Glucocorticoid drug interactions

Multiple drug interactions may occur with the glucocorticoids. Table 50-2 identifies select clinically significant interactions. 

Drug interactions Excessive glucocorticoid therapy may inhibit the growth-promoting effects of human growth hormone. 

Drug interactions that affect the efficacy of glucocorticoids have been reviewed (16). 

Because of their enzyme-inducing effects, barbiturates can cause increased inactivation of other compounds (anticoagulants, phenytoin, theophylline, digoxin, glucocorticoids, etc.). This may lead to serious problems with drug interactions. 

Glucocorticoid chemistry, pharmacokitietics, and drug interactions are described in Chapter 59. Prednisone, prednisolone, and other glucocorticoids are used alone and in combination with other immunosuppressive agents for treatment of transplant rejection and autoimmune disorders. 

Therapeutic Uses Mycophenolate mofetil is indicated for prophylaxis of transplant rejection, and it typically is used in combination with glucocorticoids and a calcineurin inhibitor, but not with azathioprine. Combined treatment with siroUmus is possible, although potential drug interactions necessitate careful monitoring of drug levels. For renal transplants, 1 g is administered orally or intravenously (over 2 hours) twice daily (2 g/day). A higher dose, 1.5 g twice daily (3 g/day), is recommended for African American renal transplant patients and all cardiac transplant patients. 

Kawai S, Ichikawa Y. Drug interactions between glucocorticoids and other drugs. Nippon Rinsho 99A) 52, 773-8. 

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