Interactions with other drugs

The effect of cortisone tablets can be altered by taking different drugs at the same time. Important medications in this context are:

Antirheumatic drugs
Cardiac glycosides (e.g. digitalis)
ACE inhibitors
“the pill”
Certain antibiotics like rifampicin
Oral antidiabetics and insulin

When is the best time to take cortisone tablets – before or after a meal?

Cortisone tablets are best taken before 8:00 in the morning. This is when the highest cortisone release occurs in the body. Taking cortisone tablets in the morning disturbs the body’s own hormonal control circuits as little as possible and minimizes the probability of side effects. There are no relevant recommendations regarding the intake before or after meals. Cortisone tablets can be taken both before and after meals.

Side effects

As a general rule, cortisone must never be discontinued suddenly, as this can lead to side effects. The discontinuation of cortisone-containing medication must always be carried out strictly according to the instructions of the doctor treating you! Side effects of long-term use of cortisone tablets usually only occur if the dose is above the body’s own production for a long time.

With short-term intake (approx. 2 weeks) the risk of side effects is very low. Some patients show a general immune deficiency after taking cortisone tablets.

In addition, taking cortisone can cause muscle atrophy in the arms and legs with simultaneous fat accumulation in the trunk area (trunk obesity). Some patients experience high blood pressure, diabetes mellitus, water retention and pancreatitis after prolonged use of cortisone tablets. The occurrence of osteoporosis and the death (necrosis) of the bones, especially the bone heads, is also possible in the course of a prolonged cortisone overdose.

A further side effect is the inhibition of the natural processes during blood coagulation. Patients often complain of delayed blood coagulation, poorer wound healing and the appearance of punctiform haematomas all over the body. In addition, the use of cortisone can lead to a sharp increase in intraocular pressure (glaucoma) and/or lens opacity (cataract). Since the production of gastric mucus is restricted in the course of cortisone therapy, stomach pain and inflammation of the gastric mucosa often occurs. Psychological symptoms such as depression, irritability, loss of appetite and drive are also possible.

What do I have to consider when I stop taking cortisone tablets?

Treatment with cortisone tablets often causes many people great concern. There are many concerns in the population about the very effective cortisone. For many diseases, however, cortisone is a very good and effective therapy that has far fewer negative consequences than is often assumed.

If cortisone is used correctly, no serious consequences are to be expected. It is therefore very important not to simply stop taking cortisone at a dosage above the so-called Cushing’s threshold. The Cushing’s threshold is defined as a threshold value above the body’s natural cortisone requirement.

Through the external supply of additional cortisone, the adrenal cortex (the adrenal cortex is the actual cortisone producer in the human body) itself produces less cortisone. If the cortisone tablets are discontinued abruptly, this can lead to adrenal cortex insufficiency. The adrenal cortex hardly produces any cortisone of its own and this leads to a lack of cortisone in the body.

The result can be a life-threatening Addison’s crisis, characterised by loss of consciousness, vomiting, nausea, drop in blood pressure and shock. Cortisone tablets must therefore be gradually reduced to avoid such complications. However, a gradual reduction does not apply to cortisone therapy below the Cushing’s threshold mentioned above.

The threshold values differ for different cortisone preparations and are taken into account by the treating physician. Tablets in lower dosages do not have to be expelled. They may be discontinued abruptly.