Frequent patient review is required to appropriately titrate the dose against disease activity.Increases susceptibility to and severity of infections with suppression of clinical symptoms and signs, opportunistic infections, recurrence of dormant tuberculosis (see section 4.4).Hypersensitivity including anaphylaxis, fatigue, malaiseCushing syndrome, cushingoid facies, weight gain, impaired carbohydrate tolerance with increased requirement for antidiabetic therapy, manifestation of latent diabetes mellitus, menstrual irregularity and amenorrhoeaSodium and water retention, hypokalaemic alkalosis, potassium loss, negative nitrogen and calcium balance A wide range of psychiatric reactions including affective disorders (such as irritable, euphoric, depressed and labile mood, and suicidal thoughts), psychotic reactions (including mania, delusions, hallucinations, and aggravation of schizophrenia), marked euphoria leading to dependence; aggravation of epilepsy, behavioural disturbances, irritability, nervousness, anxiety, sleep disturbances, and cognitive dysfunction including confusion and amnesia have been reported. The degree of plasma protein binding determines the distribution and clearance of free, pharmacologically active drug. Patients should carry “Steroid treatment” cards which give clear guidance on the precautions to be taken to minimise risk and which provide details of prescriber, drug, dosage and the duration of treatment. The clinical presentation may often be atypical and serious infections such as septicaemia and tuberculosis may be masked and may reach an advanced stage before being recognised. behavioural disturbances, irritability, anxiety, sleep disturbances, and cognitive dysfunction including confusion and amnesia. You could need a greater or lower one if you have fever, health care emergency, surgical treatment, significant ailment or infection. • Glucocorticoids should be used cautiously in patients with myasthenia gravis receiving anticholinesterase therapy.

Aspirin should be used cautiously in conjunction with glucocorticoids in patients with hypoprothrombinaemia. If prolonged therapy is necessary, treatment should be limited to the minimum suppression of the hypothalamo-pituitary adrenal axis and growth retardation. How dose reduction should be carried out depends largely on whether the disease is likely to relapse as the dose of systemic corticosteroids is reduced. The antibody response to other vaccines may be diminished. This information has been left on emc for reference purposes.This information is intended for use by health professionalsUniformly maroon in colour, circular gastro-resistant tablets of 6.8mm in diameter The initial dosage of Deltacortril Gastro-resistant Tablets may vary from 5mg to 60mg daily depending on the disorder being treated. Other preparations of this medicine may still be available. When renal crisis is suspected, blood pressure should be carefully controlled.Corticosteroids cause growth retardation in infancy, childhood and adolescence, which may be irreversible, and therefore long-term administration of pharmacological doses should be avoided.
Phenobarbital is also used short-term as a sedative to help you relax. Patients/carers should be advised to seek medical advice if symptoms develop.Caution is necessary when oral corticosteroids, including Deltacortril Gastro-resistant Tablets, are prescribed in patients with the following conditions, and frequent patient monitoring is necessary. Increase both high and low density lipoprotein cholesterol concentration in the blood. Passive immunisation with varicella/zoster immunoglobulin (VZIG) is needed by exposed non-immune patients who are receiving systemic corticosteroids or who have used them within the previous 3 months; this should be given within 10 days of exposure to chickenpox. Where a reduced response during concurrent use is noted, dosage adjustment of isoniazid may be necessary.Response to anticoagulants may be reduced or, less often, enhanced by corticosteroids.
Particular care is required when considering the use of systemic corticosteroids in patients with existing or previous history of severe affective disorders in themselves or in their first degree relatives. There is however wide inter-subject variation suggesting impaired absorption in some individuals. Although we attempt to provide accurate and up-to-date information, no guarantee is made to that effect. Seizures. - Duchenne's muscular dystrophy: transient rhabdomyolysis and myoglobinuria may occur following strenuous physical activity. However, when administered for prolonged periods or repeatedly during pregnancy, corticosteroids may increase the risk of intrauterine growth retardation.