Consumer Medicine Information

Cortisone

cortisone acetate 5 mg and 25 mg tablets

What is in this leaflet

This leaflet answers some common questions about cortisone.

It does not contain all the available information

It does not take the place of talking to your doctor or pharmacist

Keep this leaflet with the medicine, you may need to read it again.

What is it used for

Cortisone belongs to a group of medicines called corticosteroids. It's properties are:

• anti-inflammatory - acts to reduce heat, pain, swelling or redness
• Immunosuppressant - acts to lower the body's resistance to disease
• Mineralocorticoid - acts on body's fluids

Cortisone is used in replacement therapy of an inactive or underactive adrenal gland eg. Addisons disease.

Your doctor may have prescribed cortisone for another reason.

If you have any concerns about taking this medicine or would like to know why cortisone has been prescribed for you, ask your doctor.

Before you take it

When you must not take it

• Do not take if you have an allergy to cortisone (or related steroids)
• Do not take if you have an allergy to any other ingredients listed at the end of this leaflet.
  Symptoms of an allergic reaction may include skin rash, difficulty breathing, hayfever and swelling.
• Do not take if you have a severe infection
• Do not take if you have been given a live vaccine such as smallpox or polio
  It is permissible if you are being given cortisone for replacement therapy
• Do not take if you have a peptic ulcer (ulcer of the stomach)
• Do not take if you have osteoporosis (bone thinning)
• Do not take if you suffer from psychosis (abnormal thoughts) or severe psychoneuroses (out of place reactions).
• Do not use it after the expiry date (EXP) printed on the pack
  It may not be effective or produce entirely unexpected effects
• Do not use if the packaging is damaged or shows signs of tampering
• Do not use to treat other complaints unless your doctor says it is safe to.

Before you start to take it

Tell your doctor or pharmacist if you have any allergies to:

• any other medicines
• any other substances such as foods, preservatives or dyes

Tell your doctor if you have or have had any of the following conditions:

• Diabetes (disorder of sugar metabolism/control)
• an infectious disease
• heart failure
• kidney failure
• uraemia (body cannot eliminate some by products of protein metabolism)
• high blood pressure
• eye diseases eg. cataracts, glaucoma (high pressure in the eye),ocular herpes.
• weak or brittle bones (osteoporosis)
• tuberculosis (TB)
• hypothyroidism (low output from thyroid gland)
• cirrhosis (liver disease)
• ulcers of the stomach, duodenum (part of digestive tract that immediately follows the stomach) and large intestine

Tell your doctor if you have been given any vaccines recently

Tell your doctor if you are pregnant/intend to become pregnant or breast-feeding

• cortisone is generally not recommended for use during pregnancy as there is inadequate information on the effects of cortisone on the developing child. Your doctor will weigh the risks and benefits of taking this medicine while you are pregnant.
  Cortisone may pass into breast milk and affect the baby. Breastfeeding is not recommended while taking cortisone.

Tell your doctor if you are planning to father a child

• cortisone may increase or decrease the movement and number of spermatozoa

Tell your doctor if you have spent time in the tropics or have unexplained diarrhoea

• cortisone may activate latent parasites

Tell your doctor if you suffer from psychosis (abnormal thoughts)

Tell your doctor or dentist if you plan to have surgery that needs a general anaesthetic

• you may need supplementary corticosteroids to overcome this stressful time

If you have not told your doctor or pharmacist about any of the above, tell them before you start taking cortisone

Taking other medicines

Tell your doctor or pharmacist if you are taking any other medicines including any that you buy without a prescription from your pharmacy, supermarket or health food shop.

Some medicines and cortisone interfere with each other. These include:

• barbiturates or phenytoin - a group of medicines used to treat epilepsy
• phenylbutazone - a non-steroidal anti-inflammatory medicine
• rifampicin - used to treat infections
• anticoagulants - medicines to prevent blood clots
• diuretics - medicines which cause increased volume of urine eg. thiazides or frusemide
• vaccinations

Your doctor and pharmacist may have more medicines to be careful with or avoid.

Other things to consider before taking it

As with other corticosteroid medicines, cortisone may cause dizziness in some people.

Be careful driving or operating machinery until you know how it affects you.

Cortisone is not addictive.

Long term treatment should not be abruptly discontinued as this may result in symptoms of corticosteroid withdrawal syndrome.

How to take it

Follow all directions given to you by your doctor and pharmacist carefully. If you do not understand the instructions ask your pharmacist or doctor.

Do not give this medicine to anyone else even if they have the same or a similar condition to you

How much to take

Your doctor or pharmacist will tell you how many tablets you will need to take each day. This depends on your condition and whether or not you are taking any other medicines. The dose may be altered from time to time.

Do not take more or less cortisone tablets than your doctor has prescribed. If you think the dose is too weak or too strong, talk to your doctor.

How to take it

Swallow the tablets with a glass of water.

When to take it

How often depends on your condition.

In replacement therapy it is usual to take a morning and night dose.

Do not stop taking the medicine even if you feel better.

It does not matter if you take it before or after food

How long to take it

How long depends on your condition and response to the treatment.

Do not stop taking it suddenly as your symptoms may worsen, return or in cases of long term use, withdrawal symptoms may be experienced (corticosteroid withdrawal syndrome).

If you forget to take it

If you miss a dose, whether or not you should take the missed dose or not will depend on how may times a day your doctor has told you to take cortisone.

Do not take a double dose to make up for any missed dose
This may increase the chance of getting an unwanted side effect.

Ask your doctor or pharmacist what to do.

If you have trouble remembering to take your medicine, take your medicine at about the same time each day or ask your pharmacist for some hints.

While you are taking it

Tell your doctor if you get an infection or injury
Symptoms of infections may be hidden by the anti-inflammatory action of cortisone.

Tell any other doctors, dentists and pharmacists who are treating you that you are taking cortisone.

If you are about to be started on a new medicine tell your doctor, dentist and pharmacist that you are taking cortisone.

If you become pregnant, tell your doctor or pharmacist.

Do not have any immunisations
The vaccine may interfere with cortisone or not work at all.

Avoid close contact with anyone who has a contagious disease such as chickenpox or measles

Side effects

Tell your doctor as soon as possible if you do not feel well while you are taking cortisone.

All medicines have side effects. Sometimes they are serious, most of the time they are not.

The following is a list of possible side effects.
Do not be alarmed by this list.
You may not experience any of them.

Tell your doctor if you notice any of the following symptoms:

• slowed growth in children
• bloating or rounding of the face
• cramps or weakness in the muscles of the arms and legs
• water retention leading to swollen legs and feet
• irregular heartbeat or breathlessness
• weight gain
• headache
• tiredness
• irregular menstrual periods
• leg pains
• tingling in hands and feet
• painful joints

Changes in your immune system:

• an increased frequency of infections

Changes in your gastrointestinal system

• nausea
• vomiting
• indigestion (burning sensation)
• weight loss

Mental effects

• mood swings
• euphoria
• personality changes
• severe depression
• insomnia (inability to sleep)
• abnormal thoughts
• headaches
• fits

Changes to your skin

• impaired wound healing
• itchy rash
• red skin
• patches of skin which are pale or red compared to surrounding skin
• thin fragile skin

Changes to the eyes

• decreased or blurred vision
• protruding eyeballs

Tell your doctor immediately or go to the Accident and Emergency at your nearest hospital if you notice:

• severe stomach or intestinal pain
• sudden changes in vision
• chest pain or irregular heartbeat
• dizziness/fainting or feeling faint
• difficulty breathing and swelling of the face

These side effects are very serious

When cortisone is taken for long periods of time, it is important to visit your doctor regularly for check ups.
Some side effects can only be detected by your doctor. It is important that changes in the following are detected:

• strength of bones (osteoporosis)
• blood sugar levels (diabetes)
• eye pressure (glaucoma)
• sperm count
• blood pressure (hypertension)
• blood cell changes
• heart beat
• nerve function

Other side effects not listed above may occur in some patients. Tell your doctor or pharmacist about any undesirable side effects not mentioned in this leaflet.

In case of overdose

Adverse effects related to cortisone normally develop only after prolonged use.

If you take too many tablets, immediately telephone your doctor or pharmacist or the Poisons Information Centre (telephone 0800 POISON or 0800 764 766) or go to the Accident and Emergency department at your nearest hospital, if you think that you or anyone else may have taken too much cortisone. Do this even if there are no signs of discomfit or poisoning.

Storage conditions

Keep your tablets in the original container until it is time to take them.
If you take the tablets out of the original container they will not keep well.

Keep your tablets in a cool dry place away from light where the temperature stays below 30°C.

Do not store your tablets in the bathroom or near a sink.

Do not leave it in the car or on a windowsill.
Heat and dampness can destroy medicines.

Keep your tablets where children cannot reach them.
As with all medicines, you should store your tablets out of the reach of children. A locked cupboard at least one-and-a-half metres above the ground is a good place to store medicines.

Disposal

If your doctor tells you to stop taking this medicine or the tablets have passed their expiry date, ask your pharmacist what to do with any that are left over.

Product description

What it looks like

Cortisone 5 mg and 25 mg tablets come in packs of 100 and 500 tablets

Cortisone 5 mg tablets are round biconvex white tablets with a break line.

Cortisone 25 mg tablets are round flat white tablets with a break-line.

Ingredients

Active: cortisone

Other: magnesium stearate, talc, lactose, maize cornflour, povidone.

Supplier

Douglas Pharmaceuticals Ltd
PO Box 45-027
Auckland 8

Date of preparation: 19 December 2003