Can I take other medicines when I am taking steroids?
Potentially, many other medicines can "interact" with steroids. This means the steroid could affect how they work, either resulting in the other medicine being ineffective, or having more side effects than usual. Or they can interact the other way round, with the other medicine affecting the corticosteroid. Doses may have to be adjusted accordingly in order for both medicines to be taken together.
Examples of medicines which can interact with steroids include:
- Warfarin (a blood-thinning medicine to prevent blood clots).
- Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, diclofenac and naproxen. Both NSAIDs and steroids can cause gut ulcers as a side-effect, so when taken together, the risk is particularly high. A medicine such as a proton pump inhibitor (PPI) may need to be taken in addition, to reduce this risk.
- Live vaccines. Most vaccines do not contain the germ they are protecting against, but a few do. These include the measles, mumps and rubella (MMR) vaccine, rotavirus, yellow fever and tuberculosis (TB). Live vaccines are not usually given for three months after high-dose steroid treatment.
- Medicines for epilepsy, specifically carbamazepine, phenytoin and phenobarbital.
- Medicines for diabetes. (After starting steroids, blood sugars should be tested more frequently, and then the doses of medicines for diabetes can be tweaked if need be.)
- Certain inhalers. If high doses of certain inhalers, such as salbutamol, are used alongside steroids, there can occasionally be complications.
- 'Water tablets' (diuretics).
- Treatments for HIV and AIDS.
What should I do if I am taking one of the medicines which interact with steroids?
As long as your doctor knows you are taking this, he or she can advise accordingly. Usually you can take both medicines, but you may need to be monitored for the effects. For example, you may need blood tests to check the combination is not causing any problems. Doses can then be adjusted as necessary.
Further reading and references
British National Formulary; NICE Evidence Services (UK access only)
Corticosteroids - oral; NICE CKS, August 2015 (UK access only)
Gupta A, Gupta Y; Glucocorticoid-induced myopathy: Pathophysiology, diagnosis, and treatment. Indian J Endocrinol Metab. 2013 Sep17(5):913-6. doi: 10.4103/2230-8210.117215.
I've been interested to read other peoples experiences of Prednisolone on this site and, as a long term Pred user, thought I'd contribute.I was diagnosed with Sarcoidosis of the lungs about 15 years...Guest
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