Interactions with other drugs
Glucocorticoids are metabolised and broken down in the liver by special enzymes (CYP450). Therefore, drugs that are also metabolised by these enzymes can inhibit or increase their activity. This can lead to interactions with cortisone sprays.
Many antifungal drugs such as itraconazole, ketoconazole or HIV drugs such as ritonavir and nelfinavir, antibiotics such as troleandromycin and erythromycin and the drug ciclospoprine A inhibit this important enzyme and thus prevent the breakdown of glucocorticoids. Not only drugs, but also grapefruit juice, for example, leads to an inhibition of the CYP450 enzyme. Through these so-called CYP inhibitors, the glucocorticoids accumulate in the body and their effect, but unfortunately also their side effects, can be intensified.
Apart from the enhancers, there are also active substances that promote the breakdown of cortisone sprays in the liver. These include the antiepileptic drug carbamazepine and the antibiotic rifampicin. This means that a higher dose of the cortisone spray may be necessary.
In women who are taking hormonal contraceptives – apart from the minipill – the concentration of the cortisone spray may also be higher, which increases the effect and may increase the risk of side effects. Glucocorticoids can also affect the excretion of potassium and cause a potassium deficiency (hypokalemia). This potassium deficiency promotes the effect and also possible side effects of digitalis preparations.
Price for cortisone sprays
The price of cortisone sprays varies greatly and depends on the respective preparation. Many sprays are available only on prescription, for example for asthma or COPD. However, the costs of such sprays are also covered by health insurance, as they are necessary drugs.
An example of such a preparation is a budesonide inhalation spray. This costs around 40-50 euros and usually contains 200 single doses. Freely available cortisone sprays that have to be paid for privately are for example some nasal sprays or skin sprays.
The price for a cortisone nasal spray is usually between 5 and 10 euros. Skin sprays can be found starting at a price of 3 euros.
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