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It is four times more potent than hydrocortisone, also more selective gluco-corticoid but fluid retention does not occur with high doses. Drug has intermediate duration of action & causes less pituitary adrenal suppression when a single morning dose or alternate day treatment is given.


Allergic, inflammatory, autoimmune diseases, malignancies.


5-60 mg daily in divided doses.


Hypersensitivity, systemic infections. Live virus immunisation. Peptic ulcer.

Special Precautions

Pregnancy. Diabetes mellitus, osteoporosis, psychological disorders, glaucoma, diverticulitis, myasthenia gravis, hypertension, congestive cardiac failure, renal insufficency.

Side Effects

Impairment of fluid, electrolyte metabolic balance, rounded face, supraclavicular hump, obesity of trunk with relatively thin limbs. Fragile skin. Delayed healing of wounds. Psychosis.

Drug Interactions

Action blunted by antiepileptics. Rifampicin accelerates metabolism cyclosporine decreases metabolism. Increased bioavailability with oestrogens and oral contraceptives. Lower plasma salicylate levels. Large doses of antacids impair absorption. Increased requirement of insulin and oral hypoglycaemics.

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