Hysone Special Precautions





Full Prescribing Info
Special Precautions
Use with caution in patients with thyroid disease, hepatic impairment, renal impairment, heart failure, hypertension, diabetes, glaucoma, cataracts, myasthenia gravis, patients at risk for osteoporosis, patients at risk for seizures, or GI diseases (diverticulitis, peptic ulcer, ulcerative colitis) due to perforation risk. Use caution following acute MI (corticosteroids have been associated with myocardial rupture). Because of the risk of adverse effects, systemic corticosteroids should be used cautiously in the elderly in the smallest possible effective dose for the shortest duration. May affect growth velocity; growth should be routinely monitored in pediatric patients. Withdraw therapy with gradual tapering of dose.
May cause hypercorticism or suppression of hypothalamic-pituitary-adrenal (HPA) axis, particularly in younger children or in patients receiving high doses for prolonged periods. HPA axis suppression may lead to adrenal crisis. Withdrawal and discontinuation of a corticosteroid should be done slowly and carefully. Particular care is required when patients are transferred from systemic corticosteroids to inhaled products due to possible adrenal insufficiency or withdrawal from steroids, including an increase in allergic symptoms. Patients receiving >20 mg per day of prednisolone (or equivalent) may be most susceptible. Fatalities have occurred due to adrenal insufficiency in asthematic patients during and after transfer from systemic corticosteroids to aerosol steroids; aerosol steroids do not provide the systemic steroid needed to treat patients having trauma, surgery, or infections.
Acute myopathy has been reported with high dose corticosteroids, usually in patients with neuromuscular transmission disorders; may involve ocular and/or respiratory muscles; monitor creatinine kinase; recovery may be delayed. Corticosteroid use may cause psychiatric disturbances, including depression, euphoria, insomnia, mood swings, and personality changes. Pre-existing psychiatric conditions may be exacerbated by corticosteroid use.
Prolonged use of corticosteroids may also increase the incidence of secondary infection, mask acute infection (including fungal infections), prolong or exacerbate viral infections, or limit response to vaccines. Exposure to chickenpox should be avoided; corticosteroids should not be used to treat ocular herpes simplex. Corticosteroids should not be used for cerebral malaria or viral hepatitis. Oral steroid treatment is not recommended for the treatment of acute optic neuritis. Close observation is required in patients with latent tuberculosis and/or TB reactivity; restrict use in active TB (only in conjunction with antitubercolosis treatment). Prolonged treatment with corticosteroids has been associated with the development of Kaposi's sarcoma (case reports); if noted, discontinuation of therapy should be used to manage acute head injury.
Use in Children: Carefully observe growth and development of infants and children on prolonged corticosteroid therapy.
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