Drug Interactions:

Corticosteroids (Glucocorticoids)

Alternate Names
  • Glucocorticoids

Corticosteroid drugs (also known as glucocorticoids) act like the naturally occurring adrenal cortisone in the body. They are strong anti-inflammatory and immune-suppressant medications used in many inflammatory and autoimmune conditions, such as arthritis, asthma, inflammatory bowel disease, and systemic lupus erythematosus. Corticosteroids are also prescribed to suppress transplant rejection.

Drugs in this family include

• betamethasone (Celestone)
• cortisone acetate (Cortone Acetate)
• dexamethasone (Decadron, Dexameth, Dexone, Hexadrol)
• hydrocortisone (Cortef, Hydrocortone)
• methylprednisolone (Medrol)
• prednisolone (Delta-Cortef, Pediapred, Prelone)
• prednisone (Deltasone, Liquid Pred, Meticorten, Orasone, Panasol-S, Prednicen-M, Sterapred DS)
• triamcinolone (Aristocort, Atolone, Kenacort)
• and others

Calcium, Vitamin D

Helpful Interactions

One of the most serious side effects of long-term corticosteroid use is accelerated osteoporosis. Although we don't fully understand how this works, corticosteroid interference with calcium and vitamin D is known to play a major role.

Calcium and vitamin D supplements are definitely beneficial for fighting ordinary osteoporosis; in addition, there is good evidence that they also protect against osteoporosis brought on by corticosteroids.¹ A review of five trials enrolling a total of 274 participants found that calcium and vitamin D supplementation significantly prevented bone loss at the lumbar spine and forearm in corticosteroid-treated individuals.² For example, in a 2-year double-blind placebo-controlled study of 130 individuals, supplementation with 1,000 mg of calcium and 500 IU of vitamin D daily actually reversed steroid-induced bone loss, causing a net bone gain.³

Topical Herbal Treatments

Possible Helpful Interactions

Aloe and licorice are two herbs sometimes used for skin problems. Preliminary evidence suggests that each one might help topical corticosteroids such as hydrocortisone work better.^4,5

However, internal use of licorice might interfere unpredictably with corticosteroid treatment and should be avoided.^6,7,8

DHEA (Dehydroepiandrosterone)

Possible Positive Interaction

There are theoretical reasons (but little direct evidence) to believe that individuals taking corticosteroids (such as prednisone) might be protected from some side effects by taking DHEA at the same time.^9,10

Chromium

Supplementation Possibly Helpful

Long-term, high-dose corticosteroid treatment can cause diabetes. This may be at least partly caused by chromium deficiency. A very preliminary study found treatment with corticosteroids caused increased loss of chromium in the urine.¹¹ Another preliminary study found that individuals with corticosteroid-induced diabetes could improve blood sugar control by taking chromium supplements.¹²

Ipriflavone

Possible Harmful Interaction

The supplement ipriflavone is used to treat osteoporosis. A 3-year double-blind trial of almost 500 women, as well as a small study, found worrisome evidence that ipriflavone can reduce white blood cell count in some people.^13,14 For this reason, anyone taking medications that suppress the immune system should avoid using ipriflavone except under physician supervision.

Last reviewed March 2002 by Medical Review Board

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