Fluid and Electrolyte Disturbances: Sodium and fluid retention, potassium loss and hypokalemic alkalosis.
Musculoskeletal: Muscle weakness, steroid myopathy, vertebral compression fractures, aseptic necrosis, pathologic fractures, osteoporosis and tendon rupture, particularly of the Achilles tendon.
Gastrointestinal: Peptic ulcer with possible perforation and hemorrhage; pancreatitis; esophagitis; gastric hemorrhage; and perforation of the bowel. Increases in alanine transaminase (ALT, SGPT) and aspartate transaminase (AST, SGOT) have been observed. These changes are not associated with any chemical syndromes and are reversible upon discontinuation.
Dermatologic: Impaired wound healing; thin, fragile skin; petechiae and ecchymoses; facial erythema; increased sweating and may suppress reactions to skin tests.
Neurological: Increased intracranial pressure, pseudotumor cerebri, psychic derangements, seizures, convulsions, vertigo and headache.
Endocrine: Menstrual irregularities; development of Cushingoid state; suppression of pituitary-adrenal axis; suppression of growth in children; secondary adrenocortical and pituitary unresponsiveness particularly in times of stress as in trauma, surgery or illness; decreased carbohydrate tolerance; manifestations of latent diabetes mellitus and increased requirements for insulin or oral hypoglycemic agents in diabetics.
Ophthalmic: Posterior subcapsular cataracts, increased intraocular pressure, glaucoma and exophthalmos.
Immune System: Masking of infections; latent infections becoming active; opportunistic infections; may suppress reactions to skin tests; hypersensitivity reactions including anaphylaxis.
Metabolic: Negative nitrogen balance due to protein catabolism.
The following additional reactions are related to parenteral corticosteroid therapy: Hyperpigmentation or hypopigmentation; SC and cutaneous atrophy; sterile abscess and anaphylactic reaction with or without circulatory collapse, cardiac arrest, bronchospasm, urticaria, nausea and vomiting, cardiac arrhythmias; hypotension or hypertension.