Cortisone

Contraindications

Systemic fungal infection

Hypersensitivity to cortisone

Cautions

Short acting agent

Cirrhosis, ocular herpes simplex, HTN, diverticulitis, hypothyroidism, myasthenia gravis, PUD, osteoporosis, ulcerative colitis, psychotic tendencies, untreated systemic infections, renal insufficiency, pregnancy

Hydroxylated to active compound hydrocortisone

When used to treat adrenocortical insufficiency may need to use additional mineralocorticoid

Not indicated for IV use

DM, thromboembolic disorders

Long-term treatment: Risk of osteoporosis, myopathy, delayed wound healing

Patients receiving corticosteroids should avoid chickenpox or measles-infected persons if unvaccinated

Latent TB may be reactivated

Monitor patients with positive tuberculin test

Some suggestion of slightly increase cleft palate risk if corticosteroids used in pregnancy, but not fully substantiated

Pregnancy Category: not available

Lactation: excretion in milk unknown; use with caution

Pregnancy Categories

A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

NA:Information not available.

Take cortisone exactly as prescribed by your doctor. Follow the directions on your prescription label carefully.

The Cortisone dose your doctor recommends will be based on the following (use any or all that apply):

• the condition being treated
• other medical conditions you have
• other medications you are taking
• how you respond to this medication
• your weight
• your height
• your age
• your gender

Cortisone is available in the following doses:

• Cortisone 10 Mg Oral Tablet
• Cortisone 25 Mg Oral Tablet
• Cortisone 5 Mg Oral Tablet
• Cortisone 50 Mg/ml Injectable Suspension
• Cortisone Compounding Powder

Cortisone is available in the following forms:

• Injectable Suspension
• Oral Tablet

You should not use this medication if you are allergic to cortisone, or if you have a fungal infection anywhere in your body.

Steroid medication can weaken your immune system, making it easier for you to get an infection. Steroids can also worsen an infection you already have, or reactivate an infection you recently had. Before taking this medication, tell your doctor about any illness or infection you have had within the past several weeks.

To make sure you can safely take cortisone, tell your doctor if you have any of these other conditions:

• liver disease (such as cirrhosis);

• kidney disease;

• a thyroid disorder;

• diabetes;

• a history of malaria;

• tuberculosis;

• osteoporosis;

• a muscle disorder such as myasthenia gravis;

• glaucoma or cataracts;

• herpes infection of the eyes;

• stomach ulcers, ulcerative colitis, or diverticulitis;

• depression or mental illness;

• congestive heart failure; or

• high blood pressure.

It is not known whether cortisone will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication.

Cortisone can pass into breast milk and may harm a nursing baby. You should not breast-feed while you are using cortisone.

Steroids can affect growth in children. Talk with your doctor if you think your child is not growing at a normal rate while using this medication.

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have any of these serious side effects:

• problems with your vision;

• swelling, rapid weight gain, feeling short of breath;

• severe depression, unusual thoughts or behavior, seizure (convulsions);

• bloody or tarry stools, coughing up blood;

• pancreatitis (severe pain in your upper stomach spreading to your back, nausea and vomiting, fast heart rate);

• low potassium (confusion, uneven heart rate, extreme thirst, increased urination, leg discomfort, muscle weakness or limp feeling); or

• dangerously high blood pressure (severe headache, blurred vision, buzzing in your ears, anxiety, confusion, chest pain, shortness of breath, uneven heartbeats, seizure).

Less serious side effects may include:

• sleep problems (insomnia), mood changes;

• acne, dry skin, thinning skin, bruising or discoloration;

• slow wound healing;

• increased sweating;

• headache, dizziness, spinning sensation;

• nausea, stomach pain, bloating; or

• changes in the shape or location of body fat (especially in your arms, legs, face, neck, breasts, and waist).

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

May need diet with increased potassium, pyridoxine, vitamin C, vitamin D, folate, calcium, and phosphorus and decreased sodium; may be taken with food to decrease GI upset.

Store at 20°C to 25°C (68°F to 77°F). Protect from light and moisture.

• Discuss specific use of drug and side effects with patient as it relates to treatment. (HCAHPS: During this hospital stay, were you given any medicine that you had not taken before? Before giving you any new medicine, how often did hospital staff tell you what the medicine was for? How often did hospital staff describe possible side effects in a way you could understand?)

• Patient may experience nausea, vomiting, insomnia, or agitation. Have patient report immediately to prescriber signs of infection, signs of low potassium (muscle pain or weakness, muscle cramps, or an abnormal heartbeat); signs of high blood sugar (confusion, fatigue, increased thirst, increased hunger, polyuria, flushing, fast breathing, or breath that smells like fruit); signs of pancreatitis (severe abdominal pain, severe back pain, severe nausea, or vomiting); signs of adrenal gland problems (severe nausea, vomiting, severe dizziness, passing out, muscle weakness, severe fatigue, mood changes, lack of appetite, or weight loss); signs of Cushings disease (weight gain in upper back or abdomen; moon face; severe headache; or slow healing); signs of skin changes (acne, stretch marks, slow healing, or hair growth); signs of DVT (edema, warmth, numbness, change in color, or pain in the extremities); severe loss of strength and energy; irritability; tremors; tachycardia; confusion; sweating a lot; dizziness; passing out; shortness of breath; excessive weight gain; swelling of arms or legs; severe headache; angina; menstrual changes; bone pain; joint pain; vision changes; mood changes; behavioral changes; depression; seizures; bruising; bleeding; severe abdominal pain; black, tarry, or bloody stools; or vomiting blood (HCAHPS).

• Educate patient about signs of a significant reaction (eg, wheezing; chest tightness; fever; itching; bad cough; blue skin color; seizures; or swelling of face, lips, tongue, or throat). Note: This is not a comprehensive list of all side effects. Patient should consult prescriber for additional questions.

Intended Use and Disclaimer: Should not be printed and given to patients. This information is intended to serve as a concise initial reference for health care professionals to use when discussing medications with a patient. You must ultimately rely on your own discretion, experience, and judgment in diagnosing, treating, and advising patients.

25 mg to 300 mg per day, oral or IM, in 1 to 2 divided doses.

25 mg to 300 mg per day, oral or IM, in 1 to 2 divided doses.

0.5 mg to 0.75 mg/kg/day orally given in equally divided doses every 8 hours. Alternatively, 0.25 mg to 0.35 mg/kg IM once daily

Steroids should be used with caution in patients with renal insufficiency.

Steroids should be used with caution in patients with cirrhosis.

Steroids should be used with caution in patients with renal insufficiency.