Prednisone Tablets (prednisone) dose, indications, adverse effects, interactions from localhost.
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Glipizide and prednisone
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Prednisone has been used in infants, children, and adolescents; however, consider pediatric-specific issues before initiating treatment. Safety and efficacy have not been established for the use of corticosteroids in neonates. Adverse effects in newborns have included complications of treatment such as gastrointestinal bleeding, intestinal perforation, hyperglycemia, and hypertension.
The potential for growth inhibition in any pediatric patient should be monitored during prolonged therapy, and the potential for growth effects should be weighed against the clinical benefit obtained and the availability of other treatment alternatives. Administration of corticosteroids to pediatric patients should be limited to the least amount compatible with an effective therapeutic regimen.
Further, children receiving corticosteroids are immunosuppressed, and are therefore more susceptible to infection. Normally innocuous infections can become fatal in these children, and care should be taken to avoid exposure to these diseases. Published studies provide evidence of efficacy and safety in pediatric patients for the treatment of nephrotic syndrome pediatric patients more than 2 years of age , and aggressive lymphomas and leukemias patients greater than 1 month of age.
Other indications for pediatric use of corticosteroids e. Indicated vaccination procedures may be undertaken in patients receiving nonimmunosuppressive doses of corticosteroids as replacement therapy e. Administration of live or live, attenuated vaccines is contraindicated in patients receiving immunosuppressive doses of corticosteroids.
Killed or inactivated vaccines may be administered. However, the response to such vaccines may be diminished and cannot be predicted. In patients who have received high-dose, systemic corticosteroids for 2 weeks or longer, it is recommended to wait at least 3 months after discontinuation of therapy before administering a live-virus vaccine.
If systemic corticosteroids such as prednisone must be used during pregnancy, the potential risks should be discussed with the patient. Infants born to mothers who have received substantial doses of corticosteroids during pregnancy should be carefully observed for signs of hypoadrenalism. Based on findings from human and animal studies, corticosteroids can cause fetal harm when administered to a pregnant woman. Published epidemiological studies suggest a small but inconsistent increased risk of orofacial clefts with use of systemic corticosteroids during the first trimester.
Animal studies in which corticosteroids have been given to pregnant mice, rats, and rabbits have yielded an increased incidence of cleft palate in the offspring.
Intrauterine growth restriction and decreased birth weight have also been reported with maternal use of systemic corticosteroids during pregnancy; however, the underlying maternal condition may also contribute to these risks. There are no adequate and well-controlled studies in pregnant women. Corticosteroids distribute into breast milk, and the manufacturer states that in order to minimize infant exposure, the lowest dose should be prescribed to lactating women to achieve the desired clinical effect.
Prednisone concentrations in breast milk are low, and no adverse effects have been reported in the breast-fed infant with maternal use of any corticosteroid during breast-feeding; prednisone is generally considered compatible to use during lactation. Published case reports of systemic prednisone use during pregnancy that indicate little risk to a nursing infant due to lack of reported side effects.
Prednisone is converted to prednisolone in vivo, and peak concentrations in human milk appear in about 1 hour after a dose; the total daily dose reaching the infant is approximately 0.
Prednisolone and methylprednisolone have similar data available regarding systemic use during lactation. High doses of corticosteroids administered to lactating women for long periods could potentially produce problems in the breastfed infant including growth and development and interfere with endogenous corticosteroid production.
At higher daily prednisone doses, avoidance of breast-feeding during times of peak milk concentrations can help limit infant exposure; however, such adjustments are rarely necessary. Consider the benefits of breast-feeding, the risk of potential infant drug exposure, and the risk of an untreated or inadequately treated condition. Use systemic corticosteroids such as prednisone with caution in the geriatric patient; the risks and benefits of therapy should be considered for any individual patient, particularly with chronic use.
According to the Beers Criteria, systemic corticosteroids are considered potentially inappropriate medications PIMs for use in geriatric patients with delirium or at high risk for delirium and should be avoided in these patient populations due to the possibility of new-onset delirium or exacerbation of the current condition.
The Beers expert panel notes that oral and parenteral corticosteroids may be required for conditions such as exacerbation of chronic obstructive pulmonary disease COPD but should be prescribed in the lowest effective dose and for the shortest possible duration. According to the OBRA guidelines, the need for continued use of a glucocorticoid, with the exception of topical or inhaled formulations, should be documented, along with monitoring for and management of adverse consequences.
Intermediate or longer-term use may cause hyperglycemia, psychosis, edema, insomnia, hypertension, osteoporosis, mood lability, or depression. Abatacept: Moderate Concomitant use of immunosuppressives, as well as long-term corticosteroids, may potentially increase the risk of serious infection in abatacept treated patients.
Advise patients taking abatacept to seek immediate medical advice if they develop signs and symptoms suggestive of infection. Acetaminophen; Aspirin, ASA; Caffeine: Moderate Monitor for gastrointestinal toxicity during concurrent corticosteroid and salicylate use. Concomitant use increases the risk of GI bleeding. In patients receiving concomitant corticosteroids and chronic use of salicylates, withdrawal of corticosteroids may result in salicylism because corticosteroids enhance renal clearance of salicylates and their withdrawal is followed by return to normal rates of renal clearance.
Acetaminophen; Aspirin: Moderate Monitor for gastrointestinal toxicity during concurrent corticosteroid and salicylate use. Acetaminophen; Aspirin; Diphenhydramine: Moderate Monitor for gastrointestinal toxicity during concurrent corticosteroid and salicylate use.
Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine: Moderate Monitor for gastrointestinal toxicity during concurrent corticosteroid and salicylate use. Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide: Moderate Monitor for gastrointestinal toxicity during concurrent corticosteroid and salicylate use.
Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine: Moderate The therapeutic effect of phenylephrine may be increased in patient receiving corticosteroids, such as hydrocortisone. Monitor patients for increased pressor effect if these agents are administered concomitantly. Acetaminophen; Chlorpheniramine; Phenylephrine : Moderate The therapeutic effect of phenylephrine may be increased in patient receiving corticosteroids, such as hydrocortisone.
Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine: Moderate The therapeutic effect of phenylephrine may be increased in patient receiving corticosteroids, such as hydrocortisone. Acetaminophen; Dextromethorphan; Guaifenesin; Phenylephrine: Moderate The therapeutic effect of phenylephrine may be increased in patient receiving corticosteroids, such as hydrocortisone.
Acetaminophen; Dextromethorphan; Phenylephrine: Moderate The therapeutic effect of phenylephrine may be increased in patient receiving corticosteroids, such as hydrocortisone. Acetaminophen; Guaifenesin; Phenylephrine: Moderate The therapeutic effect of phenylephrine may be increased in patient receiving corticosteroids, such as hydrocortisone. Acetazolamide: Moderate Corticosteroids may increase the risk of hypokalemia if used concurrently with acetazolamide.
Hypokalemia may be especially severe with prolonged use of corticotropin, ACTH. Acetohexamide: Moderate Monitor blood glucose during concomitant corticosteroid and sulfonylurea use; a sulfonylurea dose adjustment may be necessary.
Corticosteroids may increase blood glucose concentrations. Risk factors for impaired glucose tolerance due to corticosteroids include the corticosteroid dose and duration of treatment. Corticosteroids stimulate hepatic glucose production and inhibit peripheral glucose uptake into muscle and fatty tissues, producing insulin resistance. Decreased insulin production may occur in the pancreas due to a direct effect on pancreatic beta cells. Adalimumab: Moderate Closely monitor for the development of signs and symptoms of infection if coadministration of a corticosteroid with adalimumab is necessary.
Adalimumab treatment increases the risk for serious infections that may lead to hospitalization or death. Patients taking concomitant immunosuppressants including corticosteroids may be at greater risk of infection. Albiglutide: Moderate Monitor blood glucose during concomitant corticosteroid and incretin mimetic use; an incretin mimetic dose adjustment may be necessary. Alefacept: Contraindicated Patients receiving other immunosuppressives should not receive concurrent therapy with alefacept; there is the possibility of excessive immunosuppression and subsequent risks of infection and other serious side effects.
In clinical efficacy trials, concurrent treatment of alefacept with these types of agents did not occur. The duration of the period following treatment with alefacept that is appropriate before starting other immunosuppressive therapy has not been evaluated.
Alemtuzumab: Moderate Concomitant use of alemtuzumab with immunosuppressant doses of corticosteroids may increase the risk of immunosuppression.
Monitor patients carefully for signs and symptoms of infection. Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ: Moderate Monitor potassium concentrations during concomitant corticosteroid and thiazide diuretic use due to risk for additive hypokalemia; potassium supplementation may be necessary.
Both corticosteroids and thiazide diuretics cause increased renal potassium loss. Aliskiren; Hydrochlorothiazide, HCTZ: Moderate Monitor potassium concentrations during concomitant corticosteroid and thiazide diuretic use due to risk for additive hypokalemia; potassium supplementation may be necessary. Alogliptin; Metformin: Moderate Monitor blood glucose during concomitant corticosteroid and metformin use; a metformin dose adjustment may be necessary.
Alpha-glucosidase Inhibitors: Moderate Monitor patients receiving antidiabetic agents closely for worsening glycemic control when corticosteroids are instituted and for signs of hypoglycemia when corticosteroids are discontinued. Systemic and inhaled corticosteroids are known to increase blood glucose and worsen glycemic control in patients taking antidiabetic agents.
The main risk factors for impaired glucose tolerance due to corticosteroids are the dose of steroid and duration of treatment.
Altretamine: Minor Concurrent use of altretamine with other agents which cause bone marrow or immune suppression such as corticosteroids may result in additive effects.
Ambenonium Chloride: Moderate Concomitant use of anticholinesterase agents, such as ambenonium chloride, and corticosteroids may produce severe weakness in patients with myasthenia gravis. If possible, anticholinesterase agents used to treat myasthenia should be withdrawn at least 24 hours before initiating corticosteroid therapy.
Amifampridine: Moderate Carefully consider the need for concomitant treatment with systemic corticosteroids and amifampridine, as coadministration may increase the risk of seizures. If coadministration occurs, closely monitor patients for seizure activity. Seizures have been observed in patients without a history of seizures taking amifampridine at recommended doses. Systemic corticosteroids may increase the risk of seizures in some patients. Amiloride; Hydrochlorothiazide, HCTZ: Moderate Monitor potassium concentrations during concomitant corticosteroid and thiazide diuretic use due to risk for additive hypokalemia; potassium supplementation may be necessary.
Aminolevulinic Acid: Minor Corticosteroids administered prior to or concomitantly with photosensitizing agents used in photodynamic therapy may decrease the efficacy of the treatment. Aminosalicylate sodium, Aminosalicylic acid: Moderate Monitor for gastrointestinal toxicity during concurrent corticosteroid and salicylate use. Amlodipine; Valsartan; Hydrochlorothiazide, HCTZ: Moderate Monitor potassium concentrations during concomitant corticosteroid and thiazide diuretic use due to risk for additive hypokalemia; potassium supplementation may be necessary.
Amphotericin B cholesteryl sulfate complex ABCD : Moderate The potassium-wasting effects of corticosteroid therapy can be exacerbated by concomitant administration of other potassium-depleting drugs including amphotericin B. Serum potassium levels should be monitored in patients receiving these drugs concomitantly. Amphotericin B lipid complex ABLC : Moderate The potassium-wasting effects of corticosteroid therapy can be exacerbated by concomitant administration of other potassium-depleting drugs including amphotericin B.
Amphotericin B liposomal LAmB : Moderate The potassium-wasting effects of corticosteroid therapy can be exacerbated by concomitant administration of other potassium-depleting drugs including amphotericin B.
Amphotericin B: Moderate The potassium-wasting effects of corticosteroid therapy can be exacerbated by concomitant administration of other potassium-depleting drugs including amphotericin B. Aprepitant, Fosaprepitant: Moderate Use caution if prednisone and aprepitant, fosaprepitant are used concurrently and monitor for an increase in prednisone-related adverse effects for several days after administration of a multi-day aprepitant regimen.
The active metabolite of prednisone, prednisolone, is a CYP3A4 substrate. As a single mg or 40 mg oral dose, the inhibitory effect of aprepitant on CYP3A4 is weak, with the AUC of midazolam increased by 1. After administration, fosaprepitant is rapidly converted to aprepitant and shares many of the same drug interactions. However, as a single mg intravenous dose, fosaprepitant only weakly inhibits CYP3A4 for a duration of 2 days; there is no evidence of CYP3A4 induction.
Fosaprepitant mg IV as a single dose increased the AUC of midazolam given on days 1 and 4 by approximately 1. Less than a 2-fold increase in the midazolam AUC is not considered clinically important.
Arsenic Trioxide: Moderate Caution is advisable during concurrent use of arsenic trioxide and corticosteroids as electrolyte imbalance caused by corticosteroids may increase the risk of QT prolongation with arsenic trioxide. Articaine; Epinephrine: Moderate Monitor potassium concentrations during concomitant corticosteroid and epinephrine use due to risk for additive hypokalemia; potassium supplementation may be necessary.
Corticosteroids may potentiate the hypokalemic effects of epinephrine. Asparaginase Erwinia chrysanthemi: Moderate Concomitant use of L-asparaginase with corticosteroids can result in additive hyperglycemia. L-Asparaginase transiently inhibits insulin production contributing to hyperglycemia seen during concurrent corticosteroid therapy. Insulin therapy may be required in some cases.
Administration of L-asparaginase after rather than before corticosteroids reportedly has produced fewer hypersensitivity reactions. Aspirin, ASA: Moderate Monitor for gastrointestinal toxicity during concurrent corticosteroid and salicylate use. Monitor for decreased response to prednisone during concurrent use.
Moderate Monitor for gastrointestinal toxicity during concurrent corticosteroid and salicylate use. Aspirin, ASA; Caffeine: Moderate Monitor for gastrointestinal toxicity during concurrent corticosteroid and salicylate use. Aspirin, ASA; Caffeine; Dihydrocodeine: Moderate Monitor for gastrointestinal toxicity during concurrent corticosteroid and salicylate use.
Aspirin, ASA; Caffeine; Orphenadrine: Moderate Monitor for gastrointestinal toxicity during concurrent corticosteroid and salicylate use. Aspirin, ASA; Carisoprodol: Moderate Monitor for gastrointestinal toxicity during concurrent corticosteroid and salicylate use.
Aspirin, ASA; Carisoprodol; Codeine: Moderate Monitor for gastrointestinal toxicity during concurrent corticosteroid and salicylate use. Aspirin, ASA; Dipyridamole: Moderate Monitor for gastrointestinal toxicity during concurrent corticosteroid and salicylate use.
Aspirin, ASA; Omeprazole: Moderate Monitor for gastrointestinal toxicity during concurrent corticosteroid and salicylate use. Aspirin, ASA; Oxycodone: Moderate Monitor for gastrointestinal toxicity during concurrent corticosteroid and salicylate use. Aspirin, ASA; Pravastatin: Moderate Monitor for gastrointestinal toxicity during concurrent corticosteroid and salicylate use. Atazanavir: Moderate Coadministration of prednisone with atazanavir may cause elevated prednisone serum concentrations, potentially resulting in Cushing's syndrome and adrenal suppression.
Corticosteroids, such as beclomethasone and prednisolone, whose concentrations are less affected by strong CYP3A4 inhibitors, should be considered, especially for long-term use.
Atazanavir; Cobicistat: Moderate Coadministration of prednisone with atazanavir may cause elevated prednisone serum concentrations, potentially resulting in Cushing's syndrome and adrenal suppression. Moderate Coadministration of prednisone with cobicistat may cause elevated prednisone serum concentrations, potentially resulting in Cushing's syndrome and adrenal suppression.
Atenolol; Chlorthalidone: Moderate Monitor potassium concentrations during concomitant corticosteroid and thiazide diuretic use due to risk for additive hypokalemia; potassium supplementation may be necessary. Atracurium: Moderate Limit the period of use of neuromuscular blockers and corticosteroids and only use when the specific advantages of the drugs outweigh the risks for acute myopathy.
An acute myopathy has been observed with the use of high doses of corticosteroids in patients receiving concomitant long-term therapy with neuromuscular blockers. Clinical improvement or recovery after stopping therapy may require weeks to years.
Azilsartan; Chlorthalidone: Moderate Monitor potassium concentrations during concomitant corticosteroid and thiazide diuretic use due to risk for additive hypokalemia; potassium supplementation may be necessary.
Belladonna Alkaloids; Ergotamine; Phenobarbital: Moderate Coadministration may result in decreased exposure to prednisone. Benazepril; Hydrochlorothiazide, HCTZ: Moderate Monitor potassium concentrations during concomitant corticosteroid and thiazide diuretic use due to risk for additive hypokalemia; potassium supplementation may be necessary.
Bendroflumethiazide; Nadolol: Moderate Monitor potassium concentrations during concomitant corticosteroid and thiazide diuretic use due to risk for additive hypokalemia; potassium supplementation may be necessary. Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate: Moderate Monitor for gastrointestinal toxicity during concurrent corticosteroid and salicylate use. Bismuth Subsalicylate: Moderate Monitor for gastrointestinal toxicity during concurrent corticosteroid and salicylate use.
Bismuth Subsalicylate; Metronidazole; Tetracycline: Moderate Monitor for gastrointestinal toxicity during concurrent corticosteroid and salicylate use. Bisoprolol; Hydrochlorothiazide, HCTZ: Moderate Monitor potassium concentrations during concomitant corticosteroid and thiazide diuretic use due to risk for additive hypokalemia; potassium supplementation may be necessary.
Boceprevir: Major Concurrent administration of systemic corticosteroids, such as prednisone, and boceprevir is not recommended. If prednisone and boceprevir are coadministered, close monitoring for corticosteroid-related adverse events and for decreased boceprevir efficacy is advised. If prednisone dose adjustments are made, re-adjust the dose upon completion of boceprevir treatment.
Predictions about the interaction can be made based on the metabolic pathway of prednisone. Prednisone is metabolized by the hepatic isoenzyme CYP3A4 and the drug efflux transporter P-glycoprotein P-gp ; boceprevir inhibits both the isoenzyme and the drug efflux pump.
Coadministration may result in elevated prednisone plasma concentrations. Brompheniramine; Carbetapentane; Phenylephrine: Moderate The therapeutic effect of phenylephrine may be increased in patient receiving corticosteroids, such as hydrocortisone. Brompheniramine; Dextromethorphan; Phenylephrine: Moderate The therapeutic effect of phenylephrine may be increased in patient receiving corticosteroids, such as hydrocortisone.
Brompheniramine; Phenylephrine: Moderate The therapeutic effect of phenylephrine may be increased in patient receiving corticosteroids, such as hydrocortisone. Bupivacaine; Epinephrine: Moderate Monitor potassium concentrations during concomitant corticosteroid and epinephrine use due to risk for additive hypokalemia; potassium supplementation may be necessary.
Bupropion: Moderate Monitor for seizure activity during concomitant bupropion and corticosteroid use. Bupropion is associated with a dose-related seizure risk; concomitant use of other medications that lower the seizure threshold, such as systemic corticosteroids, increases the seizure risk.
Bupropion; Naltrexone: Moderate Monitor for seizure activity during concomitant bupropion and corticosteroid use. Butabarbital: Moderate Coadministration may result in decreased exposure to prednisone. Butalbital; Acetaminophen: Moderate Coadministration may result in decreased exposure to prednisone.
Butalbital; Acetaminophen; Caffeine: Moderate Coadministration may result in decreased exposure to prednisone. Butalbital; Acetaminophen; Caffeine; Codeine: Moderate Coadministration may result in decreased exposure to prednisone. Cabozantinib: Minor Monitor for an increase in prednisone-related adverse reactions if coadministration with cabozantinib is necessary; a dose adjustment of prednisone may be necessary.
Prednisone is a P-glycoprotein P-gp substrate. Cabozantinib is a P-gp inhibitor and has the potential to increase plasma concentrations of P-gp substrates; however, the clinical relevance of this finding is unknown. Caffeine; Sodium Benzoate: Moderate Corticosteroids may cause protein breakdown, which could lead to elevated blood ammonia concentrations, especially in patients with an impaired ability to form urea.
Corticosteroids should be used with caution in patients receiving treatment for hyperammonemia. Canagliflozin; Metformin: Moderate Monitor blood glucose during concomitant corticosteroid and metformin use; a metformin dose adjustment may be necessary.
Candesartan; Hydrochlorothiazide, HCTZ: Moderate Monitor potassium concentrations during concomitant corticosteroid and thiazide diuretic use due to risk for additive hypokalemia; potassium supplementation may be necessary. Captopril; Hydrochlorothiazide, HCTZ: Moderate Monitor potassium concentrations during concomitant corticosteroid and thiazide diuretic use due to risk for additive hypokalemia; potassium supplementation may be necessary.
Carbamazepine: Moderate Hepatic microsomal enzyme inducers, including carbamazepine, can increase the metabolism of prednisone.
Carbetapentane; Chlorpheniramine; Phenylephrine: Moderate The therapeutic effect of phenylephrine may be increased in patient receiving corticosteroids, such as hydrocortisone. Carbetapentane; Diphenhydramine; Phenylephrine: Moderate The therapeutic effect of phenylephrine may be increased in patient receiving corticosteroids, such as hydrocortisone. Carbetapentane; Guaifenesin; Phenylephrine: Moderate The therapeutic effect of phenylephrine may be increased in patient receiving corticosteroids, such as hydrocortisone.
Carbetapentane; Phenylephrine: Moderate The therapeutic effect of phenylephrine may be increased in patient receiving corticosteroids, such as hydrocortisone. Carbetapentane; Phenylephrine; Pyrilamine: Moderate The therapeutic effect of phenylephrine may be increased in patient receiving corticosteroids, such as hydrocortisone. Carbinoxamine; Hydrocodone; Phenylephrine: Moderate The therapeutic effect of phenylephrine may be increased in patient receiving corticosteroids, such as hydrocortisone.
Carbinoxamine; Phenylephrine: Moderate The therapeutic effect of phenylephrine may be increased in patient receiving corticosteroids, such as hydrocortisone. Carvedilol: Minor Increased concentrations of prednisone may occur if it is coadministered with carvedilol; exercise caution. Carvedilol is a P-glycoprotein P-gp inhibitor and prednisone is a P-gp substrate.
Ceritinib: Minor Monitor for steroid-related adverse reactions if coadministration of ceritinib with prednisone is necessary, due to increased prednisone exposure. Certolizumab pegol: Moderate The safety and efficacy of certolizumab in patients with immunosuppression have not been evaluated.
Patients receiving immunosuppressives along with certolizumab may be at a greater risk of developing an infection. Many of the serious infections occurred in patients on immunosuppressive therapy who received certolizumab.
Chlophedianol; Guaifenesin; Phenylephrine: Moderate The therapeutic effect of phenylephrine may be increased in patient receiving corticosteroids, such as hydrocortisone. Chlorothiazide: Moderate Monitor potassium concentrations during concomitant corticosteroid and thiazide diuretic use due to risk for additive hypokalemia; potassium supplementation may be necessary. Chlorpheniramine; Dextromethorphan; Phenylephrine: Moderate The therapeutic effect of phenylephrine may be increased in patient receiving corticosteroids, such as hydrocortisone.
Chlorpheniramine; Dihydrocodeine; Phenylephrine: Moderate The therapeutic effect of phenylephrine may be increased in patient receiving corticosteroids, such as hydrocortisone. Chlorpheniramine; Hydrocodone; Phenylephrine: Moderate The therapeutic effect of phenylephrine may be increased in patient receiving corticosteroids, such as hydrocortisone.
Chlorpheniramine; Phenylephrine: Moderate The therapeutic effect of phenylephrine may be increased in patient receiving corticosteroids, such as hydrocortisone. Chlorpropamide: Moderate Monitor blood glucose during concomitant corticosteroid and sulfonylurea use; a sulfonylurea dose adjustment may be necessary.
Chlorthalidone: Moderate Monitor potassium concentrations during concomitant corticosteroid and thiazide diuretic use due to risk for additive hypokalemia; potassium supplementation may be necessary.
Chlorthalidone; Clonidine: Moderate Monitor potassium concentrations during concomitant corticosteroid and thiazide diuretic use due to risk for additive hypokalemia; potassium supplementation may be necessary. Cholestyramine: Moderate Cholestyramine may increase the clearance of corticosteroids, such as prednisone. Choline Salicylate; Magnesium Salicylate: Moderate Monitor for gastrointestinal toxicity during concurrent corticosteroid and salicylate use.
Cisatracurium: Moderate Limit the period of use of neuromuscular blockers and corticosteroids and only use when the specific advantages of the drugs outweigh the risks for acute myopathy. Cobicistat: Moderate Coadministration of prednisone with cobicistat may cause elevated prednisone serum concentrations, potentially resulting in Cushing's syndrome and adrenal suppression.
Codeine; Phenylephrine; Promethazine: Moderate The therapeutic effect of phenylephrine may be increased in patient receiving corticosteroids, such as hydrocortisone. Daclatasvir: Moderate Systemic exposure of prednisone, a P-glycoprotein P-gp substrate, may be increased when administered concurrently with daclatasvir, a P-gp inhibitor. Taking these drugs together could increase or prolong the therapeutic effects of prednisone; monitor patients for potential adverse effects.
Dapagliflozin; Metformin: Moderate Monitor blood glucose during concomitant corticosteroid and metformin use; a metformin dose adjustment may be necessary. Darunavir: Moderate Coadministration of prednisone with darunavir may cause elevated prednisone serum concentrations, potentially resulting in Cushing's syndrome and adrenal suppression.
Darunavir; Cobicistat: Moderate Coadministration of prednisone with cobicistat may cause elevated prednisone serum concentrations, potentially resulting in Cushing's syndrome and adrenal suppression. Moderate Coadministration of prednisone with darunavir may cause elevated prednisone serum concentrations, potentially resulting in Cushing's syndrome and adrenal suppression.
Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide: Moderate Coadministration of prednisone with cobicistat may cause elevated prednisone serum concentrations, potentially resulting in Cushing's syndrome and adrenal suppression.
Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir: Moderate Coadministration of prednisone with ritonavir a strong CYP3A4 inhibitor may cause prednisone serum concentrations to increase, potentially resulting in Cushing's syndrome and adrenal suppression. Consider use of an alternative corticosteroid whose concentrations are less affected by strong CYP3A4 inhibitors, such as beclomethasone and prednisolone, especially during long-term treatment. Deferasirox: Moderate Because gastric ulceration and GI bleeding have been reported in patients taking deferasirox, use caution when coadministering with other drugs known to increase the risk of peptic ulcers or gastric hemorrhage including corticosteroids.
Denosumab: Moderate The safety and efficacy of denosumab use in patients with immunosuppression have not been evaluated. Patients receiving immunosuppressives along with denosumab may be at a greater risk of developing an infection. Desmopressin: Major Desmopressin is contraindicated with concomitant inhaled or systemic corticosteroid use due to an increased risk of hyponatremia. Desmopressin can be started or resumed 3 days or 5 half-lives after the corticosteroid is discontinued, whichever is longer.
Dextromethorphan; Bupropion: Moderate Monitor for seizure activity during concomitant bupropion and corticosteroid use. Dextromethorphan; Diphenhydramine; Phenylephrine: Moderate The therapeutic effect of phenylephrine may be increased in patient receiving corticosteroids, such as hydrocortisone.
Dextromethorphan; Guaifenesin; Phenylephrine: Moderate The therapeutic effect of phenylephrine may be increased in patient receiving corticosteroids, such as hydrocortisone. Digoxin: Moderate Hypokalemia, hypomagnesemia, or hypercalcemia increase digoxin's effect. Corticosteroids can precipitate digoxin toxicity via their effect on electrolyte balance.
It is recommended that serum potassium, magnesium, and calcium be monitored regularly in patients receiving digoxin. Dipeptidyl Peptidase-4 Inhibitors: Moderate Monitor blood glucose during concomitant corticosteroid and dipeptidyl peptidase-4 DPP-4 inhibitor use; a DPP-4 dose adjustment may be necessary. Diphenhydramine; Hydrocodone; Phenylephrine: Moderate The therapeutic effect of phenylephrine may be increased in patient receiving corticosteroids, such as hydrocortisone.
Diphenhydramine; Phenylephrine: Moderate The therapeutic effect of phenylephrine may be increased in patient receiving corticosteroids, such as hydrocortisone.
Dofetilide: Major Corticosteroids can cause increases in blood pressure, sodium and water retention, and hypokalemia, predisposing patients to interactions with certain other medications. Corticosteroid-induced hypokalemia could also enhance the proarrhythmic effects of dofetilide. Doxacurium: Moderate Limit the period of use of neuromuscular blockers and corticosteroids and only use when the specific advantages of the drugs outweigh the risks for acute myopathy.
The concomitant administration of dronedarone with CYP3A4 and P-gp substrates may result in increased exposure of the substrate and should, therefore, be undertaken with caution. Droperidol: Moderate Caution is advised when using droperidol in combination with corticosteroids which may lead to electrolyte abnormalities, especially hypokalemia or hypomagnesemia, as such abnormalities may increase the risk for QT prolongation or cardiac arrhythmias.
Dulaglutide: Moderate Monitor blood glucose during concomitant corticosteroid and incretin mimetic use; an incretin mimetic dose adjustment may be necessary. Echinacea: Moderate Echinacea possesses immunostimulatory activity and may theoretically reduce the response to immunosuppressant drugs like corticosteroids. For some patients who are using corticosteroids for serious illness, such as cancer or organ transplant, this potential interaction may result in the preferable avoidance of Echinacea.
Although documentation is lacking, coadministration of echinacea with immunosuppressants is not recommended by some resources. Econazole: Minor In vitro studies indicate that corticosteroids inhibit the antifungal activity of econazole against C.
When the concentration of the corticosteroid was equal to or greater than that of econazole on a weight basis, the antifungal activity of econazole was substantially inhibited. When the corticosteroid concentration was one-tenth that of econazole, no inhibition of antifungal activity was observed.
Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide: Moderate Coadministration of prednisone with cobicistat may cause elevated prednisone serum concentrations, potentially resulting in Cushing's syndrome and adrenal suppression.
Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate: Moderate Coadministration of prednisone with cobicistat may cause elevated prednisone serum concentrations, potentially resulting in Cushing's syndrome and adrenal suppression. Empagliflozin; Linagliptin; Metformin: Moderate Monitor blood glucose during concomitant corticosteroid and metformin use; a metformin dose adjustment may be necessary.
Empagliflozin; Metformin: Moderate Monitor blood glucose during concomitant corticosteroid and metformin use; a metformin dose adjustment may be necessary. Enalapril; Hydrochlorothiazide, HCTZ: Moderate Monitor potassium concentrations during concomitant corticosteroid and thiazide diuretic use due to risk for additive hypokalemia; potassium supplementation may be necessary. Enzalutamide: Moderate Monitor for decreased corticosteroid efficacy if prednisone is used with enzalutamide; a dosage increase may be necessary.
Concurrent use may decrease the exposure of prednisone. Ephedrine: Moderate Ephedrine may enhance the metabolic clearance of corticosteroids.
Decreased blood concentrations and lessened physiologic activity may necessitate an increase in corticosteroid dosage. Ephedrine; Guaifenesin: Moderate Ephedrine may enhance the metabolic clearance of corticosteroids.
Epinephrine: Moderate Monitor potassium concentrations during concomitant corticosteroid and epinephrine use due to risk for additive hypokalemia; potassium supplementation may be necessary. Eprosartan; Hydrochlorothiazide, HCTZ: Moderate Monitor potassium concentrations during concomitant corticosteroid and thiazide diuretic use due to risk for additive hypokalemia; potassium supplementation may be necessary.
Erlotinib: Moderate Monitor for symptoms of gastrointestinal GI perforation e. Permanently discontinue erlotinib in patients who develop GI perforation. The pooled incidence of GI perforation clinical trials of erlotinib ranged from 0. Ertugliflozin; Metformin: Moderate Monitor blood glucose during concomitant corticosteroid and metformin use; a metformin dose adjustment may be necessary. Estrogens: Moderate Monitor for corticosteroid-related adverse events if corticosteroids are used with estrogens.
Concurrent use may increase the exposure of corticosteroids. Estrogens may decrease the hepatic clearance of corticosteroids thereby increasing their effect. Caution is warranted if these drugs are coadministered.
Exenatide: Moderate Monitor blood glucose during concomitant corticosteroid and incretin mimetic use; an incretin mimetic dose adjustment may be necessary. Fluoxymesterone: Moderate Coadministration of corticosteroids and fluoxymesterone may increase the risk of edema, especially in patients with underlying cardiac or hepatic disease. Corticosteroids with greater mineralocorticoid activity, such as fludrocortisone, may be more likely to cause edema.
Administer these drugs in combination with caution. Fosamprenavir: Moderate Concomitant use of prednisone and fosamprenavir may result in altered prednisone plasma concentrations. Amprenavir, the active metabolite of fosamprenavir, is an inducer of P-gp and a potent inhibitor and moderate inducer of CYP3A4. Fosinopril; Hydrochlorothiazide, HCTZ: Moderate Monitor potassium concentrations during concomitant corticosteroid and thiazide diuretic use due to risk for additive hypokalemia; potassium supplementation may be necessary.
Fosphenytoin: Moderate Monitor for decreased corticosteroid efficacy if prednisone is used with fosphenytoin; a dosage increase may be necessary. Gallium Ga 68 Dotatate: Moderate Repeated administration of high corticosteroid doses prior to gallium Ga 68 dotatate may result in false negative imaging.
Corticosteroids can down-regulate somatostatin subtype 2 receptors: thereby, interfering with binding of gallium Ga 68 dotatate to malignant cells that overexpress these receptors.
Glecaprevir; Pibrentasvir: Moderate Caution is advised with the coadministration of glecaprevir and prednisone as coadministration may increase serum concentrations of prednisone and increase the risk of adverse effects.
Prednisone is a substrate of P-glycoprotein P-gp ; glecaprevir is a P-gp inhibitor. Moderate Caution is advised with the coadministration of pibrentasvir and prednisone as coadministration may increase serum concentrations of prednisone and increase the risk of adverse effects. Prednisone is a substrate of P-glycoprotein P-gp ; pibrentasvir is a P-gp inhibitor.
Glimepiride: Moderate Monitor blood glucose during concomitant corticosteroid and sulfonylurea use; a sulfonylurea dose adjustment may be necessary. Glimepiride; Rosiglitazone: Moderate Monitor blood glucose during concomitant corticosteroid and sulfonylurea use; a sulfonylurea dose adjustment may be necessary. Glipizide: Moderate Monitor blood glucose during concomitant corticosteroid and sulfonylurea use; a sulfonylurea dose adjustment may be necessary.
Glipizide; Metformin: Moderate Monitor blood glucose during concomitant corticosteroid and metformin use; a metformin dose adjustment may be necessary. Moderate Monitor blood glucose during concomitant corticosteroid and sulfonylurea use; a sulfonylurea dose adjustment may be necessary. Glyburide: Moderate Monitor blood glucose during concomitant corticosteroid and sulfonylurea use; a sulfonylurea dose adjustment may be necessary. Glyburide; Metformin: Moderate Monitor blood glucose during concomitant corticosteroid and metformin use; a metformin dose adjustment may be necessary.
Glycerol Phenylbutyrate: Moderate Corticosteroids may induce elevated blood ammonia concentrations. Corticosteroids should be used with caution in patients receiving glycerol phenylbutyrate. Monitor ammonia concentrations closely. Golimumab: Moderate The safety and efficacy of golimumab in patients with immunosuppression have not been evaluated. Patients receiving immunosuppressives along with golimumab may be at a greater risk of developing an infection.
Guaifenesin; Phenylephrine: Moderate The therapeutic effect of phenylephrine may be increased in patient receiving corticosteroids, such as hydrocortisone. Haloperidol: Moderate Caution is advisable during concurrent use of haloperidol and corticosteroids as electrolyte imbalance caused by corticosteroids may increase the risk of QT prolongation with haloperidol. Hemin: Moderate Hemin works by inhibiting aminolevulinic acid synthetase.
Corticosteroids increase the activity of this enzyme should not be used with hemin. Hydralazine; Hydrochlorothiazide, HCTZ: Moderate Monitor potassium concentrations during concomitant corticosteroid and thiazide diuretic use due to risk for additive hypokalemia; potassium supplementation may be necessary.
Hydrochlorothiazide, HCTZ: Moderate Monitor potassium concentrations during concomitant corticosteroid and thiazide diuretic use due to risk for additive hypokalemia; potassium supplementation may be necessary. Hydrochlorothiazide, HCTZ; Methyldopa: Moderate Monitor potassium concentrations during concomitant corticosteroid and thiazide diuretic use due to risk for additive hypokalemia; potassium supplementation may be necessary.
Hydrochlorothiazide, HCTZ; Moexipril: Moderate Monitor potassium concentrations during concomitant corticosteroid and thiazide diuretic use due to risk for additive hypokalemia; potassium supplementation may be necessary.
Hydrocodone; Phenylephrine: Moderate The therapeutic effect of phenylephrine may be increased in patient receiving corticosteroids, such as hydrocortisone. Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate; Sodium Biphosphate: Moderate Monitor for gastrointestinal toxicity during concurrent corticosteroid and salicylate use. Moderate Use sodium phosphate cautiously with corticosteroids, especially mineralocorticoids or corticotropin, ACTH, as concurrent use can cause hypernatremia. Ibritumomab Tiuxetan: Moderate Use sodium phosphate cautiously with corticosteroids, especially mineralocorticoids or corticotropin, ACTH, as concurrent use can cause hypernatremia.
While therapy is designed to take advantage of this effect, patients may be predisposed to over-immunosuppression resulting in an increased risk for the development of severe infections.
If coadministration is necessary, close clinical monitoring is advised and therapy should be accompanied by appropriate antimicrobial therapies as indicated. Incretin Mimetics: Moderate Monitor blood glucose during concomitant corticosteroid and incretin mimetic use; an incretin mimetic dose adjustment may be necessary.
Indapamide: Moderate Additive hypokalemia may occur when indapamide is coadministered with other drugs with a significant risk of hypokalemia such as systemic corticosteroids. Coadminister with caution and careful monitoring. Inebilizumab: Moderate Concomitant usage of inebilizumab with immunosuppressant drugs, including systemic corticosteroids, may increase the risk of infection. Consider the risk of additive immune system effects when coadministering therapies that cause immunosuppression with inebilizumab.
Infliximab: Moderate Many serious infections during infliximab therapy have occurred in patients who received concurrent immunosuppressives that, in addition to their underlying Crohn's disease or rheumatoid arthritis, predisposed patients to infections.
The impact of concurrent infliximab therapy and immunosuppression on the development of malignancies is unknown. In clinical trials, the use of concomitant immunosuppressant agents appeared to reduce the frequency of antibodies to infliximab and appeared to reduce infusion reactions. Insulin Degludec; Liraglutide: Moderate Monitor blood glucose during concomitant corticosteroid and incretin mimetic use; an incretin mimetic dose adjustment may be necessary.
Insulin Glargine; Lixisenatide: Moderate Monitor blood glucose during concomitant corticosteroid and incretin mimetic use; an incretin mimetic dose adjustment may be necessary. Insulins: Moderate Monitor blood glucose during concomitant corticosteroid and insulin use; an insulin dose adjustment may be necessary. Irbesartan; Hydrochlorothiazide, HCTZ: Moderate Monitor potassium concentrations during concomitant corticosteroid and thiazide diuretic use due to risk for additive hypokalemia; potassium supplementation may be necessary.
Isavuconazonium: Moderate Concomitant use of isavuconazonium with prednisone may result in increased serum concentrations of prednisone. Prednisolone, the active metabolite of prednisone, is a substrate of the hepatic isoenzyme CYP3A4; additionally prednisone is a substrate of the drug transporter P-glycoprotein P-gp. Caution and close monitoring for adverse effects, such as corticosteroid-related side effects, are advised if these drugs are used together. Isoniazid, INH; Rifampin: Moderate Monitor for decreased corticosteroid efficacy if prednisone is used with rifampin; a dosage increase may be necessary.
Isoproterenol: Moderate The risk of cardiac toxicity with isoproterenol in asthma patients appears to be increased with the coadministration of corticosteroids.
Intravenous infusions of isoproterenol in refractory asthmatic children at rates of 0. Isotretinoin: Minor Both isotretinoin and corticosteroids can cause osteoporosis during chronic use. Patients receiving systemic corticosteroids should receive isotretinoin therapy with caution.
Itraconazole: Moderate Prednisone is metabolized by the liver to the active metabolite prednisolone. Monitor patients for corticosteroid-related side effects if both prednisone and itraconazole are taken. Ketoconazole: Moderate Monitor for corticosteroid-related adverse events if prednisone is used with ketoconazole. Concurrent use may increase the exposure of prednisone.
In a study, ketoconazole inhibited 6 beta-hydroxylase and increased the exposure of biologically active unbound prednisolone after oral prednisone administration. L-Asparaginase Escherichia coli: Moderate Concomitant use of L-asparaginase with corticosteroids can result in additive hyperglycemia. Ledipasvir; Sofosbuvir: Moderate Caution and close monitoring of prednisone-associated adverse reactions is advised with concomitant administration of ledipasvir.
Prednisone is a substrate of the drug transporter P-glycoprotein P-gp ; ledipasvir is a P-gp inhibitor. Taking these drugs together may increase prednisone plasma concentrations. Letermovir: Moderate A clinically relevant increase in the plasma concentration of prednisolone the active metabolite of prednisone may occur if given with letermovir. In patients who are also receiving treatment with cyclosporine, the magnitude of this interaction may be amplified.
Prednisolone is a CYP3A4 substrate. Levoketoconazole: Moderate Monitor for corticosteroid-related adverse events if prednisone is used with ketoconazole. Lidocaine; Epinephrine: Moderate Monitor potassium concentrations during concomitant corticosteroid and epinephrine use due to risk for additive hypokalemia; potassium supplementation may be necessary.
Linagliptin; Metformin: Moderate Monitor blood glucose during concomitant corticosteroid and metformin use; a metformin dose adjustment may be necessary.
Liraglutide: Moderate Monitor blood glucose during concomitant corticosteroid and incretin mimetic use; an incretin mimetic dose adjustment may be necessary. Lisinopril; Hydrochlorothiazide, HCTZ: Moderate Monitor potassium concentrations during concomitant corticosteroid and thiazide diuretic use due to risk for additive hypokalemia; potassium supplementation may be necessary.
Live Vaccines: Contraindicated Live vaccines should generally not be administered to an immunosuppressed patient. Live vaccines may induce the illness they are intended to prevent and are generally contraindicated for use during immunosuppressive treatment. The immune response of the immunocompromised patient to vaccines may be decreased, even despite alternate vaccination schedules or more frequent booster doses. If immunization is necessary, choose an alternative to live vaccination, or, consider a delay or change in the immunization schedule.
Practitioners should refer to the most recent CDC guidelines regarding vaccination of patients who are receiving drugs that adversely affect the immune system. Patients on corticosteroid treatment for 2 weeks or more may be vaccinated after steroid therapy has been discontinued for at least 3 months in accordance with general recommendations for the use of live vaccines.
The CDC has stated that discontinuation of steroids for 1 month prior to live vaccine administration may be sufficient. Live vaccines should not be given to individuals who are considered to be immunocompromised until more information is available. Lixisenatide: Moderate Monitor blood glucose during concomitant corticosteroid and incretin mimetic use; an incretin mimetic dose adjustment may be necessary. Lonafarnib: Moderate Monitor for corticosteroid-related adverse events if prednisone is used with lonafarnib.
Lonapegsomatropin: Moderate Corticosteroids can retard bone growth and therefore, can inhibit the growth-promoting effects of somatropin. If corticosteroid therapy is required, the corticosteroid dose should be carefully adjusted. Loop diuretics: Moderate Monitor potassium concentrations during concomitant corticosteroid and loop diuretic use due to risk for additive hypokalemia; potassium supplementation may be necessary.
Both corticosteroids and loop diuretics cause increased renal potassium loss. Lopinavir; Ritonavir: Moderate Coadministration of prednisone with ritonavir a strong CYP3A4 inhibitor may cause prednisone serum concentrations to increase, potentially resulting in Cushing's syndrome and adrenal suppression.
Losartan; Hydrochlorothiazide, HCTZ: Moderate Monitor potassium concentrations during concomitant corticosteroid and thiazide diuretic use due to risk for additive hypokalemia; potassium supplementation may be necessary.
Lumacaftor; Ivacaftor: Moderate Lumacaftor; ivacaftor may reduce the efficacy of prednisone and prednisolone by decreasing systemic exposure of the corticosteroid. If used together, a higher systemic corticosteroid dose may be required to obtain the desired therapeutic effect.
Lumateperone: Minor The manufacturer of lumateperone recommends that concurrent use of prednisone be avoided and lists prednisone as a CYP3A4 inducer. Lumateperone is a CYP3A4 substrate. However, prednisone is not an established CYP3A4 inducer, and the potential outcome of using this combination is unknown. Be alert for a potential reduction in lumateperone efficacy.
Macimorelin: Major Avoid use of macimorelin with drugs that directly affect pituitary growth hormone secretion, such as corticosteroids. Healthcare providers are advised to discontinue corticosteroid therapy and observe a sufficient washout period before administering macimorelin. Use of these medications together may impact the accuracy of the macimorelin growth hormone test.
Magnesium Salicylate: Moderate Monitor for gastrointestinal toxicity during concurrent corticosteroid and salicylate use. Mannitol: Moderate Corticosteroids may accentuate the electrolyte loss associated with diuretic therapy resulting in hypokalemia. Also, corticotropin may cause calcium loss and sodium and fluid retention. Mannitol itself can cause hypernatremia. Close monitoring of electrolytes should occur in patients receiving these drugs concomitantly. Mecasermin rinfabate: Moderate Additional monitoring may be required when coadministering systemic or inhaled corticosteroids and mecasermin, recombinant, rh-IGF In animal studies, corticosteroids impair the growth-stimulating effects of growth hormone GH through interference with the physiological stimulation of epiphyseal chondrocyte proliferation exerted by GH and IGF Dexamethasone administration on long bone tissue in vitro resulted in a decrease of local synthesis of IGF Similar counteractive effects are expected in humans.
If systemic or inhaled glucocorticoid therapy is required, the steroid dose should be carefully adjusted and growth rate monitored. Instead, the best way to dispose of your medication is through a medicine take-back program. In case of overdose, call the poison control helpline at If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at Keep all appointments with your doctor and the laboratory. Your blood sugar and urine sugar levels should be checked regularly to determine your response to glipizide.
Your doctor may order other lab tests, including glycosylated hemoglobin HbA1c , to check your response to glipizide. Your doctor will also tell you how to check your response to this medication by measuring your blood or urine sugar levels at home.
Follow these instructions carefully. If you are taking the extended-release tablets you may notice something that looks like a tablet in your bowel movement. This is just the empty tablet shell, and this does not mean that you did not get your complete dose of medication.
You should always wear a diabetic identification bracelet to be sure you get proper treatment in an emergency. Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription. It is important for you to keep a written list of all of the prescription and nonprescription over-the-counter medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital.
It is also important information to carry with you in case of emergencies. Generic alternatives may be available. Glipizide pronounced as glip' i zide. Why is this medication prescribed? How should this medicine be used? Other uses for this medicine What special precautions should I follow? What special dietary instructions should I follow? What should I do if I forget a dose?
What side effects can this medication cause? What should I know about storage and disposal of this medication? Brand names Brand names of combination products. Swallow the extended-release tablets whole. Do not chew, divide, or crush the tablets. Ask your pharmacist or doctor for a copy of the manufacturer's information for the patient. Other uses for this medicine. What special precautions should I follow?
Before taking glipizide, tell your doctor and pharmacist if you are allergic to glipizide, any other medications, or any of the ingredients in glipizide. Ask your pharmacist for a list of the ingredients. Also be sure to tell your doctor or pharmacist if you stop taking any medications while taking glipizide. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
If you are taking the extended-release tablet, tell your doctor if you have short bowel syndrome a condition where part of the intestine has been removed by surgery, damaged by disease, or you were born without part of your intestines ; you have narrowing or a blockage of the intestines; or if you have ongoing diarrhea.
If you become pregnant while taking glipizide, call your doctor. Alcohol may make the side effects of glipizide worse. Consuming alcohol while taking glipizide also rarely may cause symptoms such as flushing reddening of the face , headache, nausea, vomiting, chest pain, weakness, blurred vision, mental confusion, sweating, choking, breathing difficulty, and anxiety.
Glipizide may make your skin sensitive to sunlight. These conditions can affect your blood sugar and the amount of glipizide you may need. This medication may cause changes in your blood sugar.
You should know the symptoms of low and high blood sugar and what to do if you have these symptoms. Glipizide may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away: diarrhea gas feeling jittery dizziness uncontrollable shaking of a part of the body red or itchy skin rash hives blisters Some side effects can be serious.
If you experience any of these symptoms, call your doctor immediately: yellowing of the skin or eyes light-colored stools dark urine pain in the upper right part of the stomach unusual bruising or bleeding fever sore throat Glipizide may cause other side effects.
Send the page " " to a friend, relative, colleague or yourself. We do not record any personal information entered above. Commonly-prescribed oral corticosteroid with little mineralocorticoid activity; metabolized to prednisolone; prednisone is roughly 4 times as potent as hydrocortisone as a glucocorticoid Used in many conditions in adult and pediatric patients, including asthma, COPD, SLE, rheumatoid and psoriatic arthritis, prevention of transplant rejection, and many allergic, dermatologic, and inflammatory states If long-term therapy required, the lowest possible effective dose should be used.
For acute conditions, parenteral steroid therapy is recommended initially. NOTE: Hydrocortisone and cortisone are the preferred agents; prednisone has little to no mineralocorticoid properties. NOTE: Hydrocortisone is the preferred glucocorticoid in infants. Titrate to response. The usual range is 5 mg to 30 mg PO once daily. Renal transplant guidelines recommend a calcineurin inhibitor CNI such as tacrolimus and an antiproliferative agent such as mycophenolate plus or minus corticosteroids for initial prophylaxis.
In patients at low immunologic risk who receive induction therapy, corticosteroid discontinuation during first week after transplantation is suggested. Some evidence exists that steroids may be safely stopped in most patients after 3 to 12 months on combination therapy with a CNI and mycophenolate.
Data suggest that the risk of steroid withdrawal depends on the use of concomitant immunosuppressives, immunological risk, ethnicity, and time after transplantation. Once the prednisone taper is completed without a flare, the cyclosporine dose is tapered to alternate day dosing such that the patient is taking prednisone one day and cyclosporine the next day.
Once patients reach their maximal response, therapy is continued for another 3 months and then tapered. Multiple dosage regimens have been studied. Dosage requirements are variable though and should be individualized based on the response of the patient and tolerance to treatment. The American College of Gastroenterology states that corticosteroids are not effective for maintenance of medically-induced remission in Crohn's disease and should not be used for long-term treatment.
Corticosteroids for Crohn's disease are more effective for small-bowel involvement than for colonic involvement. Because of the potential complications of steroid use in this disease, steroids should be used selectively and in the lowest dose possible. Guidelines recommend oral corticosteroids to induce remission in persons with ulcerative colitis; however, guidelines recommend against systemic corticosteroids for the maintenance of remission.
Total course of treatment may range from 3 to 10 days. Dosing in the afternoon at PM may be helpful for patients prone to nocturnal symptoms, with no increase in adrenal suppression. Consider add-on low dose oral corticosteroids CS 7. Add CS only after exclusion of other contributory factors and consideration of other add-on treatments. In pediatric patients, the use of oral corticosteroids is usually limited to a few weeks until asthma control is improved and the patient can be stabilized on other, preferred treatments.
Increase by 5 mg every 2 to 3 days as needed. For chronic use, may change to every other day therapy. Usual dosage ranges from 5 to 30 mg PO once daily. Use the lowest effective dose usually less than 7.
American College of Rheumatology guidelines recommend 0. Taper the dose after a few weeks to the lowest effective dose that maintains control. Insufficient data exist to recommend a specific steroid taper because nephritis and extrarenal manifestations vary from patient to patient. Some patients may require long-term therapy.
If needed, the long-term maintenance dose is 0. In patients with severe skin reactions, higher initial doses e. Adjust until a satisfactory response is noted; taper as clinically indicated. High-dose corticosteroids are controversial; administration has been associated with decreased survival. Depending on the indication, the initial dose may be gradually tapered after 1 to 2 weeks and discontinued by 4 to 6 weeks, as guided by symptoms. Oral corticosteroids are usually reserved for cases not responding to standard topical treatments.
Use lowest effective dose. Corticosteroids are not indicated as initial treatment for anaphylaxis, but can be given as adjunctive therapy after the administration of epinephrine. Corticosteroid use in ARDS is controversial. The initial dosage may vary from 5 to 60 mg PO per day. Guidelines use a dose of 0. Taper to 0. Guidelines suggest use of prednisone with cyclophosphamide or azathioprine, and a minimum of 6 months duration.
Objective responses may not be noted until at least 3 months of therapy. Exact duration of treatment and need for long-term maintenance should be individualized to clinical response and tolerance of therapy. Chronic doses of prednisone 15 mg to 20 mg PO once daily may be adequate as maintenance therapy.
Gradually taper after 1 to 2 weeks and discontinue by 4 to 6 weeks, guided by symptoms. Weight-based dosing: 0. Gradually taper after 1 to 2 weeks and discontinue by 4 to 6 weeks, as guided by symptoms. Chemotherapy cycle is repeated every 57 days. Depending on indication, gradually taper the initial dose after 1 to 2 weeks and discontinue by 4 to 6 weeks, guided by symptoms. Guidelines recommend as adjunct therapy for meningitis.
Routine use outside of CNS involvement is not recommended; however, select patients may benefit. The National Institutes of Health NIH COVID treatment guidelines recommend prednisone as an alternative corticosteroid for hospitalized patients who require supplemental oxygen, including those on high-flow oxygen, noninvasive ventilation, mechanical ventilation, or extracorporeal membrane oxygenation ECMO.
The NIH recommends 40 mg PO once daily or in 2 divided doses for up to 10 days or until hospital discharge whichever comes first. The NIH advises clinicians to review the patient's medical history and assess the potential risks and benefits before starting prednisone.
Treatment cycles may be repeated when the granulocyte and platelet counts returned to normal. Response may be gradual over several months.
The optimal dosage of melphalan and prednisone plus thalidomide has not been clearly established and dosages have varied in randomized controlled trials. In one study, previously untreated patients between 65 and 75 years of age received melphalan 0. Thalidomide was stopped after day 4 of the last cycle. In another study, patients aged 75 years and older received melphalan 0. In cycles 1 through 4, bortezomib 1.
In cycles 5 to 9, bortezomib 1. Dosage not established. The progression-free survival time was not significantly improved with carfilzomib, melphalan, and prednisone compared with bortezomib, melphalan, and prednisone in a randomized, phase 3 trial the CLARION trial ; additionally, serious and fatal adverse reactions occurred more often in the carfilzomib-containing arm. There is not sufficient evidence to support the use of this drug combination for this indication. If side effects e.
NOTE: The definitive treatment for median-nerve entrapment is surgery. Corticosteroids are temporary measures; patients who have intermittent pain and paresthesias without any fixed motor sensory deficits may respond to conservative therapy. Initially, 20 mg to 30 mg PO once daily has been recommended. Some experts give a combination of prednisone and azathioprine. For maintenance, prednisone 5 mg to 15 mg PO once daily has been recommended. Doses for the various manifestations of SLE vary widely.
Maintenance doses are usually 10 to 20 mg PO once daily or 20 to 40 mg PO every other day. Initially, large doses e. Individualize dose and titrate to response. After symptoms controlled, decrease dose slowly every 5 to 7 days. Maintenance doses for chronic conditions are usually 10 to 20 mg PO once daily or 20 mg to 40 mg PO every other day. The treatment combination demonstrated superior results over colchicine alone in the treatment of primary amyloidosis. A multicenter, randomized, controlled trial confirmed that this shorter duration of low dose prednisone is equivalent to using 40 mg of prednisone for a longer duration i.
Data from studies indicate that systemic glucocorticoids shorten recovery time; improve lung function FEV-1improve oxygenation, and reduce the risk of early relapse, treatment failure, and the length of hospitalization. Taper dose over at least 6 weeks.
There is variation in the literature with regard to dosage regimens. Prednisone 0. Use of IV methylprednisolone for a few days may precede oral corticosteroid use. While many case reports suggest a possible net benefit to the use of corticosteroids, some experts advocate for more prospective study of their value.
Higher quality data are needed to establish the benefits vs. Experts generally agree that patients who have neurologic deficits should receive a corticosteroid; many patients with MSCC require corticosteroids to help preserve neurologic function, such as ambulation. Topically applied corticosteroids are as effective as systemic corticosteroids for anterior ocular inflammation.
Common regimens from high-quality clinical trials include a prednisone or prednisolone dose of 60 mg PO per day for 5 days, followed by a 5-day taper or 25 mg PO twice daily for 10 daysin combination with appropriate antiviral treatment. A prednisone dose of mg PO administered in descending doses over 10 days has also been used with efficacy.
The American Academy of Neurology notes that for new-onset Bell's palsy, steroids are effective in increasing the probability of complete facial functional recovery according to data derived from class I high quality studies. The optimal dose of prednisone for infantile spasms has not been determined. Based on the evidence currently available, the American Academy of Neurology and the Child Neurology Society's practice parameters for the treatment of infantile spasms state that there is insufficient evidence that oral corticosteroids are effective in the treatment of infantile spasms.
There are limited data available for the treatment of refractory seizure types in pediatric patients.
chlorthalidone; hydrochlorothiazide. Corticosteroids. These drugs may increase your blood sugar levels when taken with glipizide. Be sure to test your blood. Contraindicated. Never use this combination of drugs because of high risk for dangerous interaction. Medscape - Diabetes type 2-specific dosing for Glucotrol, Glucotrol XL (glipizide), frequency-based adverse effects, comprehensive interactions. Taking prednisone can make the liver resistant to insulin, which may lead to steroid-induced diabetes. In addition, people living with type 1 or type 2. Glipizide is a sulfonylurea medication used in Type 2 Diabetes to sensitize pancreatic beta can be increased when Prednisone is combined with Glipizide. The progression-free survival time evaluated via an independent review facility was significantly improved in patients with CDexpressing systemic anaplastic large-cell lymphoma sALCL or PTCL who received brentuximab vedotin plus cyclophosphamide, doxorubicin, and prednisone CHP compared with cyclophosphamide, doxorubicin, vincristine, and prednisone CHOP In addition, concomitant administration may predispose the patient to over-immunosuppression resulting in an increased risk for the development of severe infections. Less than a 2-fold increase in the midazolam AUC is not considered clinically important.Glipizide is used along with diet and exercise, and sometimes with other medications, to treat type 2 diabetes condition in which the body does not use insulin normally and, therefore, cannot control the amount of sugar in the blood. Glipizide is in a class of medications called sulfonylureas. Glipizide lowers blood sugar by causing the pancreas to produce insulin a natural substance that is needed to break down sugar in the body and helping the body use insulin efficiently.
This medication will only help lower blood sugar in people whose bodies produce insulin naturally. Glipizide is not used to treat type 1 diabetes condition in which the body does not produce insulin and, therefore, cannot control the amount of sugar in the blood or diabetic ketoacidosis a serious condition that may occur if high blood sugar is not treated. Over time, people who have diabetes and high blood sugar can develop serious or life-threatening complications, including heart disease, stroke, kidney problems, nerve damage, and eye problems.
Taking medication s , making lifestyle changes e. This therapy may also decrease your chances of having a heart attack, stroke, or other diabetes-related complications such as kidney failure, nerve damage numb, cold legs or feet; decreased sexual ability in men and women , eye problems, including changes or loss of vision, or gum disease.
Your doctor and other healthcare providers will talk to you about the best way to manage your diabetes. Glipizide comes as tablets and extended-release long-acting tablets to take by mouth. The regular tablet is usually taken one or more times a day, 30 minutes before breakfast or meals.
The extended-release tablet is usually taken once a day with breakfast. To help you remember to take glipizide, take it around the same time s every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand.
Take glipizide exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor. Your doctor will probably start you on a low dose of glipizide and gradually increase your dose if needed. After you have taken glipizide for some time, glipizide may not control your blood sugar as well as it did at the beginning of your treatment. Your doctor may adjust the dose of your medication as needed so that the medication will work best for you.
Be sure to tell your doctor how you are feeling and if your blood sugar test results have been higher or lower than normal at any time during your treatment.
Glipizide helps control blood sugar but does not cure diabetes. Continue to take glipizide even if you feel well. Do not stop taking glipizide without talking to your doctor. This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information. Be sure to follow all exercise and dietary recommendations made by your doctor or dietitian. It is important to eat a healthy diet, exercise regularly, and lose weight if necessary.
Before you start to take glipizide, ask you doctor what you should do if you forget to take a dose. Write these directions down so that you can refer to them later. As a general rule, take the missed dose as soon as you remember it. If it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule.
Do not take a double dose to make up for a missed one. Glipizide may cause other side effects. Call your doctor if you have any unusual problems while you are taking this medication.
In one study, people who took a medication similar to glipizide to treat their diabetes were more likely to die of heart problems than people who were treated with insulin and diet changes. Talk to your doctor about the risks of taking glipizide. Keep this medication in the container it came in, tightly closed, and out of reach of children.
Store it at room temperature and away from excess heat and moisture not in the bathroom. It is important to keep all medication out of sight and reach of children as many containers such as weekly pill minders and those for eye drops, creams, patches, and inhalers are not child-resistant and young children can open them easily.
To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location — one that is up and away and out of their sight and reach. Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet.
Instead, the best way to dispose of your medication is through a medicine take-back program. In case of overdose, call the poison control helpline at If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at Keep all appointments with your doctor and the laboratory. Your blood sugar and urine sugar levels should be checked regularly to determine your response to glipizide.
Your doctor may order other lab tests, including glycosylated hemoglobin HbA1c , to check your response to glipizide. Your doctor will also tell you how to check your response to this medication by measuring your blood or urine sugar levels at home. Follow these instructions carefully. If you are taking the extended-release tablets you may notice something that looks like a tablet in your bowel movement.
This is just the empty tablet shell, and this does not mean that you did not get your complete dose of medication. You should always wear a diabetic identification bracelet to be sure you get proper treatment in an emergency. Do not let anyone else take your medication.
Ask your pharmacist any questions you have about refilling your prescription. It is important for you to keep a written list of all of the prescription and nonprescription over-the-counter medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements.
You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.
Generic alternatives may be available. Glipizide pronounced as glip' i zide. Why is this medication prescribed? How should this medicine be used? Other uses for this medicine What special precautions should I follow? What special dietary instructions should I follow? What should I do if I forget a dose?
What side effects can this medication cause? What should I know about storage and disposal of this medication? Brand names Brand names of combination products. Swallow the extended-release tablets whole. Do not chew, divide, or crush the tablets. Ask your pharmacist or doctor for a copy of the manufacturer's information for the patient. Other uses for this medicine. What special precautions should I follow?
Before taking glipizide, tell your doctor and pharmacist if you are allergic to glipizide, any other medications, or any of the ingredients in glipizide.
Ask your pharmacist for a list of the ingredients. Also be sure to tell your doctor or pharmacist if you stop taking any medications while taking glipizide. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
If you are taking the extended-release tablet, tell your doctor if you have short bowel syndrome a condition where part of the intestine has been removed by surgery, damaged by disease, or you were born without part of your intestines ; you have narrowing or a blockage of the intestines; or if you have ongoing diarrhea.
If you become pregnant while taking glipizide, call your doctor. Alcohol may make the side effects of glipizide worse. Consuming alcohol while taking glipizide also rarely may cause symptoms such as flushing reddening of the face , headache, nausea, vomiting, chest pain, weakness, blurred vision, mental confusion, sweating, choking, breathing difficulty, and anxiety.
Glipizide may make your skin sensitive to sunlight. These conditions can affect your blood sugar and the amount of glipizide you may need. This medication may cause changes in your blood sugar. You should know the symptoms of low and high blood sugar and what to do if you have these symptoms. Glipizide may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away: diarrhea gas feeling jittery dizziness uncontrollable shaking of a part of the body red or itchy skin rash hives blisters Some side effects can be serious.
If you experience any of these symptoms, call your doctor immediately: yellowing of the skin or eyes light-colored stools dark urine pain in the upper right part of the stomach unusual bruising or bleeding fever sore throat Glipizide may cause other side effects.
Symptoms of overdose may include hypoglycemia symptoms as well as the following: seizures loss of consciousness. What other information should I know? Brand names. Brand names of combination products. Browse Drugs and Medicines.
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