Dyspepsia, esophagitis, peptic ulcer with possible perforation and hemorrhage, abdominal distention, esophageal ulceration, esophageal candidiasis, pancreatitis, perforation of bowel, gastric hemorrhage, of the small and large bowel particularly in patients with inflammatory bowel disease, ulcerative esophagitis, hepatomegaly, nausea.
Evaluation of serum liver enzyme levels (alanine transaminase, aspartate transaminase and alkaline phosphatase) which are usually reversible upon discontinuation have also occurred.
Musculoskeletal Effects: Proximal myopathy, steroid myopathy, osteoporosis, pathological fracture of long bones, compression fractures, avascular osteonecrosis, tendon rupture, aseptic necrosis of femoral and humeral heads. Charcot-like arthropathy, muscle weakness, steroid myopathy, aseptic necrosis, loss of mass, and tendon rupture (particularly of the Achilles tendon).
Impaired wound healing (usually at high doses), petechiae, and ecchymosis, thin fragile skin, facial erythema, skin atrophy, bruising, striae, increased sweating, telangiectasia, acne, burning or tingling (especially in the perineal area, after intravenous injection), dry scaly skin, impaired wound healing, rash and allergic dermatitis. Reports of Kaposi's sarcoma occurrence in patients receiving corticosteroid therapy; discontinuation of corticosteroids may result in clinical remission.
Suppression of hypothalamo-pituitary-adrenal axis; growth suppression in infants, children and adolescents, menstrual irregularities and amenorrhea, development of cushingoid state, glycosuria, hyperglycemia. hirsutism, hypertrichosis, weight gain, decreased carbohydrate tolerance, increased requirements for insulin or oral hypoglycemic agents in diabetes, negative nitrogen and calcium balance due to protein catabolism, increased appetite manifestations of latent diabetes mellitus, secondary adrenocortical and pituitary unresponsiveness particularly in times of stress as in trauma, surgery or illness.
Irritability, emotional instability, euphoria, depression, suicidal thoughts, mania, delusions, hallucinations, aggravation of schizophrenia, behavioral disturbances, anxiety, sleep disturbances, cognitive dysfunction, seizures, convulsions, confusion, amnesia, increased intracranial pressure with papilledema (pseudo cerebri) usually after discontinuation of treatment, psychic disorders insomnia, mood swings, neuritis, neuropathy, paresthesia, personality changes, exacerbation of pre-existing emotional instability or psychotic tendencies, headache, and vertigo.
Glaucoma, increased intraocular pressure, posterior subcapsular cataracts (associated with prolonged, high dose systemic therapy), exophthalmos, papilledema with possible damage to the optic nerve, cataracts, corneal or sclera thinning, exacerbation or ophthalmic viral or fungal disease.
Myocardial rupture following recent myocardial infarction, bradycardia. cardiac arrest, cardiac arrhythmias, cardiac enlargement, circulatory collapse, fat embolism, cardiomyopathy in premature infants, pulmonary edema, syncope, tachycardia, thromboembolism, thrombophlebitis, and vasculitis.
Immune System Effects:
Masking of infections, latent infections becoming active, including of tuberculosis and opportunistic infections, allergic reactions including anaphylactoid reactions, anaphylaxis, and angioedema; may suppress reactions to skin tests.
Parenteral corticosteroid therapy may also induce hyperpigmentation or hypopigmentation, subcutaneous and cutaneous atrophy, sterile abscess, anaphylactoid reaction (e.g., bronchospasm, laryngeal edema, urticaria).
Fluid and Electrolyte Disturbances:
Congestive heart failure in susceptible patients, hypertension, hypokalemic alkalosis, fluid retention, potassium loss, sodium retention, and increased calcium excretion.
Abnormal fat deposits, decreased resistance to infection hiccups, increased or motility and number of spermatozoa, injection site infections following non-sterile administration, malaise, moon face, weight gain.