Cortisone - glucocorticosteroid (GCS).
Release form and composition
Dosage Forms of Cortisone:
- Tablets (10 pieces in blisters, in a carton pack of 8 packs);
- Suspension for injection (in vials of 10 ml).
The active ingredient of the drug - cortisone acetate: 25 mg or 50 mg in 1 tablet, 25 mg in 1 ml of suspension.
Indications for use
- Rheumatism, rheumatoid arthritis and other collagenoses;
- Bronchial asthma;
- Acute myeloblastic and lymphoblastic leukemia;
- Addison's disease and acute insufficiency of the adrenal cortex;
- Neurodermatitis, eczema and other skin diseases;
- Viral hepatitis;
- Acute pancreatitis;
- Hemolytic anemia;
- Infectious mononucleosis;
- Collapse and shock of different nature.
For short-term use for health reasons, the only contraindication to Cortisone is hypersensitivity.
If necessary, long-term treatment of the drug is not prescribed in the following cases:
- Open and closed angle glaucoma;
- Renal and / or liver failure;
- Propensity for thromboembolism;
- Myasthenia gravis;
- Hypoalbuminemia and conditions predisposing to its occurrence;
- Obesity III – IV st .;
- Poliomyelitis (with the exception of the form of bulbar encephalitis);
- Immunodeficiency states (including AIDS and HIV infection);
- Diseases of the gastrointestinal tract: peptic ulcer and 12 duodenal ulcer, diverticulitis, recently created intestinal anastomosis, acute or latent peptic ulcer, gastritis, esophagitis, ulcerative colitis with the threat of perforation or abscess formation;
- Diseases of the cardiovascular system, incl. severe arterial hypertension, decompensated chronic heart failure, recent myocardial infarction, hyperlipidemia;
- Endocrine diseases: hypothyroidism, thyrotoxicosis, Cushing's disease, diabetes mellitus (including impaired carbohydrate tolerance);
- Parasitic and infectious diseases of a bacterial, fungal or viral nature (including recently transferred, including recent contact with a patient): the viremic phase of herpes zoster, strongyloidiasis or suspicion of it, chicken pox, herpes simplex, measles; systemic mycosis, amebiasis, tuberculosis;
- Vaccination period (8 weeks before and 2 weeks after), lymphadenitis after BCG vaccination.
In pregnancy, Cortisone can be prescribed only if, in the opinion of the doctor, the expected benefits for the expectant mother outweigh the potential risks to the fetus.
Dosing and Administration
Cortisone tablets are taken orally, suspension - administered intramuscularly.
Doses in each case are set individually depending on the evidence and the severity of the disease.
The initial daily dose for oral administration is 100-200 mg in 3-4 doses. Further, the dose is gradually reduced to achieve the minimum effective, sufficient to maintain a therapeutic effect (on average, 25 mg per day).
The total dose rate for rheumatism is 3000-4000 mg.
Intramuscularly administered 25-50 mg 1 or 2 times (at intervals of 8-12 hours) per day.
In Addison's disease, Cortisone is used in combination with deoxycorticosterone and sodium chloride. Usually, 12.5-25 mg of cortisone, 1-5 mg of deoxycorticosterone acetate and 4000-6000-10000 mg of sodium chloride are prescribed. It is also recommended to combine cortisone with ascorbic acid.
Maximum doses of Cortisone for adults: single - 150 mg daily - 300 mg.
Children are prescribed the drug in smaller doses, while taking into account mainly the severity of the disease, rather than age. Children of preschool age are usually prescribed 12.5-25 mg 3 times a day for 2 days, then 2 times a day, then the dose is reduced to maintenance. School-age children - 25 mg 3 times a day, then 2 times a day, then reduce the dose to maintenance. Depending on the circumstances, the drug may be prescribed for oral or intramuscular administration.
- Endocrine system: increased blood pressure, adrenal gland depression, manifestation of latent diabetes mellitus or steroid diabetes mellitus, decreased glucose tolerance, delayed sexual development in children, Itsenko-Cushing's syndrome (pituitary-type obesity, moon-shaped person, amenorrhea, dysmenorrhea, adrenal glandular syndrome, heart-remitting, amenorrhea, dysmenorrhea, adrenal glandular syndrome (a podvizhennoy type, aloemorrhoea, amenorrhea, dysmenorrhea) , myasthenia gravis);
- Digestive system: pancreatitis, hiccups, nausea, vomiting, erosive esophagitis, increased or decreased appetite, bleeding and perforation of the gastrointestinal tract, flatulence, steroid gastric and duodenal ulcer; rarely, increased activity of hepatic transaminases and alkaline phosphatase;
- Cardiovascular system and blood (hemostasis, hematopoiesis): increased blood pressure, bradycardia (up to cardiac arrest), arrhythmia, increased severity or development (in susceptible patients) heart failure, thrombosis, hypercoagulation, changes in the electrocardiogram, characteristic of hypokalemia; in patients with acute and subacute myocardial infarction - slowing the formation of scar tissue and the spread of necrosis, which can lead to rupture of the heart muscle;
- The nervous system and sensory organs: increased intracranial pressure, hallucinations, delirium, nervousness or anxiety, depression, euphoria, pseudotumor cerebellum, paranoia, manic-depressive psychosis, insomnia, posterior subcapsular cataracts, vertigo, headache, dizziness, convulsions, disorientation, trophic changes in the cornea, increased intraocular pressure with possible damage to the optic nerve, exophthalmos, a tendency to develop secondary viral, fungal or bacterial infections of the eye;
- Musculoskeletal system: steroid myopathy, tendon rupture, loss of muscle mass (atrophy), osteoporosis (very rarely - aseptic necrosis of the femoral head and humerus, pathological bone fractures), slowing down of the growth and ossification processes in children (premature closure of the epiphyseal growth zones) ;
- Metabolism: increased calcium excretion and hypocalcemia, increased sweating, a negative nitrogen balance (increased protein breakdown), an increase in body weight. Effects caused by mineralocorticoid activity - hypokalemic syndrome (hypokalemia, myalgia, arrhythmia, muscle spasm, fatigue and unusual weakness), hypernatremia, fluid retention and sodium (peripheral edema);
- Allergic reactions: generalized local allergic reactions (itching, rash, anaphylactic shock);
- Skin: petechiae, delayed wound healing, ecchymosis, hyper or hypopigmentation, striae, steroid acne, skin thinning, tendency to develop candidiasis and pyoderma;
- Other: withdrawal syndrome, leukocyturia, the development or exacerbation of infections (especially with the simultaneous use of immunosuppressants or vaccination).
Cortisone has side effects more often than other glucocorticosteroids. Due to the emergence of more effective and better tolerated synthetic corticosteroids, this drug currently has limited use.
Like all steroid hormones, Cortisone must be used under close medical supervision. Before prescribing the drug, patients should be carefully examined and subsequently systematically monitored the state of the cornea and intraocular pressure, blood pressure, body weight, blood picture and glucose content, as well as the state of mind.
It is necessary to stop taking Cortisone gradually to prevent the development of withdrawal syndrome: the longer the course of therapy was, the slower the dose reduction should be.
Children during the period of growth can only be prescribed by absolute indications and under the special supervision of a physician. During prolonged treatment, it is necessary to monitor the dynamics of their growth and development.
Children who have had contact with sick with chicken pox or measles during the use of Cortisone are prescribed a prophylactic course of treatment with specific immunoglobulins.
In severe infectious diseases, the drug is used only simultaneously with the conduct of specific therapy.
Newborns born to mothers who received corticosteroids during pregnancy should be closely monitored, because they may have hypofunction of the adrenal glands.
Information about the interaction of Cortisone with other drugs is missing.
Terms and conditions of storage
Store at a temperature up to 25 ºС in a dark, dry (tablets) place.
Shelf life - 5 years.