Website: www.info@bdmai.org
Patient Information:
Glucorticoids include - Short acting- Cortisone, Hydrocortisone Intermediate acting - Prednisolone, Triamcinolone, Methylprednisolone Long acting- Dexamethasone, Betamethasone Refer- Dexamethasone
Pharmacology/ Pharmacokinetics:
Glucorticoids include - Short acting- Cortisone, Hydrocortisone Intermediate acting - Prednisolone, Triamcinolone, Methylprednisolone Long acting- Dexamethasone, Betamethasone Refer- Dexamethasone
Interaction with Food:
Absorption reduced but not significant
Pregnancy and lactation:
Refer Dexamethasone
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