Cortef

January 7, 2008

Return to Drug Search. Cortef

Hydrocortisone Cortef - Cortef Side Effects - Cortef InformationPharmacology:

Hydrocortisone (cortisol) is a corticosteroid secreted by the adrenal cortex. In

physiologic doses, it is administered to replace deficient endogenous hormones.

In larger (pharmacologic) doses, hydrocortisone decreases inflammation and

suppresses the immune response. It stimulates erythroid cells of the bone

marrow, prolongs survival time of erythrocytes and platelets, and produces

neutrophilia and eosinopenia. Hydrocortisone promotes protein catabolism,

gluconeogenesis, and redistribution of fat from peripheral to central areas of

the body. It reduces intestinal absorption and increases renal excretion of

calcium.

In pharmacologic doses, systemically administered glucocorticoids suppress

release of corticotropin from the pituitary. The degree and duration of

hypothalamic-pituitary-adrenal (HPA) axis suppression produced is highly

variable among patients and depends on the dose, frequency and time of

administration, and duration of therapy. If suppressive doses are administered

for prolonged periods, the adrenal cortex atrophies and patients develop

cushingoid features and respond to stress like patients with primary

adrenocortical insufficiency. The duration of anti-inflammatory activity

approximately equals the duration of HPA-axis suppression. In one study, the

duration of HPA-axis suppression after a single oral dose of hydrocortisone 250

mg was 1.25 to 1.5 days.

Hydrocortisone is extensively bound to the plasma proteins, corticosteroid

binding globulin (transcortin) and albumin. With physiologic concentrations, it

is bound primarily to transcortin and only 5 to 10% of cortisol in plasma is

unbound.

Hydrocortisone is metabolized in most tissues, but primarily in the liver to

biologically inactive compounds. The half-life of hydrocortisone may be

prolonged in patients with hypothyroidism. Inactive metabolites are excreted by

the kidneys, primarily as glucuronides and sulfates, but also as unconjugated

products. Negligible amounts are excreted in bile.

Indications: Endocrine Disorders: Primary or secondary adrenocortical

insufficiency (hydrocortisone or cortisone is the first choice; synthetic

analogs may be used in conjunction with mineralocorticoids where applicable; in

infancy, mineralocorticoid supplementation is of particular importance);

congenital adrenal hyperplasia; nonsuppurative thyroiditis; hypercalcemia

associated with cancer.

Nonendocrine Disorders: Rheumatic Disorders: As adjunctive therapyshort-term

administration (to tide the patient over an acute episode or exacerbation) in:

psoriatic arthritis, rheumatoid arthritis, including juvenile rheumatoid

arthritis (selected cases may require low dose maintenance therapy), ankylosing

spondylitis, acute and subacute bursitis, acute non-specific tenosynovitis,

acute gouty arthritis, post-traumatic osteoarthritis, synovitis of

osteoarthritis, epicondylitis.

Collagen Diseases: During an exacerbation or as maintenance therapy in selected

cases of systemic lupus erythematosus, acute rheumatic carditis, systemic

dermatomyositis (polymyositis).

Dermatologic Diseases: pemphigus, bullous dermatitis herpetiformis, severe

erythema multiforme (s- syndrome), exfoliative dermatitis, mycosis

fungoides, severe psoriasis and severe seborrheic dermatitis.

Allergic States: Control of severe or incapacitating allergic conditions

intractable to adequate trials of conventional treatment: seasonal or perennial

allergic rhinitis, bronchial asthma, contact dermatitis, atopic dermatitis,

serum sickness and drug hypersensitivity reactions.

Ophthalmic Diseases: Severe acute and chronic allergic and inflammatory

processes involving the eye and its adnexa such as: allergic conjunctivitis,

keratitis, allergic corneal marginal ulcers, herpes zoster ophthalmicus, iritis

and iridocyclitis, chorioretinitis, anterior segment inflammation, diffuse

posterior uveitis and choroiditis, optic neuritis, sympathetic ophthalmia.

Respiratory Diseases: Symptomatic sarcoidosis, Löffler's syndrome not manageable

by other means, berylliosis, fulminating or disseminated pulmonary tuberculosis

when used concurrently with appropriate antituberculous chemotherapy, aspiration

pneumonitis.

Hematologic Disorders: Idiopathic thrombocytopenic purpura in adults, secondary

thrombocytopenia in adults, acquired (autoimmune) hemolytic anemia,

erythroblastopenia (RBC anemia), congenital (erythroid) hypoplastic anemia.

Neoplastic Diseases: For palliative management of: leukemias and lymphomas in

adults, acute leukemia of childhood.

Edematous States: To induce a diuresis or remission of proteinuria in the

nephrotic syndrome, without uremia, of the idiopathic type or that due to lupus

erythematosus.

Gastrointestinal Diseases: To tide the patient over a critical period of the

disease in: ulcerative colitis, regional enteritis.

CNS: Acute exacerbations of multiple sclerosis.

Miscellaneous: Tuberculous meningitis with subarachnoid block or impending block

when used concurrently with appropriate antituberculous chemotherapy,

trichinosis with neurologic or myocardial involvement.

Contraindications: Systemic fungal infections and known hypersensitivity to

hydrocortisone or components of the tablet.

Warnings: In patients on corticosteroid therapy subjected to unusual stress,

increased dosage of rapidly acting corticosteroids before, during and after the

stressful situation is indicated.

Corticosteroids may mask some signs of infection, and new infections may appear

during their use. There may be decreased resistance and inability to localize

infection when corticosteroids are used. Infections with any pathogen including

viral, bacterial, fungal, protozoan or helminthic infections, in any location in

the body, may be associated with the use of corticosteroids alone or in

combination with other immunosuppressive agents that affect cellular immunity,

humoral immunity, or neutrophil function. These infections may be mild, but can

be severe and at times fatal. With increasing doses of corticosteroids, the rate

of occurrence of infectious complications increases.

Persons who are on drugs which suppress the immune system are more susceptible

to infections than healthy individuals. Chickenpox and measles, for example, can

have a more serious or even fatal course in nonimmune children or adults on

corticosteroids. In such children or adults who have not had these diseases,

particular care should be taken to avoid exposure. How the dose, route and

duration of corticosteroid administration affects the risk of developing a

disseminated infection is not known. The contribution of the underlying disease

and/or prior corticosteroid treatment to the risk is also not known. If exposed

to chickenpox, prophylaxis with varicella zoster immune globulin (VZIG) may be

indicated. If exposed to measles, prophylaxis with pooled i.m. immunoglobulin

(IG) may be indicated. If chickenpox develops, treatment with antiviral agents

may be considered. Similarly, corticosteroids should be used with great care in

patients with known or suspected Strongyloides

(threadworm) infestation. In such patients, corticosteroid-induced

immunosuppresion may lead to Strongyloides hyperinfection and dissemination with

widespread larval migration often accompanied by severe enterocolitis and

potentially fatal gram-negative septicemia.

Prolonged use of corticosteroids may produce posterior subcapsular cataracts,

glaucoma with possible damage to the optic nerves, and may enhance the

establishment of secondary ocular infections due to fungi or viruses.

Allergic reactions (e.g., angioedema) may occur.

Average and large doses of hydrocortisone or cortisone can cause elevation of

blood pressure, salt and water retention, and increased excretion of potassium.

These effects are less likely to occur with the synthetic derivatives except

when used in large doses. Dietary salt restriction and potassium supplementation

may be necessary. All corticosteroids increase calcium excretion.

Administration of live or live, attenuated vaccines is contraindicated in

patients receiving immunosuppressive doses of corticosteroids. Killed or

inactivated vaccines may be administered to patients receiving immunosuppressive

doses of corticosteroids. However the response to such vaccines may be

diminished. Indicated immunization procedures may be undertaken in patients

receiving non-immunosuppressive doses of corticosteroids.

The use of hydrocortisone in active tuberculosis should be restricted to those

cases of fulminating or disseminated tuberculosis in which the corticosteroid is

used for the management of the disease in conjunction with an appropriate

antituberculous regimen.

If corticosteroids are indicated in patients with latent tuberculosis or

tuberculin reactivity, close observation is necessary as reactivation of the

disease may occur. During prolonged corticosteroid therapy, these patients

should receive chemoprophylaxis.

There is no universal agreement on whether corticosteroids per se are

responsible for peptic ulcers encountered during therapy; however,

glucocorticoid therapy may mask the symptoms of peptic ulcer so that perforation

or hemorrhage may occur without significant pain.

Osteoporosis is a common but infrequently recognized adverse effect associated

with a long-term use of large doses of glucocorticoid.

Growth may be suppressed in children receiving long-term daily, divided dose

glucocorticoid therapy and use of such regimen should be restricted to the most

urgent indications. Alternate day glucocorticoid therapy usually avoids or

minimizes this side effect.

Host defenses are impaired in patients receiving large doses of glucocorticoids

and this effect increases susceptibility to fungus infections as well as

bacterial and viral infections.

Pregnancy and Lactation: Some animal studies have shown that corticosteroids,

when administered to the mother at high doses, may cause fetal malformations.

Adequate human reproduction studies have not been done with corticosteroids.

Therefore, the use of this drug in pregnancy, nursing mothers or women of

childbearing potential requires that the benefits of the drug be carefully

weighed against the potential risk to the mother and embryo or fetus. Since

there is inadequate evidence of safety in human pregnancy, this drug should be

used in pregnancy only if clearly needed.

Corticosteroids readily cross the placenta. Infants born of mothers who have

received substantial doses of corticosteroids during pregnancy must be carefully

observed and evaluated for signs of adrenal insufficiency. There are no known

effects of corticosteroids on labour and delivery. Corticosteroids are excreted

in breast milk.

Precautions: Drug induced secondary adrenocortical insufficiency may be

minimized by gradual reduction of dosage. This type of relative insufficiency

may persist for months after discontinuation of therapy; therefore, in any

situation of stress occurring during that period, hormone therapy should be

reinstituted. Since mineralocorticoid secretion may be impaired, salt and/or a

mineralocorticoid should be administered concurrently.

There is an enhanced effect of corticosteroids on patients with hypothyroidism

and in those with cirrhosis.

Corticosteroids should be used cautiously in patients with ocular herpes simplex

because of possible corneal perforation.

The lowest possible dose of corticosteroid should be used to control the

condition under treatment and when reduction in dosage is possible, the

reduction should be gradual.

Psychic derangements may appear when corticosteroids are used, ranging from

euphoria, insomnia, mood swings, personality changes and severe depression to

frank psychotic manifestations. Also, existing emotional instability or

psychotic tendencies may be aggravated by corticosteroids.

ASA and nonsteroidal anti-inflammatory agents should be used cautiously in

conjunction with corticosteroids in patients with hypoprothrombinemia.

Corticosteroids should be used with caution in nonspecific ulcerative colitis,

if there is a probability of impending perforation, abscess or other pyogenic

infection; diverticulitis; fresh intestinal anastomoses; active or latent peptic

ulcer; renal insufficiency; hypertension; osteoporosis; or myasthenia gravis.

Because complications of treatment with glucocorticoids are dependent on the

size of the dose and the duration of treatment, a risk/benefit decision must be

made in each individual case as to dose and duration of treatment and as to

whether daily or intermittent therapy should be used.

Convulsions have been reported with concurrent use of methylprednisolone and

cyclosporine. Since concurrent administration of these agents results in a

mutual inhibition of metabolism, it is possible that convulsions and other

adverse events associated with the individual use of either drug may be more apt

to occur.

Drug Interactions : The pharmacokinetic interactions listed below are

potentially clinically important. Drugs that induce hepatic enzymes such as

phenobarbital, phenytoin and rifampin may increase the clearance of

corticosteroids and may require increases in corticosteroid dose to achieve the

desired response. Drugs such as troleandomycin and ketoconazole may inhibit the

metabolism of corticosteroids and thus decrease their clearance. Therefore, the

dose of corticosteroid should be titrated to avoid steroid toxicity.

Corticosteroids may increase the clearance of chronic high dose ASA. This could

lead to decreased salicylate serum levels or increase the risk of salicylate

toxicity when the corticosteroid is withdrawn. ASA should be used cautiously in

conjunction with corticosteroids in patients suffering from hypothrombinemia.

The effect of corticosteroids on oral anticoagulants is variable. There are

reports of enhanced as well as diminished effects of anticoagulants when

given concurrently with corticosteroids. Therefore, coagulation indices should

be monitored to maintain the desired anticoagulant effect.

Information for the Patient: Persons who are on immunosuppressant doses of

corticosteroids should be warned to avoid exposure to chickenpox or measles.

Patients should also be advised that if they are exposed medical advice should

be sought without delay.

Adverse Effects: Note: The following are typical for all systemic

corticosteroids. Their inclusion in this list does not necessarily indicate that

the specific event has been observed with this particular formulation.

Fluid and Electrolyte Disturbances: sodium retention; fluid retention;

congestive heart failure in susceptible patients; potassium loss, hypokalemic

alkalosis; hypertension.

Musculoskeletal: steroid myopathy; muscle weakness; osteoporosis; pathologic

fractures; vertebral compression fractures, aseptic necrosis of femoral and

humeral heads, loss of muscle mass, tendon rupture, particular of the Achilles.

Gastrointestinal: peptic ulcer with possible perforation and hemorrhage;

pancreatitis; abdominal distention; ulcerative esophagitis; increases in AST,

ALT and alkaline phosphatase have been observed following corticosteroid

treatment. These changes are usually small, not associated with any clinical

significance.

Dermatologic: impaired wound healing; petechiae and ecchymoses; thin fragile

skin; increased sweating, facial erythema may suppress reactions to skin tests.

Metabolic: negative nitrogen balance due to protein catabolism.

Neurological: increased intracranial pressure; pseudotumor cerebri; psychic

derangements and seizures; convulsions, vertigo and headache.

Endocrine: menstrual irregularities; development of cushingoid state;

suppression of pituitary-adrenal axis particularly at times of stress as in

trauma, surgery or illness; decreased carbohydrate tolerance; manifestations of

latent diabetes mellitus; increased requirements for insulin or oral

hypoglycemic agents in diabetes; suppression of growth in children.

Ophthalmic: posterior subcapsular cataracts; increased intraocular pressure;

exophthalmos glaucoma.

Immune System: masking of infections; latent infections becoming active;

opportunistic infections; hypersensitivity reactions including anaphylaxis; may

suppress reactions to skin tests.

Dosage: The initial dosage may vary from 20 to 240 mg of hydrocortisone per day

depending on the specific disease entity being treated. In situations of less

severity, lower doses will generally suffice, while in selected patients higher

initial doses may be required. The initial dosage should be maintained or

adjusted until a satisfactory response is noted. If after a reasonable period of

time there is a lack of satisfactory clinical response, hydrocortisone should be

discontinued and the patient transferred to another appropriate therapy.

It should be emphasized that dosage requirements are variable and must be

individualized on the basis of the disease under treatment and the response of

the patient.

After a favorable response is noted, the proper maintenance dosage should be

determined by decreasing the initial drug dosage in small decrements at

appropriate time intervals until the lowest dosage which will maintain an

adequate clinical response is reached. It should be kept in mind that constant

monitoring is needed in regard to drug dosage. Included in the situations which

may make dosage adjustments necessary are changes in clinical status secondary

to remissions or exacerbations in the disease process, the patient's individual

drug responsiveness, and the effect of patient exposure to stressful situations

not directly related to the disease entity under treatment; in this latter

situation it may be necessary to increase the dosage of hydrocortisone for a

period of time consistent with the patient's condition.

Supplied: 10 mg: Each white, round, scored, compressed tablet, engraved Cortef

10, contains: hydrocortisone 10 mg. Nonmedicinal ingredients: calcium stearate,

cornstarch, lactose, mineral oil, sorbic acid, sucrose. Sodium: <1 mmol. Gluten-

and tartrazine-free. Bottles of 100.

20 mg: Each white, round, scored, compressed tablet, engraved Cortef 20,

contains: hydrocortisone 20 mg. Nonmedicinal ingredients: calcium stearate,

cornstarch, lactose, mineral oil, sorbic acid, sucrose. Sodium: <1 mmol. Gluten-

and tartrazine-free. Bottles of 100. IMPORTANT NOTE: THE FOLLOWING INFORMATION

IS INTENDED TO SUPPLEMENT, NOT SUBSTITUTE FOR, THE EXPERTISE AND JUDGMENT OF

YOUR PHYSICIAN, PHARMACIST OR OTHER HEALTHCARE PROFESSIONAL. IT SHOULD NOT BE

CONSTRUED TO INDICATE THAT USE OF THE DRUG IS SAFE, APPROPRIATE, OR EFFECTIVE

FOR YOU. CONSULT YOUR HEALTHCARE PROFESSIONAL BEFORE USING THIS DRUG.

---------------------------------

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March 17, 2009

That list is very sobering indeed. Does anyone know what the

similarities are to the asthma inhalers that I've been using for decades

[i'm using the prophylactic type, not the type for an attack]? Further,

how are the dose levels related to long term effects? Do the negative

effects show up with both therapeutic and physiologic dose levels?

..

>

> Posted by: " Roni Molin " matchermaam@...

> <mailto:matchermaam@...?Subject=%20Re%3ACortef>

> matchermaam <matchermaam>

>

> Mon Mar 16, 2009 11:14 pm (PDT)

>

> Gracia, the reason that I won't take Cortef is because I already have

> permanent side effects in my spine and eyes from multiple treatments

> with cortisone for bronchitis and

> asthma. Maybe a review of what it does would be prudent for you to read.

>

> http://www.drugs.com/sfx/cortef-side-effects.html

> <http://www.drugs.com/sfx/cortef-side-effects.html>

>

> Roni

March 17, 2009

Roni

<>Just because something

isn't seen doesn't mean it's

not there<>

From: <res075oh@...>

Subject: Re:Cortef

hypothyroidism

Date: Tuesday, March 17, 2009, 10:16 AM

That list is very sobering indeed. Does anyone know what the

similarities are to the asthma inhalers that I've been using for decades

[i'm using the prophylactic type, not the type for an attack]?

Apparently, and I've done lots of reading on this, have never stayed on

any kind of steroid for a long time, internal or inhaled, and I developed

a cataract, which my Opththalmologist says could definitely be from

any steroids I have been given, especially since after developing a

sensitivity to the sun in 1956, I never stay out in the sun, always wear

sunglasses with the UV factors.

Side effects can come from inhaled and/or internally taken steroids.

The doses can vary and the episodes of use could be less than two

weeks at a time.

If you are on a combination inhaler like Advair, there is a much higher

incidence of death because of the double medication in that drug. If

you decide to stop it you'll have to tell your doctor you will not take it

any longer and wish to have the formula for weaning yourself off of the

drug. I did it with my doctor after taking it for about a week while I was

busy researching. He agreed, and I went off using his formula for

stopping.

Further,

how are the dose levels related to long term effects? Do the negative

effects show up with both therapeutic and physiologic dose levels?

Evidently the higher dose and the longer you're on it of course effects

will be worse or sooner. However, it affects everything no matter what

dose you're on, especially if you're taking it all the time.

Even the doctors call it the wonderful terrible drug. It works wonders

but creates terrible side effects, many of which don't show up right

away.

Roni

..

>

> Posted by: " Roni Molin " matchermaam@...

> <mailto:matchermaam@...?Subject=%20Re%3ACortef>

> matchermaam <matchermaam>

>

> Mon Mar 16, 2009 11:14 pm (PDT)

>

> Gracia, the reason that I won't take Cortef is because I already have

> permanent side effects in my spine and eyes from multiple treatments

> with cortisone for bronchitis and

> asthma. Maybe a review of what it does would be prudent for you to read.

>

> http://www.drugs.com/sfx/cortef-side-effects.html

> <http://www.drugs.com/sfx/cortef-side-effects.html>

>

> Roni

------------------------------------

March 17, 2009

james-

the amount of steroids that are in inhalers is not that concerning because

almost all of the effect is localized to your lungs and only a tiny amount

gets into your blood stream vs taking oral steroids ie prednisone for your

asthma [ which severe asthmatics often have to take during a severe flare]

that do get into your blood stream and cause the horrific side effects. Also

the dose of the oral steroids and the duration that you take the oral

steroids are also important.

We look at it as a risk/benefit ratio. The risk of taking inhaled steroids

is low versus the risk of having an asthmatic attack that can kill you is

high.

personally, I don't have a problem with taking an inhaler for asthma, where

I will not take any oral steroids unless I am dying or in a coma. But, then

I just have ocassional asthma.

Nancie

-------Original Message-------

That list is very sobering indeed. Does anyone know what the

similarities are to the asthma inhalers that I've been using for decades

[i'm using the prophylactic type, not the type for an attack]? Further,

how are the dose levels related to long term effects? Do the negative

effects show up with both therapeutic and physiologic dose levels?

..

>

..

March 17, 2009

IMO this is a tragedy!! terrible confusion. I have never known anyone who

has these side effects from cortef, and certainly not me. I urge ppl to get

better info--read Safe Uses of Cortisol by Jefferies MD. look on

http://www.stopthethyroidmadness.com

really!!! ignorance is not bliss.

gracia

That list is very sobering indeed. Does anyone know what the

similarities are to the asthma inhalers that I've been using for decades

[i'm using the prophylactic type, not the type for an attack]? Further,

how are the dose levels related to long term effects? Do the negative

effects show up with both therapeutic and physiologic dose levels?

.

>

> Posted by: " Roni Molin " matchermaam@...

> <mailto:matchermaam@...?Subject=%20Re%3ACortef>

> matchermaam <matchermaam>

>

> Mon Mar 16, 2009 11:14 pm (PDT)

>

> Gracia, the reason that I won't take Cortef is because I already have

> permanent side effects in my spine and eyes from multiple treatments

> with cortisone for bronchitis and

> asthma. Maybe a review of what it does would be prudent for you to read.

>

> http://www.drugs.com/sfx/cortef-side-effects.html

> <http://www.drugs.com/sfx/cortef-side-effects.html>

>

> Roni

------------------------------------------------------------------------------

No virus found in this incoming message.

Checked by AVG - www.avg.com

Version: 8.0.237 / Virus Database: 270.11.18/2008 - Release Date: 03/17/09

16:25:00

March 17, 2009

The asthma inhaler I'm on now is Symbicort and the fact sheet lists lots

of possible negative results. By my doctor says I'm getting less

steroid now than I was from the previous inhaler.

Thanks for the input,

..

>

> Posted by: " Roni Molin " matchermaam@...

> <mailto:matchermaam@...?Subject=%20Re%3A%20Cortef>

> matchermaam <matchermaam>

>

> Tue Mar 17, 2009 11:39 am (PDT)

>

> From: <res075oh@... <mailto:res075oh%40verizon.net>>

> Subject: Re:Cortef

> hypothyroidism

> <mailto:hypothyroidism%40>

> Date: Tuesday, March 17, 2009, 10:16 AM

>

> That list is very sobering indeed. Does anyone know what the

> similarities are to the asthma inhalers that I've been using for decades

> [i'm using the prophylactic type, not the type for an attack]?

>

> Apparently, and I've done lots of reading on this, have never stayed on

> any kind of steroid for a long time, internal or inhaled, and I developed

> a cataract, which my Opththalmologist says could definitely be from

> any steroids I have been given, especially since after developing a

> sensitivity to the sun in 1956, I never stay out in the sun, always wear

> sunglasses with the UV factors.

>

> Side effects can come from inhaled and/or internally taken steroids.

> The doses can vary and the episodes of use could be less than two

> weeks at a time.

>

> If you are on a combination inhaler like Advair, there is a much higher

> incidence of death because of the double medication in that drug. If

> you decide to stop it you'll have to tell your doctor you will not take it

> any longer and wish to have the formula for weaning yourself off of the

> drug. I did it with my doctor after taking it for about a week while I was

> busy researching. He agreed, and I went off using his formula for

> stopping.

>

> Further,

> how are the dose levels related to long term effects? Do the negative

> effects show up with both therapeutic and physiologic dose levels?

>

> Evidently the higher dose and the longer you're on it of course effects

> will be worse or sooner. However, it affects everything no matter what

> dose you're on, especially if you're taking it all the time.

>

> Even the doctors call it the wonderful terrible drug. It works wonders

> but creates terrible side effects, many of which don't show up right

> away.

>

> Roni

March 17, 2009

That sounds pretty much like what my allergy specialist who wrote the

prescription told me. He doesn't seem concerned at all about the

quantity of steroid.

I haven't had an asthma attack since 1999 but I still use the

preventative inhaler twice daily.

My allergy specialist and my eye doctor both were much more concerned

with the steroid eye drop that I sometimes use. Both discussed with me

very extensively the damage that could occur to my eyes with heavy or

long term use. But my use is so limited that both seem very well

convinced that I'm handling it intelligently. I use it for extremely

short periods [typically 24 hours] but it is the only thing that will

overcome a flare-up of my eyes having severe itching from allergies.

Fortunately the preventive eye drops [none-steroid] that I'm now taking

seem to be keeping it under control and I haven't had to use the steroid

yet this year IIRC.

Thanks,

..

>

> Posted by: " Nancie Barnett " deifspirit@...

> <mailto:deifspirit@...?Subject=%20Re%3A%20Cortef>

> aspenfairy1 <aspenfairy1>

>

> Tue Mar 17, 2009 12:39 pm (PDT)

>

> james-

> the amount of steroids that are in inhalers is not that concerning because

> almost all of the effect is localized to your lungs and only a tiny amount

> gets into your blood stream vs taking oral steroids ie prednisone for your

> asthma [ which severe asthmatics often have to take during a severe flare]

> that do get into your blood stream and cause the horrific side

> effects. Also

> the dose of the oral steroids and the duration that you take the oral

> steroids are also important.

> We look at it as a risk/benefit ratio. The risk of taking inhaled steroids

> is low versus the risk of having an asthmatic attack that can kill you is

> high.

> personally, I don't have a problem with taking an inhaler for asthma,

> where

> I will not take any oral steroids unless I am dying or in a coma. But,

> then

> I just have ocassional asthma.

> Nancie

> -------Original Message-----

> --

>

> That list is very sobering indeed. Does anyone know what the

> similarities are to the asthma inhalers that I've been using for decades

> [i'm using the prophylactic type, not the type for an attack]? Further,

> how are the dose levels related to long term effects? Do the negative

> effects show up with both therapeutic and physiologic dose levels?

>

March 17, 2009

I know people who have gotten side effects from cortisone, including me.

Roni

<>Just because something

isn't seen doesn't mean it's

not there<>

From: Gracia <circe@...>

Subject: Re: Re:Cortef

hypothyroidism

Date: Tuesday, March 17, 2009, 8:23 PM

IMO this is a tragedy!! terrible confusion. I have never known anyone who

has these side effects from cortef, and certainly not me. I urge ppl to get

better info--read Safe Uses of Cortisol by Jefferies MD. look on

http://www.stopthethyroidmadness.com

really!!! ignorance is not bliss.

gracia

That list is very sobering indeed. Does anyone know what the

similarities are to the asthma inhalers that I've been using for decades

[i'm using the prophylactic type, not the type for an attack]? Further,

how are the dose levels related to long term effects? Do the negative

effects show up with both therapeutic and physiologic dose levels?

.

>

> Posted by: " Roni Molin " matchermaam@...

> <mailto:matchermaam@...?Subject=%20Re%3ACortef>

> matchermaam <matchermaam>

>

> Mon Mar 16, 2009 11:14 pm (PDT)

>

> Gracia, the reason that I won't take Cortef is because I already have

> permanent side effects in my spine and eyes from multiple treatments

> with cortisone for bronchitis and

> asthma. Maybe a review of what it does would be prudent for you to read.

>

> http://www.drugs.com/sfx/cortef-side-effects.html

> <http://www.drugs.com/sfx/cortef-side-effects.html>

>

> Roni

------------------------------------------------------------------------------

No virus found in this incoming message.

Checked by AVG - www.avg.com

Version: 8.0.237 / Virus Database: 270.11.18/2008 - Release Date: 03/17/09

16:25:00

March 17, 2009

Symbicort also lists death as one of the side effects.

Roni

<>Just because something

isn't seen doesn't mean it's

not there<>

>

> From: <res075oh@... <mailto:res075oh%40verizon.net>>

> Subject: Re:Cortef

> hypothyroidism

> <mailto:hypothyroidism%40>

> Date: Tuesday, March 17, 2009, 10:16 AM

>

> That list is very sobering indeed. Does anyone know what the

> similarities are to the asthma inhalers that I've been using for decades

> [i'm using the prophylactic type, not the type for an attack]?

>

> Apparently, and I've done lots of reading on this, have never stayed on

> any kind of steroid for a long time, internal or inhaled, and I developed

> a cataract, which my Opththalmologist says could definitely be from

> any steroids I have been given, especially since after developing a

> sensitivity to the sun in 1956, I never stay out in the sun, always wear

> sunglasses with the UV factors.

>

> Side effects can come from inhaled and/or internally taken steroids.

> The doses can vary and the episodes of use could be less than two

> weeks at a time.

>

> If you are on a combination inhaler like Advair, there is a much higher

> incidence of death because of the double medication in that drug. If

> you decide to stop it you'll have to tell your doctor you will not take it

> any longer and wish to have the formula for weaning yourself off of the

> drug. I did it with my doctor after taking it for about a week while I was

> busy researching. He agreed, and I went off using his formula for

> stopping.

>

> Further,

> how are the dose levels related to long term effects? Do the negative

> effects show up with both therapeutic and physiologic dose levels?

>

> Evidently the higher dose and the longer you're on it of course effects

> will be worse or sooner. However, it affects everything no matter what

> dose you're on, especially if you're taking it all the time.

>

> Even the doctors call it the wonderful terrible drug. It works wonders

> but creates terrible side effects, many of which don't show up right

> away.

>

> Roni

------------------------------------

March 17, 2009

,

Please read this site very carefully, and you will see what I am talking about.

http://www.drugs.com/pro/symbicort.html

Roni

<>Just because something

isn't seen doesn't mean it's

not there<>

From: <res075oh@...>

Subject: Re: Cortef

hypothyroidism

Date: Tuesday, March 17, 2009, 8:52 PM