Cortisone (Cortone Acetate) – Side Effects, Interactions, Uses, Dosage, Warnings

uses

What is Cortisone (Cortone Acetate) used for?

• Adrenal Insufficiency
• Allergic Rhinitis
• Anaphylaxis
• Ankylosing Spondylitis
• Atopic Dermatitis
• Bursitis
• Dermatitis Herpetiformis
• Idiopathic (Immune) Thrombocytopenic Purpura
• Loeffler’s Syndrome
• Nephrotic Syndrome
• Osteoarthritis
• Psoriasis
• Rheumatoid Arthritis
• Sarcoidosis
• Seborrheic Dermatitis
• Shock
• Systemic Lupus Erythematosus
• Ulcerative Colitis — Active
• Uveitis
• Anemia
• Asthma
• Iritis
• Gouty Arthritis
• Hemolytic Anemia
• Cardiogenic Shock
• G-6-PD Deficiency
• Pulmonary Impairment
• Tuberculous Meningitis
• Collagen Vascular Disease
• Thalassemia
• Keratitis
• Adrenogenital Syndrome
• Conjunctivitis
• Visual Defect/Disturbance
• Sepsis
• Sickle Cell Anemia
• Thrombotic Thrombocytopenic Purpura
• Infectious Posterior Uveitis
• Hemoglobinopathy
• Hemolytic Uremic Syndrome
• Herpes Simplex Iridocyclitis
• Herpes Zoster Iridocyclitis
• Adrenal Tuberculosis
• Allergic Asthma
• Autoimmune Disorder
• Autoimmune Hemolytic Anemia
• Infectious Anterior Uveitis
• Bone Marrow Depression/Low Blood Counts
• Pemphigus
• Felty’s Syndrome
• Psoriatic Arthropathy
• Rheumatoid Lung
• Adrenal Hemorrhage
• Waterhouse-Friderichsen Syndrome
• Syphilitic Uveitis
• Uveitis (Anterior)
• Panuveitis
• Uveitis (Posterior)
• Lymphoma
• Psoriatic Arthritis
• Dermatomyositis
• Epicondylitis
• Iridocyclitis
• Chorioretinitis
• Choroiditis
• Erythroblastopenia
• Berylliosis
• Serum Sickness
• Erythema Multiforme

warnings

What is the most important information I should know about Cortisone (Cortone Acetate)?

You should not use cortisone if you are allergic to it, or if you have a fungal infection anywhere in your body.

Steroids can weaken your immune system, making it easier for you to get an infection or worsening an infection you already have. Tell your doctor about any illness or infection you had within the past several weeks, especially:

• tuberculosis;
• herpes infection of the eyes; or
• a parasite infection that causes diarrhea (such as threadworms).

Tell your doctor if you have ever had:

• cirrhosis or other liver disease;
• kidney disease;
• a thyroid disorder;
• osteoporosis;
• a muscle disorder such as myasthenia gravis;
• glaucoma or cataracts;
• stomach ulcers, ulcerative colitis, or diverticulitis;
• depression or mental illness;
• congestive heart failure; or
• high blood pressure.

Tell your doctor if you are pregnant or breastfeeding.

Side Effects

What are the side effects of Cortisone (Cortone Acetate)?

Get emergency medical help if you have signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

• blurred vision, eye pain or redness, seeing halos around lights;
• swelling, rapid weight gain, feeling short of breath;
• unusual changes in mood or behavior;
• skin lesions;
• sudden unusual pain in a bone or joint;
• severe headaches, ringing in your ears, pain behind your eyes;
• stomach bleeding–bloody or tarry stools, coughing up blood or vomit that looks like coffee grounds;
• pancreatitis–severe pain in your upper stomach spreading to your back, nausea and vomiting; or
• low blood potassium–leg cramps, constipation, irregular heartbeats, fluttering in your chest, increased thirst or urination, numbness or tingling, muscle weakness or limp feeling.

Cortisone can affect growth in children. Tell your doctor if your child is not growing at a normal rate.

Common side effects may include:

• high blood pressure;
• muscle pain or weakness;
• sleep problems (insomnia), mood changes;
• thinning skin, bruising or discoloration;
• increased sweating;
• headache, dizziness, spinning sensation;
• stomach pain, bloating; or
• slow wound healing.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Pregnancy & Breastfeeding

Can I take Cortisone (Cortone Acetate) if I’m pregnant or breastfeeding?

Tell your doctor if you are pregnant or breastfeeding.

Interactions

What drugs and food should I avoid while taking Cortisone (Cortone Acetate)?

Ask your doctor before receiving a vaccine. The vaccine may not work as well while you are using cortisone.

Avoid being near people who are sick or have infections. Call your doctor for preventive treatment if you are exposed to chickenpox or measles. These conditions can be serious or even fatal in people who are using cortisone.

Avoid drinking alcohol.

Dosage Guidelines & Tips

How to take Cortisone (Cortone Acetate)?

Use Cortisone (Cortone Acetate) exactly as directed on the label, or as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended.

What should I do if I missed a dose of Cortisone (Cortone Acetate)?

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

Overdose Signs

What happens if I overdose on Cortisone (Cortone Acetate)?

High doses or long-term use of steroid medicine can lead to thinning skin, easy bruising, changes in body fat (especially in your face, neck, back, and waist), increased acne or facial hair, menstrual problems, impotence, or loss of interest in sex.

If you think you or someone else may have overdosed on: Cortisone (Cortone Acetate),  call your doctor or the Poison Control center

(800) 222-1222

If someone collapses or isn’t breathing after taking Cortisone (Cortone Acetate), call 911

911

What to Expect

The length of time you take cortisone will depend on your condition and your response to treatment.

If you take cortisone for a long time, you may be more likely to develop an infection. Be sure to wash your hands often and report any unusual symptoms to your healthcare provider.

Don’t stop taking cortisone suddenly without talking to your doctor.

Secondary Uses

Cortisone may be used for many other medical conditions that aren’t listed in this guide. For instance, cortisone is sometimes used to treat nausea and vomiting in people who receive chemotherapy or to stimulate appetite in certain patients.

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Allergic-type reactions to corticosteroids – PubMed

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Review

. 1999 Apr;33(4):451-60.

doi: 10.1345/aph.18276.

G L Kamm 
¹
, K O Hagmeyer

Affiliations

Affiliation

• ¹ College of Pharmacy, University of Toledo, OH 43606, USA. [email protected]

• PMID:

  10332537

• DOI:

  10.1345/aph.18276

Review

G L Kamm et al.

Ann Pharmacother.

1999 Apr.

. 1999 Apr;33(4):451-60.

doi: 10.1345/aph.18276.

Authors

G L Kamm 
¹
, K O Hagmeyer

Affiliation

• ¹ College of Pharmacy, University of Toledo, OH 43606, USA. [email protected]

• PMID:

  10332537

• DOI:

  10.1345/aph.18276

Abstract

Objective:

To review reported cases of suspected allergic reactions to various corticosteroids.

Data sources:

A MEDLINE search (January 1966-December 1997) was performed to obtain case reports and review articles on allergic-type reactions to corticosteroids. Further references were obtained from these publications.

Study selection:

Reports involving allergic or allergic-type reactions to systemic administration of corticosteroids were chosen for this review. An allergic-type reaction was defined as any reaction after administration of the drug that involved the appearance of adverse symptoms that are characteristic of unwanted immune responses. These symptoms include rash, sneezing, dyspnea, edema, bronchospasm, or death. Articles were excluded from the evaluation if they described reactions to topical, intraarticular, or ophthalmic corticosteroid administration.

Data synthesis:

Corticosteroids are medications that are often used to treat allergic reactions. However, it appears that patients can also have allergic-type reactions to these agents. The severity of the reaction can vary from a rash to anaphylaxis or death. Both immediate and delayed reactions can occur. Allergic-type reactions are reported to occur more frequently in asthmatic and renal transplant patients than other patient populations. However, it is questionable whether all of these are true allergic responses, as there is conflicting evidence regarding the mechanism of the reaction. The most commonly implicated corticosteroids are methylprednisolone and hydrocortisone, but reactions have also occurred with others. Intradermal skin testing can help determine cross-sensitivity, although its value has not been conclusively demonstrated.

Conclusions:

Clinicians should be aware that allergic reactions to corticosteroids are possible. Worsening of symptoms may not always mean treatment failure, but may indicate an allergic reaction. High doses of corticosteroids (> or = 500 mg) should be given over 30-60 minutes, and patients should be observed after administration for at least the same time period. Asthmatics, renal transplant patients, and hemodynamically unstable patients may be at higher risk for adverse events. If a patient is found to be allergic to one corticosteroid, intradermal skin testing may help identify another corticosteroid that can be tolerated.

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antihistamines and cortisone, how to use them correctly

However, antihistamines and cortisone are drugs with a certain degree of invasiveness.

As a result, they can be harmful, both directly and through side effects, if used incorrectly.

How do antihistamines work?

Antihistamines are drugs used to treat allergy symptoms by counteracting the action of histamine receptors, a substance released by immune system cells when the body comes into contact with common allergens such as dust mites, pollen, and food.

Antihistamines, taken as nasal sprays, eye drops, capsules, tablets, and creams, are ideal for controlling common reactions such as itching, swelling, runny nose, nasal congestion, sneezing, watery eyes, and hives.

How do corticosteroids work?

Cortisone drugs are drugs used for anti-inflammatory and immunosuppressive treatment of allergy symptoms.

These drugs modify the body’s response to immune stimuli, taking effect within a short time, and are therefore suitable for acute allergy attacks. The physician must carefully evaluate the benefit / risk ratio in relation to undesirable effects.

Antihistamines and Cortisone Side Effects

Antihistamines and corticosteroids should always be taken in the order and dosage recommended by your doctor to minimize side effects.

First generation antihistamines (currently used mainly in hospitals) have several side effects such as:

• drowsiness and decreased alertness and concentration
• insomnia, nervousness, anxiety
• increased appetite, urinary retention, constipation.

In contrast, second-generation antihistamines are less active on the central nervous system and have almost no side effects, but their use is associated with an increased risk of cardiac arrhythmias.

On the other hand, the undesirable effects of corticosteroids are mainly associated with their use, since over time they can cause:

• acne, redness and skin changes
• weight gain and edema due to water retention
• hyperglycemia and high blood pressure
• osteoporosis and muscle weakness.

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Allergic Contact Dermatitis and Atopic Dermatitis : differences

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CORTISOL AND ITS RELATION TO IMMUNE REACTIONS

Cortisol and Allergy

Allergy is certainly a subject of immunology, because it is associated with hypersensitivity of the immune system. Immunity refers to the immunity of the body to antigens (foreign pathogens, infectious agents).

Glucocorticoids affect the immune system by inhibiting the phagocytic activity of lymphocytes and reducing their number in the blood. Therefore, synthetic analogues of cortisol are used to treat allergic diseases, as they can have anti-allergic and anti-inflammatory effects.

Mechanism of origin of allergic reactions

Allergic reactions can be immediate (E-dependent) and immunocytotoxic. An important role in the formation of an allergic reaction is played by mast cells, which are found in large numbers in the nasal cavity, upper and lower respiratory tract, and also in the skin. Mast cells have special receptors on their surface, with which they can bind to immunoglobulins E. When allergen molecules interact with immunoglobulin E antibodies, special substances – mediators – begin to be released from mast cell granules.

The first of them was discovered by scientists histamine (probably even people who are far from the world of medicine know the term “antihistamine drug” – a drug that suppresses allergic reactions). A consequence of the activity of mast cells is also the release of arachidonic acid, a precursor of prostaglandins and leukotrienes. Prostaglandins are active biological substances that are formed from fatty acids, they affect blood circulation, lung function, and regulate cell metabolism.

The most common allergic diseases are:

• allergic rhinitis – allergic disease of the nasal cavity
• bronchial asthma – allergic disease of the lower respiratory tract
• allergic dermatitis – allergic skin lesion

The best known synthetic analogues of cortisol are dexamethasone and prednisolone. They are an effective remedy against allergic diseases, as they have the ability to suppress the immune system. How are cortisol and the immune system related?

Glucocorticoids. Cortisol and the immune system.

Immunity can be innate (for example, all people are immune to canine distemper) and acquired (after scarlet fever, the chance of getting sick again is negligible). Acquired immunity can be natural (after an illness) or artificial (after a vaccine). Allergy is an immune reaction in which the human body produces immunoglobulins E, which serve as antibodies to certain proteins.

The main cells of the immune system are leukocytes.

Man is surrounded by a huge number of unfavorable factors – without protection mechanisms, he simply could not resist a huge variety of viruses, bacteria and protozoa attacking his body. The human immune system protects the body from diseases by detecting and destroying potentially threatening substances.

Immunity is an integral system of protecting the body from various diseases and adverse environmental factors.

Adverse environmental factors:

• Bacteria
• Viruses
• Protozoa
• Somatic mutations: malignant transformation

Despite the fact that all these factors are very far from each other and have different origins, they have one thing in common – they are all genetically alien to the human body. Substances that threaten a person in science are called antigens. Antigen – a substance of a certain structure that is potentially dangerous for the body.

Main organs of the immune system:

• Bone marrow
• Spleen
• Lymph nodes
• Thymus (mammary gland)

Lymphocytes are one of the types of leukocytes, the main cells of the immune system. The main function of lymphocytes is participation in the work of immunity. We can safely say that lymphocytes form the backbone of the human immune system, because they are its defenders, destroying foreign structures.

In the course of evolution, a universal mechanism for protecting a person from harmful environmental factors was formed – immunity. The main cells of the immune system are lymphocytes (one of the types of white blood cells).

Immune system functions:

• Recognition of foreign agents
• Neutralizing them with special protective proteins

A change in the number of lymphocytes in the blood indicates the beginning of an inflammatory process – the body fights against the “invader” by increasing the number of lymphocytes. Lymphocytes synthesize protective proteins-antibodies that are involved in providing immunity.

Antibodies are protective immunoglobulin proteins (lgG, lgM, lgA, lgD, lgE). Antibodies are produced by B-lymphocytes. In addition to immunoglobulins, the immune system also activates other biological substances: interferons, lysozyme, etc.

The main thing in the development of inflammation is phagocytosis, which is carried out by lymphocytes (biological theory of II Mechnikov). Cortisol has the property of suppressing immune responses by reducing phagocytosis, as a result of which the formation of protective antibodies slows down.