Interactions : אינטראקציות

4.5   Interaction with other medicinal products and other forms of interaction
Oestrogens (e.g. ovulation inhibitors): The half-life of glucocorticoids may be prolonged.
Hence, the corticosteroid effect may be potentiated.

Antacids: During concomitant administration of aluminium hydroxide or magnesium hydroxide, glucocorticoid absorption may be diminished, resulting in reduced efficacy of Sterocort 4 mg. The glucocorticoid and antacid should therefore be taken separately, with an interval of 2 hours between them.

Medicinal products that induce CYP3A4, such as rifampicin, phenytoin, carbamazepine, barbiturates and primidone: The corticosteroid effect may be reduced.

Medicinal products that inhibit CYP3A4, such as ketoconazole and itraconazole: The corticosteroid effect may be potentiated.

Ephedrine: The metabolism of glucocorticoids may be accelerated, thereby reducing their efficacy.

ACE inhibitors: Increased risk for the onset of blood dyscrasias.

Cardiac glycosides: The glycoside effect may be potentiated by potassium deficiency.
Saluretics/laxatives: Potassium excretion may be increased.

Antidiabetics: The hypoglycaemic effect may be reduced.

Coumarin derivatives: The anticoagulant effect may be attenuated or potentiated. Adjustment of the anticoagulant dose may be required during concomitant use.

Non-steroidal anti-inflammatory drugs/antirheumatic agents (NSAIDs), salicylates and indomethacin: The risk of gastrointestinal ulceration and bleeding is increased.

Non-depolarising muscle relaxants: Muscle relaxation may be prolonged.

Atropine, other anticholinergics: Additional increases in intraocular pressure are possible with concomitant use of Sterocort 4 mg.

Praziquantel: Corticosteroids may cause a decrease in praziquantel blood concentrations.

Chloroquine, hydroxychloroquine, mefloquine: There is an increased risk that myopathy and cardiomyopathy may occur.

Somatropin: The effect of somatropin may be reduced during long-term therapy.

Protirelin: The increase in TSH upon protirelin administration may be reduced.
Immunosuppressants: Increased susceptibility to infections and possible exacerbation or manifestation of latent infections. Additionally, for ciclosporin: The blood levels of ciclosporin are increased: There is an increased risk of cerebral seizures.

Fluoroquinolones can increase the risk of tendinopathies.

During concomitant treatment with CYP3A inhibitors, including products containing cobicistat or ritonavir, an increased risk of systemic adverse reactions can be expected. The combination should be avoided, unless the benefit outweighs the increased risk of adverse systemic reactions to corticosteroids, in which case, patients should be monitored for adverse systemic reactions to corticosteroids.

Influence on testing methods:
Skin reactions to allergy tests may be suppressed.