NSAIDs Prednisolone

Clinically important, potentially hazardous interactions with aldesleukin, aspirin, diflunisal, diuretics, methotrexate, NSAIDs, prednisolone, prednisone, sermorelin, tiludronate, torsemide, triamterene, urokinase... 

Notwithstanding DMARDs therapy (NSAIDs and/or prednisolone and/or hydroxychloroquine and/or azathioprine) lupus nephritis still develops in 48% of patients with SLE. Of these 40% develop into End Stage Renal Disease and subsequent mortality mostly due to infections. 

Systemic steroids (e.g. prednisolone) can also be used. These may be of use in patients with severe or polyarticular attacks or those with renal disease or heart failure which may preclude the use of NSAIDs or colchicine. 

No controlled studies have been performed to determine whether NSAIDs are helpful in providing symptom relief in EKC. However, in animal studies there is a suggestion that treatment of EKC using topical NSAIDs may be a safer alternative to using potent topical steroids (e.g., 1% prednisolone acetate) to control symptoms during the acute phase. 

Acute gout is usually treated with an NSAID in full dose. Any such drug which is tolerated may be used (except aspirin which in low dose promotes urate retention, see below) indomethacin is often chosen because of its strong anti-inflammatory action and efficacy. If treatment is started early, the attack may be terminated in a few hours. Colchicine is useful if NSAIDs are contraindicated. If neither colchicine nor NSAIDs are tolerated, oral prednisolone 40 mg/d and tapered over a week is also effective. It requires only a moment s thought to appreciate that the uricosurics and allopurinol will not relieve an acute attack of gout. 

Clinically important, potentially hazardous interactions with amiloride, aminoglycosides, amphotericin B, ampicillin, anisindione, anticoagulants, armodafinil, atorvastatin, azathioprine, azithromycin, bacampicillin, basiliximab, bezafibrate, bosentan, bupropion, carbenicillin, caspofungin, cholestyramine, clarithromycin, cloxacillin, co-trimoxazole, corticosteroids, cyclophosphamide, daclizumab, danazol, dicloxacillin, dicumarol, digoxin, diltiazem, disulfiram, echinacea, erythromycin, ethotoin, etoposide, ezetimibe, flunisolide, fluoxymesterone, fluvastatin, foscarnet, fosphenytoin, gemfibrozil, hemophilus B vaccine, HMG-CoA reductase inhibitors, imatinib, imipenem/cilastatin, influenza vaccines, ketoconazole, lanreotide, lopinavir, lovastatin, mephenytoin, methicillin, methoxsalen, methylphenidate, methylprednisolone, methyltestosterone, mezlocillin, mizolastine, mycophenolate, nafcillin, nisoldipine, NSAIDs, orlistat, oxacillin, penicillins, phellodendron, phenytoin, pravastatin, prednisolone, prednisone, pristinamycin, ranolazine, red rice yeast, rifabutin, rifampin, rifapentine, ritonavir, rosuvastatin, simvastatin, sirolimus, spironolactone, St John s wort, sulfacetamide, sulfadiazine, sulfamethoxazole, sulfisoxazole, sulfonamides, tacrolimus, telithromycin, tenoxicam, testosterone, ticarcillin, tolvaptan, trabectedin, triamterene, troleandomycin, ursodeoxycholic acid, vaccines, vecuronium, warfarin, zofenopril... 

Clinically important, potentially hazardous interactions with acitretin, aldesleukin, aminoglycosides, amiodarone, amoxicillin, ampicillin, aspirin, bacampicillin, bismuth, carbenicillin, chloroquine, cisplatin, cloxacillin, co-trimoxazole, dapsone, demeclocycline, dexamethasone, diclofenac, dicloxacillin, etodolac, etoricoxib, etretinate, fenoprofen, flurbiprofen, folic acid antagonists, haloperidol, hydrocortisone, ibuprofen, indomethacin, influenza vaccines, ketoprofen, ketorolac, lithium, magnesium trisalicylate, meclofenamate, mefenamic acid, methicillin, mezlocillin, minocycline, nabumetone, nafcillin, naproxen, NSAIDs, omeprazole, oxacillin, oxaprozin, oxytetracycline, paromomycin, penicillin G, penicillin V, penicillins, phenylbutazone, piperacillin, piroxicam, polypeptide antibiotics, prednisolone, prednisone, probenecid, procarbazine, rofecoxib, salicylates, salsalate, sapropterin, sulfadiazine, sulfamethoxazole, sulfapyridine, sulfasalazine, sulfisoxazole, sulindac, tazobactum, tenoxicam, tetracycline, ticarcillin, tolmetin, trimethoprim, vaccines... 

Almost three decades ago, steroids namely prednisolone, dexamethasone, betamethasone, triamcinoline and hydrocortisone were considered to be the dmg of choice as anti-inflammatory agents. Owing to the several adverse effects caused by either short-term or long-term steroid therapy, these have been more or less replaced by much safer and better tolerated non-steroidal anti-inflammatory drugs (NSAIDs). 

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