Can you take Cortisone with Nifedipine?
1 drug interaction and 56 additional warnings found for the following 2 drugs:
- cortisone
- nifedipine
Drug interactions
Moderate drug interactions
Moderate:
NIFEdipine cortisone
Applies to: nifedipine and cortisone
Cortisone may reduce the effects of NIFEdipine in lowering blood pressure. The interaction is most likely to occur when cortisone is used for more than a week, since prolonged use can cause sodium and water retention.
Let your doctor know if you experience sudden, unexplained weight gain or swelling of the hands, ankles, or feet.
You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications.
It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
Food/lifestyle interactions
Moderate food/lifestyle interactions
Moderate:
NIFEdipine Food/Lifestyle
Applies to: nifedipine
You should avoid or limit the consumption of grapefruit and grapefruit juice if you are receiving treatment with NIFEdipine.
Grapefruit juice can significantly increase the blood levels and effects of medications like NIFEdipine.
You may be more likely to experience side effects such as:
- headache
- low blood pressure
- irregular heartbeat
- swelling
- fluid retention
Talk to your doctor or pharmacist if you have any questions or concerns. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
Moderate:
cortisone Food/Lifestyle
Applies to: cortisone
Using cortisone together with alcohol or grapefruit may increase the risk of side effects of cortisone.
You may want to limit your consumption of grapefruit, grapefruit juice, and/or alcohol during treatment with cortisone.
Talk to your doctor if you have any questions or concerns.
You should seek immediate medical attention if you experience any unusual bleeding or bruising, or have other signs and symptoms of bleeding such as:
- dizziness
- lightheadedness
- red or black, tarry stools
- coughing up or vomiting fresh or dried blood that looks like coffee grounds
- severe headache
- weakness
It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
Moderate:
NIFEdipine Alcohol (Ethanol)
Applies to: nifedipine
Ethanol and NIFEdipine may have additive effects in lowering your blood pressure.
You may experience headache, dizziness, lightheadedness, fainting, or changes in pulse or heart rate, especially when treatment is started, the dose is changed, or treatment is restarted.
Tell your doctor promptly if these symptoms occur and seek urgent medical help if you faint or have severe dizziness.
Avoid driving or operating hazardous machinery until you know how the medications affect you, and use caution when getting up from a sitting or lying position.
It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
Moderate:
NIFEdipine multivitamins with minerals
Applies to: nifedipine
Using NIFEdipine together with multivitamins with minerals can decrease the effects of NIFEdipine.
Talk with your doctor before using NIFEdipine and multivitamins with minerals together. You may need a dose adjustment or need your blood pressure checked more often if you take both medications.
It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
Disease interactions
52 potential interactions Applies to: 46 conditions, including High Blood Pressure, High Cholesterol, Depression, Underactive Thyroid, and Heart Failure.
Abnormal Glucose Tolerance
Moderate:
cortisone
Cortisone has a moderate potential interaction with Abnormal Glucose Tolerance.
Corticosteroids can raise blood glucose level by antagonizing the action and suppressing the secretion of insulin, which results in inhibition of peripheral glucose uptake and increased gluconeogenesis. Therapy with corticosteroids should be administered cautiously in patients with diabetes mellitus, glucose intolerance, or a predisposition to hyperglycemia. Patients with diabetes mellitus should be monitored more closely during corticosteroid therapy, and their antidiabetic regimen adjusted accordingly.
Adrenal Tumor
Moderate:
cortisone
Cortisone has a moderate potential interaction with Adrenal Tumor.
Corticosteroids mimic the effects of endogenous cortisol and aldosterone. Use of these agents may aggravate conditions of hyperadrenocorticalism in a dose-dependent manner.
Aortic Stenosis
Major:
nifedipine
NIFEdipine has a major potential interaction with Aortic Stenosis.
The use of some calcium channel blockers (CCBs) is contraindicated in patients with advanced aortic stenosis. CCBs whose pharmacologic effect is partially dependent on their ability to reduce afterload (e.g., diltiazem, nicardipine, nifedipine, verapamil) may be of less benefit in these patients due to a fixed impedance to flow across the aortic valve and may, in fact, worsen rather than improve myocardial oxygen balance. Rarely, heart failure has developed following the initiation of these CCBs, particularly in patients receiving concomitant beta-blocker therapy.
Cardiogenic Shock
Major:
nifedipine
NIFEdipine has a major potential interaction with Cardiogenic Shock.
In general, calcium channel blockers (CCBs) should not be used in patients with hypotension (systolic pressure < 90 mm Hg) or cardiogenic shock. Due to potential negative inotropic and peripheral vasodilating effects, the use of CCBs may further depress cardiac output and blood pressure, which can be detrimental in these patients. The use of verapamil and diltiazem is specifically contraindicated under these circumstances.
Cataract
Moderate:
cortisone
Cortisone has a moderate potential interaction with Cataract.
Prolonged use of corticosteroids may cause posterior subcapsular cataracts and elevated intraocular pressure, the latter of which may lead to glaucoma and/or damage to the optic nerves. Long-term therapy with corticosteroids should be administered cautiously in patients with a history of cataracts, glaucoma, or increased intraocular pressure.
Cirrhosis
Moderate:
cortisone
Cortisone has a moderate potential interaction with Cirrhosis.
Corticosteroids may have enhanced effects on patients with cirrhosis due to decreased metabolism of these agents. Patients with cirrhosis should be monitored more closely for excessive cortisol effects. Dosage adjustments may be required in these patients.
Depression
Moderate:
cortisone
Cortisone has a moderate potential interaction with Depression.
Corticosteroids may aggravate the symptoms of psychosis and emotional instability. Patients with these conditions should be monitored for increased or worsened symptoms during corticosteroid therapy.
Diabetes Mellitus
Moderate:
cortisone
Cortisone has a moderate potential interaction with Diabetes Mellitus.
Corticosteroids can raise blood glucose level by antagonizing the action and suppressing the secretion of insulin, which results in inhibition of peripheral glucose uptake and increased gluconeogenesis. Therapy with corticosteroids should be administered cautiously in patients with diabetes mellitus, glucose intolerance, or a predisposition to hyperglycemia. Patients with diabetes mellitus should be monitored more closely during corticosteroid therapy, and their antidiabetic regimen adjusted accordingly.
Diverticulitis
Moderate:
cortisone
Cortisone has a moderate potential interaction with Diverticulitis.
Corticosteroids may cause gastrointestinal perforation and hemorrhage, usually when given in high dosages or for prolonged periods. They may also mask symptoms of complications such as peritonitis or intraabdominal sepsis. Therapy with corticosteroids should be avoided or administered cautiously in patients with diverticulitis, nonspecific ulcerative colitis (if there is a probability of impending perforation, abscess, or other pyogenic infection), or recent intestinal anastomoses.
Electrolyte Abnormalities
Moderate:
cortisone
Cortisone has a moderate potential interaction with Electrolyte Abnormalities.
Corticosteroids can cause hypernatremia, hypokalemia, and fluid retention. These mineralocorticoid effects are most significant with fludrocortisone, followed by hydrocortisone and cortisone, then by prednisone and prednisolone. The remaining corticosteroids, betamethasone, dexamethasone, methylprednisolone, and triamcinolone, have little mineralocorticoid activities. However, large doses of any corticosteroid can demonstrate these effects, particularly if given for longer than brief periods. All corticosteroids also increase excretion of calcium and can cause hypocalcemia. Therapy with corticosteroids should be administered cautiously in patients with preexisting electrolyte disturbances. Caution is also advised when treating patients with seizure disorders, since electrolyte disturbances may trigger seizure activity.
Fluid Retention
Moderate:
cortisone
Cortisone has a moderate potential interaction with Fluid Retention.
Corticosteroids may cause hypernatremia, hypokalemia, fluid retention, and elevation in blood pressure. Large doses of any corticosteroid can demonstrate these effects, particularly if given for longer periods. Therapy with corticosteroids should be administered cautiously in patients with preexisting fluid retention, hypertension, congestive heart failure, and/or renal dysfunction. Dietary sodium restriction and potassium supplementation may be advisable.
Gastrointestinal Obstruction
Moderate:
nifedipine
NIFEdipine has a moderate potential interaction with Gastrointestinal Obstruction.
The extended-release formulation of nifedipine (Procardia XL) contains a non-deformable material. There have been rare reports of obstructive symptoms in patients with known strictures following the ingestion of similar sustained-release products. Therapy with the extended-release formulation of nifedipine should be administered cautiously in patients with preexisting severe gastrointestinal narrowing or obstruction, whether pathologic or iatrogenic.
Glaucoma/Intraocular Hypertension
Moderate:
cortisone
Cortisone has a moderate potential interaction with Glaucoma/Intraocular Hypertension.
Prolonged use of corticosteroids may cause posterior subcapsular cataracts and elevated intraocular pressure, the latter of which may lead to glaucoma and/or damage to the optic nerves. Long-term therapy with corticosteroids should be administered cautiously in patients with a history of cataracts, glaucoma, or increased intraocular pressure.
Heart Attack
Major:
nifedipine
NIFEdipine has a major potential interaction with Heart Attack.
Nifedipine capsules should not be administered within the first two weeks after myocardial infarction, and they should also be avoided in the setting of acute coronary syndrome (when myocardial infarction may be imminent). Clinical trials studying the use of immediate-release nifedipine in patients who had just sustained myocardial infarctions have not demonstrated any benefit and in some cases patients had worse outcomes compared to those who received placebo.
Moderate:
cortisone
Cortisone has a moderate potential interaction with Heart Attack.
The use of corticosteroids may be associated with left ventricular free-wall rupture in patients who have had a recent myocardial infarction. Pharmacologic dosages of corticosteroids should be administered with great caution in such patients.
Moderate:
nifedipine
NIFEdipine has a moderate potential interaction with Heart Attack.
Calcium channel blockers (CCBs) may have varying degrees of negative inotropic effect. Congestive heart failure (CHF), worsening of CHF, and pulmonary edema have occurred in some patients treated with a CCB, primarily verapamil. Some CCBs have also caused mild to moderate peripheral edema due to localized vasodilation of dependent arterioles and small blood vessels, which can be confused with the effects of increasing left ventricular dysfunction. Although some CCBs have been used in the treatment of CHF, therapy with CCBs should be administered cautiously in patients with severe left ventricular dysfunction (e.g., ejection fraction < 30%) or moderate to severe symptoms of cardiac failure and in patients with any degree of ventricular dysfunction if they are receiving a beta-adrenergic blocker. Likewise, caution is advised in patients with acute myocardial infarction and pulmonary congestion documented by X-ray on admission, since associated heart failure may be acutely worsened by administration of a CCB.
Heart Failure
Moderate:
cortisone
Cortisone has a moderate potential interaction with Heart Failure.
Corticosteroids may cause hypernatremia, hypokalemia, fluid retention, and elevation in blood pressure. Large doses of any corticosteroid can demonstrate these effects, particularly if given for longer periods. Therapy with corticosteroids should be administered cautiously in patients with preexisting fluid retention, hypertension, congestive heart failure, and/or renal dysfunction. Dietary sodium restriction and potassium supplementation may be advisable.
Moderate:
nifedipine
NIFEdipine has a moderate potential interaction with Heart Failure.
Calcium channel blockers (CCBs) may have varying degrees of negative inotropic effect. Congestive heart failure (CHF), worsening of CHF, and pulmonary edema have occurred in some patients treated with a CCB, primarily verapamil. Some CCBs have also caused mild to moderate peripheral edema due to localized vasodilation of dependent arterioles and small blood vessels, which can be confused with the effects of increasing left ventricular dysfunction. Although some CCBs have been used in the treatment of CHF, therapy with CCBs should be administered cautiously in patients with severe left ventricular dysfunction (e.g., ejection fraction < 30%) or moderate to severe symptoms of cardiac failure and in patients with any degree of ventricular dysfunction if they are receiving a beta-adrenergic blocker. Likewise, caution is advised in patients with acute myocardial infarction and pulmonary congestion documented by X-ray on admission, since associated heart failure may be acutely worsened by administration of a CCB.
Herpetic Keratitis
Moderate:
cortisone
Cortisone has a moderate potential interaction with Herpetic Keratitis.
Pharmacologic dosages of corticosteroids should be used cautiously in patients with ocular herpes simplex because of the risk of corneal perforation. Corticosteroids are not recommended for patients with active ocular herpes simplex.
High Blood Pressure
Major:
nifedipine
NIFEdipine has a major potential interaction with High Blood Pressure.
For the long-term treatment of hypertension, only the extended-release formulations of nifedipine should be used. The US National Heart, Lung, and Blood Institute and the FDA Cardiovascular and Renal Drug Advisory Committee have issued warnings against the use of immediate-release nifedipine for this purpose based on review of three epidemiologic studies of patients with hypertension and unstable angina who were treated with calcium channel blockers (CCBs) and at least two meta-analyses of randomized, controlled trials that included patients receiving CCBs. Two of the case-control studies found an increased risk of myocardial infarction (MI) in patients taking immediate-release nifedipine, although the third did not.
The use of immediate-release nifedipine (orally or sublingually) is also contraindicated for acute reduction of blood pressure. Profound hypotension, acute myocardial infarction, and deaths have been reported when nifedipine was used in this manner.
Moderate:
cortisone
Cortisone has a moderate potential interaction with High Blood Pressure.
Corticosteroids may cause hypernatremia, hypokalemia, fluid retention, and elevation in blood pressure. Large doses of any corticosteroid can demonstrate these effects, particularly if given for longer periods. Therapy with corticosteroids should be administered cautiously in patients with preexisting fluid retention, hypertension, congestive heart failure, and/or renal dysfunction. Dietary sodium restriction and potassium supplementation may be advisable.
High Cholesterol
Moderate:
cortisone
Cortisone has a moderate potential interaction with High Cholesterol.
Corticosteroids may elevate serum triglyceride and LDL cholesterol levels if used for longer than brief periods. Patients with preexisting hyperlipidemia may require closer monitoring during prolonged corticosteroid therapy, and adjustments made accordingly in their lipid-lowering regimen.
History, Peptic Ulcer
Moderate:
cortisone
Cortisone has a moderate potential interaction with History, Peptic Ulcer.
Corticosteroids may cause peptic ulcer disease and gastrointestinal (GI) hemorrhage, usually when given in high dosages or for prolonged periods. However, even conventional dosages may aggravate symptoms in patients with a history of peptic ulcers. Delayed healing of ulcers has also been reported. Therapy with corticosteroids should be avoided or administered cautiously in patients with active or latent peptic ulcers or other risk factors for GI bleeding. Some clinicians recommend the use of prophylactic antacids or H2-antagonists between meals when large doses of corticosteroids are necessary.
History, Thrombotic/Thromboembolic Disorder
Moderate:
cortisone
Cortisone has a moderate potential interaction with History, Thrombotic/Thromboembolic Disorder.
Corticosteroids may increase blood coagulability and have rarely been associated with the development of intravascular thrombosis, thromboembolism, and thrombophlebitis. Therapy with corticosteroids should be administered cautiously in patients who have or may be predisposed to thrombotic or thromboembolic disorders.
History, Tuberculosis
Moderate:
cortisone
Cortisone has a moderate potential interaction with History, Tuberculosis.
In patients with latent tuberculosis or tuberculin reactivity, the use of pharmacologic dosages of corticosteroids may cause a reactivation of the disease. Close monitoring for signs and symptoms of tuberculosis is recommended if corticosteroid therapy is administered to patients with a history of tuberculosis or tuberculin reactivity. During prolonged corticosteroid therapy, tuberculosis chemoprophylaxis may be considered.
Hyperadrenocorticism
Moderate:
cortisone
Cortisone has a moderate potential interaction with Hyperadrenocorticism.
Corticosteroids mimic the effects of endogenous cortisol and aldosterone. Use of these agents may aggravate conditions of hyperadrenocorticalism in a dose-dependent manner.
Hyperaldosteronism
Moderate:
cortisone
Cortisone has a moderate potential interaction with Hyperaldosteronism.
Corticosteroids mimic the effects of endogenous cortisol and aldosterone. Use of these agents may aggravate conditions of hyperadrenocorticalism in a dose-dependent manner.
Hypernatremia
Moderate:
cortisone
Cortisone has a moderate potential interaction with Hypernatremia.
Corticosteroids can cause hypernatremia, hypokalemia, and fluid retention. These mineralocorticoid effects are most significant with fludrocortisone, followed by hydrocortisone and cortisone, then by prednisone and prednisolone. The remaining corticosteroids, betamethasone, dexamethasone, methylprednisolone, and triamcinolone, have little mineralocorticoid activities. However, large doses of any corticosteroid can demonstrate these effects, particularly if given for longer than brief periods. All corticosteroids also increase excretion of calcium and can cause hypocalcemia. Therapy with corticosteroids should be administered cautiously in patients with preexisting electrolyte disturbances. Caution is also advised when treating patients with seizure disorders, since electrolyte disturbances may trigger seizure activity.
Hypocalcemia
Moderate:
cortisone
Cortisone has a moderate potential interaction with Hypocalcemia.
Corticosteroids can cause hypernatremia, hypokalemia, and fluid retention. These mineralocorticoid effects are most significant with fludrocortisone, followed by hydrocortisone and cortisone, then by prednisone and prednisolone. The remaining corticosteroids, betamethasone, dexamethasone, methylprednisolone, and triamcinolone, have little mineralocorticoid activities. However, large doses of any corticosteroid can demonstrate these effects, particularly if given for longer than brief periods. All corticosteroids also increase excretion of calcium and can cause hypocalcemia. Therapy with corticosteroids should be administered cautiously in patients with preexisting electrolyte disturbances. Caution is also advised when treating patients with seizure disorders, since electrolyte disturbances may trigger seizure activity.
Hypokalemia
Moderate:
cortisone
Cortisone has a moderate potential interaction with Hypokalemia.
Corticosteroids can cause hypernatremia, hypokalemia, and fluid retention. These mineralocorticoid effects are most significant with fludrocortisone, followed by hydrocortisone and cortisone, then by prednisone and prednisolone. The remaining corticosteroids, betamethasone, dexamethasone, methylprednisolone, and triamcinolone, have little mineralocorticoid activities. However, large doses of any corticosteroid can demonstrate these effects, particularly if given for longer than brief periods. All corticosteroids also increase excretion of calcium and can cause hypocalcemia. Therapy with corticosteroids should be administered cautiously in patients with preexisting electrolyte disturbances. Caution is also advised when treating patients with seizure disorders, since electrolyte disturbances may trigger seizure activity.
Hypotension
Major:
nifedipine
NIFEdipine has a major potential interaction with Hypotension.
In general, calcium channel blockers (CCBs) should not be used in patients with hypotension (systolic pressure < 90 mm Hg) or cardiogenic shock. Due to potential negative inotropic and peripheral vasodilating effects, the use of CCBs may further depress cardiac output and blood pressure, which can be detrimental in these patients. The use of verapamil and diltiazem is specifically contraindicated under these circumstances.
Infection
Major:
cortisone
Cortisone has a major potential interaction with Infection.
The immunosuppressant and anti-inflammatory effects of corticosteroids, particularly at higher dosages, may reduce resistance to infectious agents, increase the risk of disseminated infections, mask symptoms of infection, and reactivate or exacerbate latent/resolved infections; fatal cases have been reported. Avoid use of corticosteroids in patients with cerebral malaria. Screen patients for active (or history of) infection with tuberculosis, hepatitis, varicella, measles, and amebiasis, especially prior to prolonged treatment. Closely monitor for reactivation of latent infections; chemoprophylaxis may be required. In general, corticosteroids should not be used in patients with active infections, especially systemic fungal infections, unless medically necessary to control drug reactions. However, for corticosteroid-dependent patients who develop a severe or life-threatening infection, continuation of corticosteroid therapy with at least physiologic replacement dosages should be considered, since these patients may have secondary adrenocortical insufficiency. Removal of external steroid during periods of stress may be detrimental to these patients.
Intestinal Anastomoses
Moderate:
cortisone
Cortisone has a moderate potential interaction with Intestinal Anastomoses.
Corticosteroids may cause gastrointestinal perforation and hemorrhage, usually when given in high dosages or for prolonged periods. They may also mask symptoms of complications such as peritonitis or intraabdominal sepsis. Therapy with corticosteroids should be avoided or administered cautiously in patients with diverticulitis, nonspecific ulcerative colitis (if there is a probability of impending perforation, abscess, or other pyogenic infection), or recent intestinal anastomoses.
Ischemic Heart Disease
Major:
nifedipine
NIFEdipine has a major potential interaction with Ischemic Heart Disease.
Increased frequency, duration, and/or severity of angina, as well as acute myocardial infarction, have rarely developed during initiation or dosage increase of calcium channel blockers (CCBs), particularly in patients with severe obstructive coronary artery disease and those treated with immediate-release formulations. The mechanism of this effect is not established. Therapy with CCBs should be administered cautiously in patients with significant coronary artery disease.
Liver Disease
Major:
nifedipine
NIFEdipine has a major potential interaction with Liver Disease.
Calcium channel blockers (CCBs) are extensively metabolized by the liver. The half-lives of CCBs may be prolonged substantially in patients with severe hepatic impairment, with the potential for significant drug accumulation. In addition, the use of some CCBs has been associated with elevations in serum transaminases, both with and without concomitant elevations in alkaline phosphatase and bilirubin. While these effects may be transient and reversible, some patients have developed cholestasis or hepatocellular injury. Therapy with CCBs should be administered cautiously and often at reduced dosages in patients with significantly impaired hepatic function. Periodic monitoring of liver function is advised.
Moderate:
cortisone
Cortisone has a moderate potential interaction with Liver Disease.
Corticosteroids are primarily metabolized by the liver and may have enhanced effects in patients with liver disease. Dosage adjustments may be necessary in these patients.
Myasthenia Gravis
Moderate:
cortisone
Cortisone has a moderate potential interaction with Myasthenia Gravis.
Although corticosteroids are commonly used in the treatment of myasthenia gravis to increase muscle strength, these agents should nevertheless be administered with caution in such setting. Patients should be treated in an intensive care unit and receive respiratory support, since muscle strength may markedly decrease initially, particularly with high dosages. Preferably, therapy should begin with relatively low dosages (15 to 25 mg/day of prednisone or equivalent) and be increased stepwise as tolerated (approximately 5 mg/day of prednisone or equivalent at 2- to 3-day intervals until marked clinical improvement or a dosage of 50 mg/day is reached). Improvement may be delayed and gradual. Thus, it is important not to discontinue therapy prematurely.
Myoneural Disorder
Moderate:
cortisone
Cortisone has a moderate potential interaction with Myoneural Disorder.
Toxic myopathy has been observed with the chronic use or the administration of large doses of corticosteroids, often in patients with disorders of neuromuscular transmission such as myasthenia gravis or in patients receiving neuromuscular blocking agents. Fluorinated corticosteroids such as betamethasone, dexamethasone, and triamcinolone appear to cause more severe muscle atrophy and weakness than the nonfluorinated agents. Moreover, multiple-daily doses are more toxic than once-daily or, preferably, alternate-day morning doses. Steroid myopathy is generalized and sometimes accompanied by respiratory weakness and dyspnea. In some cases, it has resulted in quadriparesis. Elevations of creatine kinase (CK) may also occur, albeit infrequently. After withdrawal of corticosteroid therapy, recovery may be slow and incomplete. Therapy with corticosteroids should be administered cautiously in patients with preexisting myopathy or myoneural disorders since these conditions may confound the diagnosis of steroid-induced myopathy. The presence of a normal serum CK level, minimal/no changes of myopathy on electromyography, and type 2 muscle fiber atrophy on biopsy are helpful in suggesting steroid-induced weakness. If steroid myopathy is suspected, a dosage reduction or discontinuation of the steroid should be considered.
Myopathy
Moderate:
cortisone
Cortisone has a moderate potential interaction with Myopathy.
Toxic myopathy has been observed with the chronic use or the administration of large doses of corticosteroids, often in patients with disorders of neuromuscular transmission such as myasthenia gravis or in patients receiving neuromuscular blocking agents. Fluorinated corticosteroids such as betamethasone, dexamethasone, and triamcinolone appear to cause more severe muscle atrophy and weakness than the nonfluorinated agents. Moreover, multiple-daily doses are more toxic than once-daily or, preferably, alternate-day morning doses. Steroid myopathy is generalized and sometimes accompanied by respiratory weakness and dyspnea. In some cases, it has resulted in quadriparesis. Elevations of creatine kinase (CK) may also occur, albeit infrequently. After withdrawal of corticosteroid therapy, recovery may be slow and incomplete. Therapy with corticosteroids should be administered cautiously in patients with preexisting myopathy or myoneural disorders since these conditions may confound the diagnosis of steroid-induced myopathy. The presence of a normal serum CK level, minimal/no changes of myopathy on electromyography, and type 2 muscle fiber atrophy on biopsy are helpful in suggesting steroid-induced weakness. If steroid myopathy is suspected, a dosage reduction or discontinuation of the steroid should be considered.
Osteoporosis
Moderate:
cortisone
Cortisone has a moderate potential interaction with Osteoporosis.
Corticosteroids reduce osteoblastic function and inhibit the absorption of intestinal calcium, which can result in bone resorption and bone loss during prolonged therapy. In addition, bone matrix may be affected by the protein-catabolic effects of corticosteroids, especially when given in high dosages or for prolonged periods, leading to aseptic necrosis and fractures. Long-term or high-dose corticosteroid therapy should be administered cautiously and only if necessary in patients with or at risk for osteoporosis. Adverse skeletal effects may be minimized by alternate-day or intermittent administration. Any patient receiving prolonged therapy with the equivalent of 7.5 mg prednisone/day or more are at risk for glucocorticoid-induced osteoporosis and should be managed according to The American College of Rheumatology (ACR) guidelines.
Peptic Ulcer
Moderate:
cortisone
Cortisone has a moderate potential interaction with Peptic Ulcer.
Corticosteroids may cause peptic ulcer disease and gastrointestinal (GI) hemorrhage, usually when given in high dosages or for prolonged periods. However, even conventional dosages may aggravate symptoms in patients with a history of peptic ulcers. Delayed healing of ulcers has also been reported. Therapy with corticosteroids should be avoided or administered cautiously in patients with active or latent peptic ulcers or other risk factors for GI bleeding. Some clinicians recommend the use of prophylactic antacids or H2-antagonists between meals when large doses of corticosteroids are necessary.
Post MI Syndrome
Moderate:
cortisone
Cortisone has a moderate potential interaction with Post MI Syndrome.
The use of corticosteroids may be associated with left ventricular free-wall rupture in patients who have had a recent myocardial infarction. Pharmacologic dosages of corticosteroids should be administered with great caution in such patients.
Psychosis
Moderate:
cortisone
Cortisone has a moderate potential interaction with Psychosis.
Corticosteroids may aggravate the symptoms of psychosis and emotional instability. Patients with these conditions should be monitored for increased or worsened symptoms during corticosteroid therapy.
Renal Dysfunction
Moderate:
cortisone
Cortisone has a moderate potential interaction with Renal Dysfunction.
Corticosteroids may cause hypernatremia, hypokalemia, fluid retention, and elevation in blood pressure. Large doses of any corticosteroid can demonstrate these effects, particularly if given for longer periods. Therapy with corticosteroids should be administered cautiously in patients with preexisting fluid retention, hypertension, congestive heart failure, and/or renal dysfunction. Dietary sodium restriction and potassium supplementation may be advisable.
Moderate:
nifedipine
NIFEdipine has a moderate potential interaction with Renal Dysfunction.
Although the clearance of nifedipine is not dependent on renal function, use of the drug in patients with uremia has been associated with enhanced pharmacologic effects, possibly due to increased sensitivity to the drug or reduced protein binding. Rarely, reversible elevations in BUN and serum creatinine have been reported in patients with preexisting chronic renal insufficiency given nifedipine, although a causal relationship has not been established. Nephritis and renal failure have also been observed. Therapy with nifedipine should be administered cautiously in patients with significantly impaired renal function.
Seizures
Moderate:
cortisone
Cortisone has a moderate potential interaction with Seizures.
Corticosteroids can cause hypernatremia, hypokalemia, and fluid retention. These mineralocorticoid effects are most significant with fludrocortisone, followed by hydrocortisone and cortisone, then by prednisone and prednisolone. The remaining corticosteroids, betamethasone, dexamethasone, methylprednisolone, and triamcinolone, have little mineralocorticoid activities. However, large doses of any corticosteroid can demonstrate these effects, particularly if given for longer than brief periods. All corticosteroids also increase excretion of calcium and can cause hypocalcemia. Therapy with corticosteroids should be administered cautiously in patients with preexisting electrolyte disturbances. Caution is also advised when treating patients with seizure disorders, since electrolyte disturbances may trigger seizure activity.
Strongyloidiasis
Moderate:
cortisone
Cortisone has a moderate potential interaction with Strongyloidiasis.
Unlike most helminths, Strongyloides stercoralis has the ability to replicate in the human host. In patients with strongyloidiasis, the use of pharmacologic or immunosuppressive dosages of corticosteroids may result in Strongyloides hyperinfection and dissemination with widespread larval migration, often accompanied by severe enterocolitis and potentially fatal gram-negative septicemia. Therapy with corticosteroids should be administered with extreme caution, if at all, in these patients. For patients on corticosteroids who develop known or suspected Strongyloides infestation, withdrawal of corticosteroids or reduction of the dose of corticosteroids is recommended.
Systemic Sclerosis
Moderate:
cortisone
Cortisone has a moderate potential interaction with Systemic Sclerosis.
In patients with scleroderma, corticosteroids may precipitate renal crisis with malignant hypertension, possibly via steroid-induced increases in renin substrate and angiotensin II levels and decreases in vasodilator prostaglandin production. Renal failure may ensue. Therapy with corticosteroids should be administered cautiously in patients with scleroderma. In addition, they should be limited to short-term use.
Thrombotic/Thromboembolic Disorder
Moderate:
cortisone
Cortisone has a moderate potential interaction with Thrombotic/Thromboembolic Disorder.
Corticosteroids may increase blood coagulability and have rarely been associated with the development of intravascular thrombosis, thromboembolism, and thrombophlebitis. Therapy with corticosteroids should be administered cautiously in patients who have or may be predisposed to thrombotic or thromboembolic disorders.
Tuberculosis, Latent
Moderate:
cortisone
Cortisone has a moderate potential interaction with Tuberculosis, Latent.
In patients with latent tuberculosis or tuberculin reactivity, the use of pharmacologic dosages of corticosteroids may cause a reactivation of the disease. Close monitoring for signs and symptoms of tuberculosis is recommended if corticosteroid therapy is administered to patients with a history of tuberculosis or tuberculin reactivity. During prolonged corticosteroid therapy, tuberculosis chemoprophylaxis may be considered.
Ulcerative Colitis
Moderate:
cortisone
Cortisone has a moderate potential interaction with Ulcerative Colitis.
Corticosteroids may cause gastrointestinal perforation and hemorrhage, usually when given in high dosages or for prolonged periods. They may also mask symptoms of complications such as peritonitis or intraabdominal sepsis. Therapy with corticosteroids should be avoided or administered cautiously in patients with diverticulitis, nonspecific ulcerative colitis (if there is a probability of impending perforation, abscess, or other pyogenic infection), or recent intestinal anastomoses.
Underactive Thyroid
Moderate:
cortisone
Cortisone has a moderate potential interaction with Underactive Thyroid.
Corticosteroids may have enhanced effects in hypothyroidism due to decreased metabolism of these agents. Patients with hypothyroidism should be monitored more closely for excessive cortisol effects. Dosage adjustments may be required secondary to changes in their thyroid condition.
More resources
cortisone
A total of 678 drugs are known to interact with cortisone.
- Cortisone is in the drug class glucocorticoids.
-
Cortisone is used to treat the following conditions:
- Adrenal Insufficiency
- Ankylosing Spondylitis
- Berylliosis
- Bursitis
- Chorioditis
- Chorioretinitis
- Conjunctivitis
- Crohn's Disease, Active
- Dermatomyositis
- Epicondylitis, Tennis Elbow
- Erythroblastopenia
- Gouty Arthritis
- Hemolytic Anemia
- Immune Thrombocytopenia
- Iridocyclitis
- Iritis
- Keratitis
- Loeffler's Syndrome
- Lupus
- Lymphoma
- Nephrotic Syndrome
- Osteoarthritis
- Psoriatic Arthritis
- Rheumatoid Arthritis
- Sarcoidosis
- Shock
- Ulcerative Colitis, Active
- Uveitis
nifedipine
A total of 668 drugs are known to interact with nifedipine.
- Nifedipine is in the drug class calcium channel blockers.
-
Nifedipine is used to treat the following conditions:
- Angina Pectoris Prophylaxis
- High Blood Pressure
- Hypertensive Emergency (off-label)
- Hypertrophic Cardiomyopathy (off-label)
- Migraine Prevention (off-label)
- Premature Labor (off-label)
- Raynaud's Syndrome (off-label)
Drug Interaction Classification
| Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
| Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
| Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan. | |
| No interaction information available. |
Further information
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.