$Unique_ID{BRK01908}
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$Title{CORTISONE (SYSTEMIC)}
$Subject{cortisone acetate (various manufacturers)
Cortone Acetate (Merck Sharp & Dohme)}
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Copyright (C) 1991 Publications International, Ltd.


CORTISONE (SYSTEMIC)
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BRAND NAMES (Manufacturers):
     cortisone acetate (various manufacturers)
     Cortone Acetate (Merck Sharp & Dohme)
TYPE OF DRUG:
     Adrenocorticosteroid hormone
INGREDIENT:
     cortisone
DOSAGE FORM:
     Tablets (5 mg, 10 mg, and 25 mg)
STORAGE:
     Cortisone tablets should be stored at room temperature in a tightly
       closed container.

USES

     Your adrenal glands naturally produce certain cortisone-like chemicals.
These chemicals are involved in various regulatory processes in the body (such
as those involving fluid balance, temperature, and reaction to inflammation).
Cortisone belongs to a group of drugs known as adrenocorticosteroids (or
cortisone-like medications).  It is used to treat a variety of disorders,
including hormonal disorders; asthma; blood diseases; certain cancers; eye
disorders; gastrointestinal disturbances, such as ulcerative colitis;
respiratory diseases; and inflammations such as arthritis, dermatitis, and
poison ivy.  How this drug acts to relieve these disorders is not completely
understood.

TREATMENT

     In order to prevent stomach irritation, you can take cortisone with food
or with milk.
     If you are taking only one dose of this medication each day, try to take
it before 9:00 A.M.  This will mimic the body's normal production of this type
of chemical.
     It is important to try not to miss any doses of cortisone.  However, if
you do miss a dose of this medication, follow these guidelines:
     1. If you are taking it more than once a day, take the missed dose as
soon as possible and return to your regular schedule.  If it is already time
for the next dose, double the dose.
     2. If you are taking this medication once a day, take the dose you missed
as soon as possible, unless you don't remember until the next day.  In that
case, do not take the missed dose at all; just follow your regular dosing
schedule.  Do not double the next dose.
     3. If you are taking this drug every other day, take it as soon as you
remember.  If you missed the scheduled time by a whole day, take it when you
remember, then skip a day before you take the next dose.  Do not double the
dose.
     If you miss more than one dose of cortisone, CONTACT YOUR DOCTOR.

SIDE EFFECTS

     Minor.

     Dizziness, false sense of well-being, fatigue, increased appetite,
increased sweating, indigestion, menstrual irregularities, muscle weakness,
nausea, reddening of the skin on the face, restlessness, sleep disorders,
thinning of the skin, or weight gain.  These side effects should disappear as
your body adjusts to the medication.
     To help avoid potassium loss while using this drug, you can take
your dose with a glass of fresh or frozen orange juice, or eat a
banana each day.  The use of a salt substitute also helps to
prevent potassium loss.  Do not change your diet or take a salt
substitute, however, before discussing it with your doctor.

     Major.

     Tell your doctor about any side effects that are persistent or
particularly bothersome.  IT IS ESPECIALLY IMPORTANT TO TELL YOUR DOCTOR about
abdominal enlargement; acne or other skin problems; back or rib pain; bloody
or black, tarry stools; blurred vision; convulsions; depression; eye pain;
fever; glaucoma; growth impairment (in children); headaches; impaired healing
of wounds; increased thirst and urination; mood changes; muscle wasting;
nightmares; rapid weight gain (three to five pounds within a week); rash;
severe abdominal pain; shortness of breath; sore throat; unusual bleeding or
bruising; or unusual weakness.

INTERACTIONS

     Cortisone interacts with several other types of medications:
     1. Alcohol, aspirin, and anti-inflammatory medications (such as
diflunisal, ibuprofen, indomethacin, ketoprofen, mefenamic acid,
meclofenamate, naproxen, piroxicam, sulindac, and tolmetin) aggravate the
stomach problems that may occur with use of this medication.
     2. The dosage of oral anticoagulants (blood thinners, such as warfarin)
and oral antidiabetic drugs or insulin may need to be altered when this
medication is started or stopped.
     3. The loss of potassium caused by cortisone can lead to serious side
effects in individuals taking digoxin.  Thiazide diuretics (water pills) and
furosemide can increase the potassium loss caused by cortisone.
     4. Phenobarbital, phenytoin, rifampin, and ephedrine can increase the
elimination of cortisone from the body, thereby decreasing its effectiveness.
     5. Oral contraceptives (birth control pills) and estrogen-containing
drugs may decrease the elimination of this drug from the body, which can lead
to an increase in side effects.
     6. Cortisone can increase elimination of aspirin and isoniazid from the
body, decreasing their effectiveness.
     7. Cholestyramine and colestipol can chemically bind this medication in
the stomach and gastrointestinal tract, preventing its absorption.
     BE SURE TO TELL YOUR DOCTOR about any medications you are
currently taking, especially any listed above.

WARNINGS

     * Tell your doctor about unusual or allergic reactions you have had to
any medications, especially to cortisone or other adrenocorticosteroids (such
as betamethasone, dexamethasone, hydrocortisone, methylprednisolone,
paramethasone, prednisolone, prednisone, or triamcinolone).
     * Tell your doctor if you now have or if you have ever had bone disease,
diabetes mellitus, emotional instability, glaucoma, fungal infections, heart
disease, high blood pressure, high cholesterol levels, myasthenia gravis,
peptic ulcers, osteoporosis, thyroid disease, tuberculosis, ulcerative
colitis, kidney disease, or liver disease.
     * If you are using this medication for longer than a week, you may need
to receive higher dosages if you are subjected to stress, such as serious
infections, injury, or surgery.  Discuss this with your doctor.
     * If you have been taking this drug for more than a week, do not stop
taking it suddenly.  If it is stopped suddenly, you may experience abdominal
or back pain, dizziness, extreme weakness, fainting, fever, muscle or joint
pain, nausea, vomiting, or shortness of breath.  Your doctor may, therefore,
want to reduce the dosage gradually.  Never increase the dose or take the drug
for longer than the prescribed time unless you first consult your doctor.
     * While you are taking this drug, you should not be vaccinated or
immunized.  This medication decreases the effectiveness of vaccines and can
lead to infection if a live-virus vaccine is administered.
     * Before having surgery or any other medical or dental treatment, be sure
to tell your doctor or dentist that you are taking this medication.
     * If you are taking this medication for prolonged periods of time, you
should wear or carry an identification card or notice indicating that you are
taking an adrenocorticosteroid drug.
     * Because this drug can cause glaucoma and cataracts with long-term use,
your doctor may want you to have your eyes examined by an ophthalmologist
periodically during treatment.
     * This medication can raise blood sugar levels in diabetic patients.
Blood sugar should, therefore, be monitored carefully with blood or urine
tests when this medication is being taken.
     * Be sure to tell your doctor if you are pregnant.  This drug crosses the
placenta.  Although studies in humans have not been conducted, birth defects
have been observed in the offspring of animals that were given large doses of
this type of drug during pregnancy.  Also, tell your doctor if you are
breast-feeding an infant.  Small amounts of this drug pass into breast milk
and can cause growth suppression or a decrease in natural adrenocorticosteroid
production in the nursing infant.

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The material contained here is "FOR INFORMATION ONLY" and should not replace 
the counsel and advice of your personal physician.  Promptly consulting your 
doctor is the best path to a quick and successful resolution of any medical 
problem.
