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Frequency not reported : Opportunistic infections (bacterial, viral, fungal and parasitic infections), recurrence of dormant tuberculosis, suppressed response to skin tests [Ref] Musculoskeletal. Frequency not reported : Aseptic necrosis of femoral and humeral heads, Charcot-like arthropathy, loss of muscle mass, muscle weakness, osteoporosis, pathologic fracture of long bones, steroid myopathy, tendon rupture (particularly of the Achilles tendon), vertebral compression fractures, growth suppression in pediatric patients (infancy, childhood and adolescence), proximal myopathy, vertebral and long bone fractures, avascular osteonecrosis, tendinopathies, myalgia [Ref] Corticosteroid myopathy presents as weakness and wasting of the proximal limb and girdle muscles and is generally reversible following cessation of therapy. Corticosteroids inhibit intestinal calcium absorption and increase urinary calcium excretion leading to bone resorption and bone loss. Bone loss of 3% over one year has been demonstrated with prednisolone 10 mg per day. Postmenopausal females are particularly at risk for loss of bone density. Sixteen percent of elderly patients treated with corticosteroids for 5 years may experience vertebral compression fractures. One author reported measurable bone loss over two years in women on concomitant therapy with prednisolone 7. Frequency not reported : Exophthalmos, glaucoma, increased intraocular pressure, posterior subcapsular cataracts, nuclear cataracts (particularly in children), corneal or scleral thinning, exacerbation of ophthalmic viral or fungal disease [Ref] In renal transplant patients maintained on prednisolone 10 mg per day, 33% developed posterior subcapsular cataracts. Mean time to cataract development is 26 months. Increased intraocular pressure has occurred in 5% of patients. A wide range of psychiatric reactions have been commonly reported in both adults and children. The frequency of severe reactions has been estimated at around 5% to 6%. Psychological effects have been reported on withdrawal of corticosteroids, the frequency of this is unknown. Frequency not reported : Depression, emotional instability, euphoria, insomnia, mood swings, personality changes, euphoria, psychological dependence [Ref] Hematologic. Frequency not reported : Leucocytosis [Ref] Dermatologic. Frequency not reported : Acne, allergic dermatitis, cutaneous and subcutaneous fat atrophy, dry scalp, edema, facial erythema, hyper or hypo pigmentation, impaired wound healing, increased sweating, petechiae, ecchymosis, rash, sterile abscess, striae, suppressed reactions to skin tests, thinning of skin, thinning scalp hair, urticaria, hirsutism, bruising, telangiectasia, rash, perineal irritation [Ref] Genitourinary. Frequency not reported : Amenorrhea, postmenopausal bleeding or menstrual irregularities, increased or decreased motility and number of spermatozoa [Ref] Hepatic. Frequency not reported : Elevation in serum liver enzyme levels, hepatomegaly [Ref] Hypersensitivity. Frequency not reported : Anaphylactoid reaction, anaphylaxis, angioedema [Ref] Nervous system. Frequency not reported : Arachnoiditis, convulsions, headache, increased intracranial hypertension with papilledema (pseudotumour cerebri) usually following discontinuation of therapy, meningitis, neuritis, neuropathy, paraparesis/paraplegia, paraesthesia, sensory disturbances, aggravation of epilepsy, clinical signs of evolving stroke, EEG abnormalities, increased motor activity, ischemic neuropathy, severe tiredness, weakness [Ref] Other. A steroid withdrawal syndrome unrelated to adrenocortical insufficiency has been reported following discontinuation. The syndrome includes symptoms such as anorexia, nausea, vomiting, lethargy, headache, fever, joint pain, desquamation, myalgia, arthralgia, rhinitis, conjunctivitis, painful itchy skin nodules, weight loss, and/or hypotension, sermorelin 2 mg peptides $21.00. These effects may be due to the sudden change in glucocorticosteroid concentrations rather than to low corticosteroid levels. Kaposi’s sarcoma has been reported among patients receiving corticosteroid therapy; discontinuation may result in clinical remission. Pediapred (prednisoLONE sodium phosphate).
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