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Concomitant use of aspirin (or other nonsteroidal anti-inflammatory agents) and corticosteroids increases the risk of gastrointestinal side effects. Aspirin should be used cautiously in conjunction with corticosteroids in hypoprothrombinemia. The clearance of salicylates may be increased with concurrent use of corticosteroids.

Because corticosteroids may increase blood glucose concentrations.dosage adjustments of antidiabetic agents may be required.

IT SHOULD BE EMPHASIZED THAT DOSAGE REQUIREMENTS ARE VARIABLE AND MUST BE INDIVIDUALIZED ON THE BASIS OF THE DISEASE UNDER TREATMENT AND THE RESPONSE OF THE PATIENT.

Administration of live or live.attenuated vaccines is contraindicated in patients receiving immunosuppressive doses of corticosteroids. Killed or decadron shipping vaccines may be administered. However.the response to such vaccines cannot be predicted. Immunization procedures may be undertaken in patients who are receiving corticosteroids as replacement therapy.e.g..for Addison’s disease.

Corticosteroids decrease bone formation and increase bone resorption both through their effect on calcium regulation (i.e..decreasing absorption and increasing excretion) and inhibition of osteoblast function. This.together with a decrease in the protein matrix of the bone secondary to an increase in protein catabolism.and reduced sex hormone production.may lead to inhibition of bone growth in decadron shipping patients and the development of osteoporosis at any age. Special consideration should be given to patients at increased risk of osteoporosis (e.g..postmenopausal women) before initiating corticosteroid therapy.

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