Diuretics: Concurrent use of potassium-depleting diuretics with corticosteroids may result in severe hypokalaemia.
Digitalis glycosides: Concurrent use with glucocorticoids may increase the possibility of arrhythmias or digitalis toxicity associated with hypokalaemia.
Anti-diabetic agents, sulfonylurea or Insulin: Glucocorticoids may increase blood glucose concentration; dosage adjustment of one or both agents may be necessary during concurrent use.
Alcohol or Anti-inflammatory drugs, non-steroidal (NSAIDS): Risk of gastrointestinal ulceration or haemorrhage may be increased when these substances are used concurrently with glucocorticoids: however, concurrent use of NSAIDS in the treatment of arthritis may provide additive therapeutic benefit and permit glucocorticoid dosage reduction.
Anticoagulants, coumarin, or indandione - derivative, or Heparin or Streptokinase or Urokinase: Effects of coumarin or indandione derivatives are usually decreased but may be increased in some patients when used concurrently with glucocorticoids. Dosage adjustments based on prothrombin time determinations may be necessary during and after glucocorticoid therapy.
Vaccines, live virus or other immunizations: Administration may increase the risk of the patient's developing the viral disease and/or decrease the patient's antibody response to the vaccine and is not recommended.
Liver enzyme-inducing drugs, e.g. rifampicin, ephedrine, barbiturates, phenytoin, phenobarbitone and primidone: Concurrent use may decrease the corticosteroid effect because of increased corticosteroid metabolism resulting from induction of hepatic microsomal enzymes.
Salicylates: Glucocorticoids may increase salicylate excretion and reduce salicylate plasma concentrations so that the salicylate dosage requirement may be increased; salicylism may occur when glucocorticoid dosage is subsequently decreased or discontinued, especially in patients receiving large (anti-rheumatic) doses of salicylates; also, the risk of gastrointestinal ulceration or haemorrhage may be increased.
Combinations containing any of the following medications depending on the amount present, may also interact with this medications: Acetaminophen (paracetamol); Aminoglutethimide; Amphotericin B, parenteral or Carbonic anhydrase inhibitors; Anabolic steroids or Androgens; Anticholinergics, especially atropine and related compounds; Antidepressants, tricyclic; Contraceptives, oral, estrogen-containing, or Oestrogen; Folic Acid; Immunosuppressant agents, other; lsoniazid, Mexiletine; lophendylate or Metrizamide; Mitotane; Neuromuscular blocking agents, nondepolarizing; pancuronium; Potassium supplements; Ritodrine; Sodium-containing medication or foods; Somatrem or Somatropin; Streptozocin.