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Drug Profile

The information on this site is intended to supplement and enhance, not replace, the advice of a physician who is familiar with your medical history. Decisions about your health should always be made ONLY after detailed conversation with your doctor.

Generic drug name: dexamethasone (dex a METH a sone)
Brand name(s): DECADRON, HEMADY, HEXADROL, MYMETHASONE
GENERIC: available FAMILY: Adrenal Steroids
Find the drug label by searching at DailyMed.

Generic drug name: hydrocortisone [oral] (hye droe KOR ti sone)
Brand name(s): ALKINDI SPRINKLE, CORTEF, HYDROCORTONE, SOLU-CORTEF
GENERIC: available FAMILY: Adrenal Steroids
Find the drug label by searching at DailyMed.

Generic drug name: methylprednisolone (meth il pred NISS oh lone)
Brand name(s): A-METHAPRED, DEPO-MEDROL, MEDROL, SOLU-MEDROL
GENERIC: available FAMILY: Adrenal Steroids
Find the drug label by searching at DailyMed.

Generic drug name: prednisolone (pred NISS oh lone)
Brand name(s): FLO-PRED, ORAPRED, PEDIAPRED, PRELONE
GENERIC: available FAMILY: Adrenal Steroids
Find the drug label by searching at DailyMed.

Generic drug name: prednisone (PRED ni sone)
Brand name(s): PREDNISONE INTENSOL, RAYOS
GENERIC: available FAMILY: Adrenal Steroids
Find the drug label by searching at DailyMed.

Pregnancy and Breast-feeding Warnings [top]

Pregnancy Warning

Glucocorticoids cross the placenta and expose the fetus to the drug. Because of the potential for serious adverse effects to the fetus, including cleft palate, spontaneous abortions, and growth retardation, these drugs should not be used by pregnant women.

Breast-feeding Warning

Glucocorticoids are excreted in human milk. Because of the potential for serious adverse effects in nursing infants, including growth suppression and inhibition of steroid production in the infant, you should not take these drugs while nursing.

Facts About This Drug [top]

Glucocorticoids, one of the groups of adrenal steroids, are used to treat asthma, bronchitis, allergies and other breathing problems; conditions that produce inflammation, such as arthritis and other joint and muscle disorders; skin conditions; and certain cancers, hormonal disorders and infections. For several of these conditions (e.g., asthma), these drugs can be extremely effective and even lifesaving. For others (e.g., allergies, arthritis), they are best not used as initial therapy and...

Glucocorticoids, one of the groups of adrenal steroids, are used to treat asthma, bronchitis, allergies and other breathing problems; conditions that produce inflammation, such as arthritis and other joint and muscle disorders; skin conditions; and certain cancers, hormonal disorders and infections. For several of these conditions (e.g., asthma), these drugs can be extremely effective and even lifesaving. For others (e.g., allergies, arthritis), they are best not used as initial therapy and should instead be saved for more severe cases. Unfortunately, some physicians still prescribe oral glucocorticoids too widely. For example, some pediatricians use the drugs for a variety of ear, nose and throat conditions, despite the absence of evidence to support most such uses.[1] Similarly, glucocorticoids can be effective in the treatment of rheumatoid arthritis, but their place in therapy remains controversial; other drugs should be used first.[2]

Drugs taken by mouth (orally) are distributed throughout the body to areas that require treatment as well as to those that do not. Because the entire body is exposed to the drug’s action, there can be unnecessary adverse effects. For this reason, if the drug can be delivered directly to the site of action (e.g., eye, lung, skin), this is generally preferred. For similar reasons, the oral glucocorticoids should be used at the lowest effective dose and for the shortest duration possible.  Rarely, patients taking glucocorticoids have experienced severe allergic (anaphylactic) reactions.

Corticosteroids can produce reversible suppression of the production of the hormones that help the body deal with stress and produce the “fight or flight” response. It is possible that after treatment, your body will not produce enough of these hormones right away. 

Adverse effects from oral glucocorticoids can be minimized further by using alternate-day therapy. If you will be taking oral steroids on a long-term basis, ask your doctor about switching to alternate-day therapy. The body’s own glucocorticoids are released primarily in the early morning hours between 4:00 a.m. and 8:00 a.m., with very little being released in the evenings. These variations help to set your body’s clock and to establish sleep and waking cycles. Therefore, for the least disruption of your body’s natural rhythms, a single daily dose or an alternate-day dose should be taken in the morning prior to 8:00 a.m.

If you take an oral glucocorticoid every day or every other day, you will need one that stays in the body long enough. Adrenal steroids are divided into short-acting (e.g., hydrocortisone), intermediate-acting (e.g., methylprednisolone, prednisolone, prednisone), and long-acting (e.g., dexamethasone) glucocorticoids. For the conditions discussed in this chapter, intermediate-acting glucocorticoids will usually be the most appropriate choice,3 and prednisone is the one used most frequently.

Glucocorticoids suppress your immune system, lowering your defenses against disease and making you more vulnerable to infections. If you use these drugs for a long time, you increase your risk of getting bacterial, viral, parasitic and fungal infections. For this reason, avoid exposure to chicken pox and measles, in particular, if you are taking these drugs.

Glucocorticoids also can cause osteoporosis, even if used short-term or at low doses;[3] fluid retention; and high blood pressure. These adverse effects are all more common in the elderly.

Glucocorticoid users also are more prone to gastrointestinal ulcers and psychiatric disturbances ranging from confusion to depression to psychosis. Cases of psychiatric and behavior disorders have been reported with inhaled, oral and injectable corticosteriod use.[4] Glucocorticoids cause glaucoma and cataracts and slow wound healing. More commonly, they lead to weight gain and high blood sugar. The drugs should not be used if body-wide fungal or threadworm infection is present. Live virus vaccines (e.g., smallpox, oral polio virus) should not be administered to patients on high doses of glucocorticoids.

If you no longer need an oral glucocorticoid, your doctor should slowly reduce your dose over several weeks, unless you have only been taking the medication for less than a week. This is done to avoid a withdrawal syndrome (muscle and joint pain, fever) and, rarely, the absence of or reduction in adrenal function (due to previous suppression by the glucocorticoid), a serious medical problem.

On July 26, 2011, Public Citizen petitioned the Food and Drug Administration (FDA) to immediately require that the labels for all brands of prednisone and other glucocorticosteroids currently on the market in the U.S. be revised to include central serous chorioretinopathy as one of the ophthalmic adverse reactions reported with these medications if not already included. At present, a substantial proportion of the labels for these products (87 percent of labels that we reviewed) do not contain a warning about this potentially serious adverse reaction. Furthermore, the FDA should review the labels for all such medications and, as appropriate, require additional label changes to ensure that other important information regarding the use and safety of these medications is presented in a consistent manner across all labels.

In summary, these are useful drugs that are sometimes overprescribed but whose toxicity can be minimized if they are prescribed and taken properly.

Before You Use This Drug [top]

Tell your doctor if you have or have had:

  • albumin levels in blood that are low
  • allergy to adrenal steroids
  • blood pressure that is elevated
  • chicken pox (existing or recent)
  • cholesterol that is elevated
  • cold sores
  • colitis
  • diabetes
  • diverticulitis
  • fungal infection throughout the body
  • glaucoma
  • heart disease
  • herpes eye infection
  • HIV or AIDS
  • infection
  • kidney disease
  • liver disease
  • lupus
  • measles (existing or recent)
  • myasthenia gravis
  • osteoporosis
  • pregnancy or are breast-feeding
  • psychosis
  • stomach ulcer, esophagitis, or gastritis
  • surgery or serious injury that is recent
  • threadworm infection
  • thyroid problems
  • tuberculosis

Tell your doctor about any other drugs you take, including aspirin, herbs, vitamins, and other nonprescription products.

When You Use This Drug [top]

  • If you plan to have any surgery, including dental, tell your doctor that you take this drug.
  • Do not drink alcohol; it may increase the chance of ulcers.
  • Check with doctor before discontinuing medicine.
  • This drug may increase blood glucose concentrations in patients with diabetes.
  • See doctor regularly to check progress during and following therapy.

For patients on long-term therapy:

  • Possible need for
    • salt restriction
    • potassium supplements
    • calorie restriction
    • increased protein in diet
    • eye exams
    • caution when receiving skin tests
  • Carry a medical identification card or bracelet indicating use of this drug.
  • Tell your doctor if you get a serious infection or injury.
  • Avoid exposure to persons who have chicken pox or measles, or who have just had an oral polio virus vaccine. Tell your doctor immediately if contact occurs.
  • Check with your doctor before getting any vaccinations.

How to Use This Drug [top]

  • Do not share your medication with others.
  • Take the drug at the same time(s) each day.
  • Swallow capsules whole.
  • Do not take more drug than prescribed.
  • Take with food.
  • Store at room temperature with lid on tightly. Do not store in the bathroom. Do not expose to heat, moisture, or strong light. Keep out of reach of children.
  • Do not suddenly stop taking this drug without checking with your doctor to find out if you need to taper off. Gradual dosage reduction may be necessary. Check with your doctor if symptoms recur or worsen when the dose is decreased or therapy discontinued.
  • If you miss a dose and your dosing schedule is every other day, take as soon as possible if remembered the same morning. If you remember later, then take the next morning and skip a day. If your dosing schedule is once a day, take the dose as soon as you remember, but skip it if it is almost time for the next dose. Do not take double doses. If your dosing schedule is several times a day, take the dose as soon as possible. Take double the dose if it’s time for the next dose.

Interactions with Other Drugs [top]

The following drugs, biologics (e.g., vaccines, therapeutic antibodies), or foods are listed in Evaluations of Drug Interactions 2003 as causing “highly clinically significant” or “clinically significant” interactions when used together with any of the drugs in this section. In some sections with multiple drugs, the interaction may have been reported for one but not all drugs in this section, but we include the interaction because the drugs in this section are similar to one another. We have also included potentially serious interactions listed in the drug’s FDA-approved professional package insert or in published medical journal articles. There may be other drugs, especially those in the families of drugs listed below, that also will react with this drug to cause severe adverse effects. Make sure to tell your doctor and pharmacist the drugs you are taking and tell them if you are taking any of these interacting drugs:

aminogluthethimide, aspirin, BLOCADREN, carbamazepine, COUMADIN, CRIXIVAN, cyclosporine, CYTADREN, digoxin, DILANTIN, E-BASE, ECOTRIN, E-MYCIN, ephedrine, ERYC, ERY-TAB, erythromycin, FORTOVASE, GENUINE BAYER ASPIRIN, GLUCOPHAGE, hormonal contraceptives, interleukin-2, INVIRASE, ketoconazole, LANOXICAPS, LANOXIN, metformin, NIZORAL, NORVIR, PCE, phenobarbital, phenytoin, potassium-depleting diuretics (e.g., hydrochlorothiazide, see p. 60), RIFADIN, rifampin, RIMACTANE, ritonavir, SANDIMMUNE, saquinavir, TAO, TEGRETOL, THALOMID, thalidomide, timolol, TIMOPTIC, troleandomycin, warfarin.

Adverse Effects [top]

Call your doctor immediately if you experience:

  • allergic reaction
  • blindness that is sudden
  • breathing difficulty
  • confusion
  • depression
  • disorientation
  • excitement
  • false sense of well-being
  • hallucinations
  • heart problems
  • leg swelling
  • mistaken feelings of self-importance or sense of being mistreated
  • mood swings
  • paranoia
  • restlessness
  • skin rash or hives
  • thirst increased
  • urination that is frequent
  • vision that is decreased or blurred

Call your doctor if these symptoms continue:

  • appetite increased
  • dizziness, sensation of spinning, or lightheadedness
  • flushing of face or cheeks
  • headache
  • hiccups
  • indigestion
  • joint pain
  • nausea
  • nervousness or restlessness
  • skin color changes
  • sleeping difficulty
  • sweating increased
  • vomiting
  • weight gain

Call your doctor immediately if you experience these symptoms during long-term use:

  • acne
  • apathy
  • appetite loss
  • blood pressure decreased
  • blood pressure elevated
  • bone fractures
  • breathing difficulty
  • bruising that is unusual
  • burning, tingling, or prickly sensations in any part of the body
  • cataracts
  • coma
  • confusion
  • eye pain
  • eyes red
  • eyes sensitive to light
  • eyes tearing
  • face rounder
  • fainting
  • glaucoma
  • growth suppression in children
  • hair growth increase
  • headache
  • heart problems
  • hip or shoulder pain
  • lightheadedness
  • lines on the skin of arms, face, legs, trunk or groin that are reddish or purplish
  • menstrual irregularities
  • muscle cramps or pain
  • muscle weakness
  • nausea
  • osteoporosis
  • pain in back, ribs, arms, or legs
  • seizures
  • skin that is thin and shiny
  • sleeping difficulty
  • stomach pain
  • stools that are bloody or black, tarry
  • swelling of feet or lower legs
  • tendon rupture
  • tiredness or weakness that is unusual
  • vision blurry or gradual loss of vision
  • vomiting
  • weight gain that is unusual
  • wounds that will not heal

Call your doctor if these symptoms continue after you stop taking this drug:

  • abdominal or back pain
  • appetite loss that is prolonged
  • breathing difficulty
  • dizziness
  • fainting
  • fever
  • headaches that are frequent or continuing
  • muscle or joint pain
  • nausea
  • reappearance of disease symptoms
  • tiredness or weakness that is unusual
  • vomiting
  • weight loss that is rapid

Periodic Tests[top]

Ask your doctor which of these tests should be done periodically while you are taking this drug:

  • adrenal function tests
  • blood in stool
  • electrolytes
  • eye exam
  • glucose testing in blood or urine

last reviewed May 31, 2021