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The safety information below outlines important warnings regarding the use of this medication. It is essential to understand these risks and precautions to ensure safe use. Always consult your healthcare provider if you have questions or concerns.

• Increased Blood Pressure and Swelling: This medication can lead to fluid and salt retention, potentially causing high blood pressure, weight gain, and swelling. These side effects may exacerbate conditions such as heart failure, electrolyte imbalances, and kidney issues. It is advisable to follow a low-salt diet and regularly monitor your weight and blood pressure. Notify your healthcare provider about any significant changes. Those with a recent heart attack, heart failure history, high blood pressure, or kidney problems are at greater risk.

• Bone Weakening: Prolonged use may lead to weakened bones, increasing the risk of fractures and potentially slowing growth in children. This risk is higher with long-term or high-dose use, particularly in infants, young children, individuals over 60, post-menopausal women, and those who smoke or consume alcohol. Discuss any concerns with your healthcare provider.

• Adrenal Gland Suppression: Extended use can impair adrenal gland function, making it dangerous to abruptly stop the medication. If discontinuation is necessary, consult your healthcare provider to gradually reduce the dosage and prevent withdrawal symptoms like fatigue, aches, and dizziness. High doses of corticosteroids, long-term use, young children, and stressful situations increase this risk.

• Increased Infection Risk: Long-term use heightens the risk of infections and may mask infection symptoms. Avoid contact with individuals suffering from chickenpox or measles. Those with a history of tuberculosis (TB) require monitoring and possibly preventative treatment. Discuss vaccination plans with your provider, as live vaccines may increase infection risk. Those taking immunosuppressive medications, not vaccinated, or with a history of infections are at increased risk.

• Eye Issues: Prolonged use may increase the risk of cataracts, glaucoma, and eye infections. Do not use this medication if you have herpes simplex of the eye. Report any vision changes, eye pain, or blurry vision to your provider and discuss the frequency of eye exams. Those with a history of cataracts, glaucoma, or herpes simplex in the eye are at increased risk.

• Mood and Behavioral Changes: This medication may cause mood alterations, such as depression, anxiety, mood swings, insomnia, or hallucinations. Report these symptoms to your provider promptly. Consult your provider or pharmacist before adjusting your dose. Those with a history of psychiatric conditions are at higher risk.

• Stomach Issues: There is an increased risk of stomach damage, particularly if alcohol is consumed. Report persistent stomach pain or bloody/dark stools to your provider. You may need protective medication if long-term use is prescribed. Those with a history of stomach bleeding, ulcers, or ulcerative colitis, or who use other stomach-irritating medications, are at greater risk.

Contraindications: Do not use this medication if you have a serious fungal infection. Consult your healthcare provider if this applies to you.

Common side effects:

• Stomach upset
• Headache
• Changes in menstrual cycle (delayed or irregular periods)
• Fluid retention
• Swelling
• Increased blood pressure
• Weight gain
• Trouble sleeping

Less common but important to monitor:

• Changes in skin appearance (thinning or color changes)
• Slow wound healing
• Muscle and bone weakness
• Mood changes
• Fragile skin

Serious side effects:

• Severe allergic reaction (difficulty breathing, swelling of face, tongue, or throat, severe dizziness)
• Changes in vision
• Severe headaches
• Mental health changes (depression or mood swings)
• Seizures
• Symptoms of internal bleeding (abdominal pain or black stools)

Interactions with high risk of serious adverse effects and should be avoided:

• Desmopressin
• Rotavirus Vaccine, Live

Interactions with moderate risk that may require dose adjustment, closer monitoring, or timing changes:

• Balofloxacin
• Besifloxacin
• Bupropion
• Ciprofloxacin
• Enoxacin
• Fleroxacin
• Flumequine
• Gatifloxacin
• Gemifloxacin
• Levofloxacin
• Lomefloxacin
• Macimorelin
• Moxifloxacin
• Nadifloxacin
• Norfloxacin
• Ofloxacin
• Pazufloxacin
• Pefloxacin
• Prulifloxacin
• Rufloxacin
• Sargramostim
• Sparfloxacin
• Tosufloxacin

Interactions with low risk that usually do not require a change in therapy:

• Aldesleukin
• Mifepristone
• Fosphenytoin
• Furosemide
• Licorice
• Phenytoin
• Rifampin
• Rifapentine
• Saiboku-To
• Clopidogrel
• Dabigatran
• Warfarin
• Aspirin
• Celecoxib
• Ibuprofen
• Androgens
• Birth control pills
• Estrogens
• Cyclosporine