Cortisone

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Cortisone Brand Name– Cortone

What is Cortisone

Cortisone is an endogenous corticosteroid hormone secreted by the adrenal cortex.

Unlike most of the corticosteroids, cortisone exhibits significant mineralocorticoid as well as glucocorticoid properties and is used clinically as replacement therapy in patients with adrenocortical insufficiency.

Cortisone has about 80% of the anti-inflammatory and sodium-retaining potency of hydrocortisone.

Synthetic corticosteroids that have minimal mineralocorticoid activity are preferred over cortisone for anti-inflammatory or immunosuppressive uses.

Commercial cortisone products are available as the acetate ester. Cortisone was approved by the FDA in 1950.

Indications

  1. acute lymphocytic leukemia (ALL)
  2. Addison’s disease
  3. adrenocortical insufficiency
  4. adrenogenital syndrome
  5. allergic conjunctivitis
  6. allergic rhinitis
  7. anaphylactic shock
  8. anaphylaxis
  9. angioedema
  10. ankylosing spondylitis
  11. anterior segment inflammation
  12. asthma
  13. atopic dermatitis
  14. berylliosis
  15. bronchospasm prophylaxis
  16. bursitis
  17. chorioretinitis
  18. chronic lymphocytic leukemia (CLL)
  19. chronic obstructive pulmonary disease (COPD)
  20. Churg-Strauss syndrome
  21. congenital adrenal hyperplasia
  22. contact dermatitis
  23. corneal ulcer
  24. Crohn’s disease
  25. dermatitis herpetiformis
  26. dermatomyositis
  27. eczema
  28. endophthalmitis
  29. epicondylitis
  30. erythroblastopenia
  31. exfoliative dermatitis
  32. gouty arthritis
  33. Graves’ ophthalmopathy
  34. hemangioma
  35. hemolytic anemia
  36. herpes zoster ocular infection
  37. Hodgkin lymphoma
  38. hypercalcemia
  39. hypoplastic anemia
  40. immune thrombocytopenic purpura (ITP)
  41. iritis
  42. juvenile rheumatoid arthritis (JRA)/juvenile idiopathic arthritis (JIA)
  43. keratitis
  44. kidney transplant rejection
  45. kidney transplant rejection prophylaxis
  46. laryngotracheobronchitis (croup)
  47. Loeffler’s syndrome
  48. meningitis
  49. mixed connective tissue disease
  50. multiple myeloma
  51. multiple sclerosis
  52. myasthenia gravis
  53. mycosis fungoides
  54. nasal polyps
  55. nephrotic syndrome
  56. non-Hodgkin’s lymphoma (NHL)
  57. optic neuritis
  58. osteoarthritis
  59. pemphigus
  60. perennial allergies
  61. pneumonitis
  62. polyarteritis nodosa
  63. polychondritis
  64. polymyositis
  65. postoperative ocular inflammation
  66. proteinuria
  67. pseudogout
  68. psoriasis
  69. psoriatic arthritis
  70. pulmonary edema
  71. rheumatic carditis
  72. rheumatoid arthritis
  73. sarcoidosis
  74. seasonal allergies
  75. seborrheic dermatitis
  76. serum sickness
  77. Stevens-Johnson syndrome
  78. systemic lupus erythematosus (SLE)
  79. temporal arteritis
  80. tenosynovitis
  81. thrombocytopenia
  82. thyroiditis
  83. trichinosis
  84. tuberculosis infection
  85. ulcerative colitis
  86. uveitis
  87. vernal keratoconjunctivitis
  88. Wegener’s granulomatosis

Side Effects

  1. abdominal pain
  2. acne vulgaris
  3. acneiform rash
  4. adrenocortical insufficiency
  5. alopecia
  6. amenorrhea
  7. amnesia
  8. anaphylactoid reactions
  9. anemia
  10. angina
  11. angioedema
  12. anorexia
  13. anxiety
  14. appetite stimulation
  15. arrhythmia exacerbation
  16. arthralgia
  17. avascular necrosis
  18. blurred vision
  19. bone fractures
  20. bradycardia
  21. candidiasis
  22. cardiac arrest
  23. cardiomyopathy
  24. cataracts
  25. constipation
  26. Cushing’s syndrome
  27. delirium
  28. depression
  29. diabetes mellitus
  30. diaphoresis
  31. diarrhea
  32. dizziness
  33. dysmenorrhea
  34. ecchymosis
  35. edema
  36. EEG changes
  37. elevated hepatic enzymes
  38. emotional lability
  39. erythema
  40. esophageal ulceration
  41. euphoria
  42. exfoliative dermatitis
  43. exophthalmos
  44. fever
  45. fluid retention
  46. gastritis
  47. GI bleeding
  48. GI perforation
  49. glossitis
  50. glycosuria
  51. growth inhibition
  52. hallucinations
  53. headache
  54. heart failure
  55. hepatomegaly
  56. hiccups
  57. hirsutism
  58. hypercholesterolemia
  59. hyperglycemia
  60. hypernatremia
  61. hypertension
  62. hyperthyroidism
  63. hypocalcemia
  64. hypokalemia
  65. hypotension
  66. hypothalamic-pituitary-adrenal (HPA) suppression
  67. hypothyroidism
  68. immunosuppression
  69. impaired cognition
  70. impaired wound healing
  71. increased intracranial pressure
  72. infection
  73. insomnia
  74. irritability
  75. lethargy
  76. lupus-like symptoms
  77. malaise
  78. mania
  79. memory impairment
  80. menstrual irregularity
  81. metabolic alkalosis
  82. myalgia
  83. myocardial infarction
  84. myopathy
  85. nausea
  86. neuritis
  87. neutropenia
  88. ocular hypertension
  89. ocular infection
  90. optic neuritis
  91. osteopenia
  92. osteoporosis
  93. palpitations
  94. pancreatitis
  95. papilledema
  96. paresthesias
  97. peptic ulcer
  98. perineal pain
  99. peripheral neuropathy
  100. petechiae
  101. phlebitis
  102. physiological dependence
  103. postmenopausal bleeding
  104. pruritus
  105. pseudotumor cerebri
  106. psychosis
  107. pulmonary edema
  108. purpura
  109. rash
  110. restlessness
  111. retinopathy
  112. seizures
  113. sinus tachycardia
  114. skin atrophy
  115. sodium retention
  116. striae
  117. stroke
  118. syncope
  119. telangiectasia
  120. tendon rupture
  121. thromboembolism
  122. thrombosis
  123. urticaria
  124. vasculitis
  125. vertigo
  126. visual impairment
  127. vomiting
  128. weakness
  129. weight gain
  130. weight loss
  131. withdrawal
  132. xerosis

Monitoring Parameters

  • blood glucose
  • blood pressure
  • growth rate
  • heart rate
  • serum potassium
  • weight

Contraindications

  • abrupt discontinuation
  • breast-feeding
  • cataracts
  • children
  • coagulopathy
  • corticosteroid hypersensitivity
  • Cushing’s syndrome
  • diabetes mellitus
  • diverticulitis
  • fungal infection
  • geriatric
  • GI disease
  • glaucoma
  • growth inhibition
  • heart failure
  • hepatic disease
  • herpes infection
  • hypertension
  • hypothyroidism
  • increased intracranial pressure
  • infants
  • infection
  • inflammatory bowel disease
  • measles
  • myasthenia gravis
  • myocardial infarction
  • neonates
  • ocular infection
  • osteoporosis
  • peptic ulcer disease
  • pregnancy
  • psychosis
  • renal disease
  • seizure disorder
  • surgery
  • thromboembolic disease
  • tuberculosis
  • ulcerative colitis
  • vaccination
  • varicella
  • viral infection
  • visual disturbance

Interactions

  • Abatacept
  • Acetaminophen; Aspirin, ASA; Caffeine
  • Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
  • Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide
  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
  • Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
  • Acetaminophen; Dextromethorphan; Guaifenesin; Phenylephrine
  • Acetaminophen; Dextromethorphan; Phenylephrine
  • Acetaminophen; Guaifenesin; Phenylephrine
  • Acetazolamide
  • Acetohexamide
  • Adalimumab
  • Albiglutide
  • Aldesleukin, IL-2
  • Alemtuzumab
  • Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ
  • Aliskiren; Hydrochlorothiazide, HCTZ
  • Alogliptin; Metformin
  • Alpha-glucosidase Inhibitors
  • Altretamine
  • Ambenonium Chloride
  • Amifampridine
  • Amiloride; Hydrochlorothiazide, HCTZ
  • Aminolevulinic Acid
  • Aminosalicylate sodium, Aminosalicylic acid
  • Amlodipine; Hydrochlorothiazide, HCTZ; Olmesartan
  • Amlodipine; Hydrochlorothiazide, HCTZ; Valsartan
  • Amphotericin B
  • Amphotericin B cholesteryl sulfate complex (ABCD)
  • Amphotericin B lipid complex (ABLC)
  • Amphotericin B liposomal (LAmB)
  • Antithymocyte Globulin
  • Antitumor antibiotics
  • Argatroban
  • Arsenic Trioxide
  • Asparaginase Erwinia chrysanthemi
  • Aspirin, ASA
  • Aspirin, ASA; Butalbital; Caffeine
  • Aspirin, ASA; Butalbital; Caffeine; Codeine
  • Aspirin, ASA; Caffeine; Dihydrocodeine
  • Aspirin, ASA; Caffeine; Orphenadrine
  • Aspirin, ASA; Carisoprodol
  • Aspirin, ASA; Carisoprodol; Codeine
  • Aspirin, ASA; Citric Acid; Sodium Bicarbonate
  • Aspirin, ASA; Dipyridamole
  • Aspirin, ASA; Omeprazole
  • Aspirin, ASA; Oxycodone
  • Aspirin, ASA; Pravastatin
  • Atenolol; Chlorthalidone
  • Atracurium
  • Atropine; Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
  • Azathioprine
  • Azilsartan; Chlorthalidone
  • Basiliximab
  • Benazepril; Hydrochlorothiazide, HCTZ
  • Bendroflumethiazide; Nadolol
  • Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
  • Bepridil
  • Bismuth Subsalicylate
  • Bismuth Subsalicylate; Metronidazole; Tetracycline
  • Bisoprolol; Hydrochlorothiazide, HCTZ
  • Bivalirudin
  • Bortezomib
  • Brompheniramine; Carbetapentane; Phenylephrine
  • Bupropion
  • Bupropion; Naltrexone
  • Calcium Carbonate
  • Calcium Carbonate; Magnesium Hydroxide
  • Calcium Carbonate; Risedronate
  • Calcium Carbonate; Simethicone
  • Canagliflozin
  • Canagliflozin; Metformin
  • Candesartan; Hydrochlorothiazide, HCTZ
  • Captopril; Hydrochlorothiazide, HCTZ
  • Carbetapentane; Chlorpheniramine; Phenylephrine
  • Carbetapentane; Diphenhydramine; Phenylephrine
  • Carbetapentane; Guaifenesin; Phenylephrine
  • Carbetapentane; Phenylephrine
  • Carbetapentane; Phenylephrine; Pyrilamine
  • Carbinoxamine; Hydrocodone; Phenylephrine
  • Carbinoxamine; Phenylephrine
  • Carmustine, BCNU
  • Chlophedianol; Guaifenesin; Phenylephrine
  • Chlorambucil
  • Chlorothiazide
  • Chlorpheniramine; Dextromethorphan; Phenylephrine
  • Chlorpheniramine; Dihydrocodeine; Phenylephrine
  • Chlorpheniramine; Hydrocodone; Phenylephrine
  • Chlorpheniramine; Phenylephrine
  • Chlorpropamide
  • Chlorthalidone
  • Chlorthalidone; Clonidine
  • Choline Salicylate; Magnesium Salicylate
  • Cimetidine
  • Cisatracurium
  • Citalopram
  • Clindamycin
  • Clofarabine
  • Codeine; Phenylephrine; Promethazine
  • Conivaptan
  • Cosyntropin
  • Dapagliflozin
  • Dapagliflozin; Metformin
  • Dapagliflozin; Saxagliptin
  • Denileukin Diftitox
  • Denosumab
  • Desmopressin
  • Dextran
  • Dextromethorphan; Diphenhydramine; Phenylephrine
  • Dextromethorphan; Guaifenesin; Phenylephrine
  • Digoxin
  • Dipeptidyl Peptidase-4 Inhibitors
  • Diphenhydramine; Hydrocodone; Phenylephrine
  • Diphenhydramine; Phenylephrine
  • Dofetilide
  • Doxacurium
  • Droperidol
  • Dulaglutide
  • Echinacea
  • Econazole
  • Efalizumab
  • Empagliflozin
  • Empagliflozin; Linagliptin
  • Empagliflozin; Linagliptin; Metformin
  • Empagliflozin; Metformin
  • Enalapril; Hydrochlorothiazide, HCTZ
  • Ephedrine
  • Eprosartan; Hydrochlorothiazide, HCTZ
  • Erlotinib
  • Ertugliflozin
  • Ertugliflozin; Metformin
  • Ertugliflozin; Sitagliptin
  • Estramustine
  • Estrogens
  • Exenatide
  • Fluconazole
  • Fluoxymesterone
  • Fosinopril; Hydrochlorothiazide, HCTZ
  • Gallium Ga 68 Dotatate
  • Gemcitabine
  • Gentamicin
  • Glimepiride
  • Glimepiride; Pioglitazone
  • Glimepiride; Rosiglitazone
  • Glipizide
  • Glipizide; Metformin
  • Glyburide
  • Glyburide; Metformin
  • Glycerol Phenylbutyrate
  • Guaifenesin; Phenylephrine
  • Halofantrine
  • Haloperidol
  • Hemin
  • Heparin
  • Hetastarch
  • Hyaluronidase
  • Hyaluronidase, Recombinant; Immune Globulin
  • Hydralazine; Hydrochlorothiazide, HCTZ
  • Hydrochlorothiazide, HCTZ
  • Hydrochlorothiazide, HCTZ; Irbesartan
  • Hydrochlorothiazide, HCTZ; Lisinopril
  • Hydrochlorothiazide, HCTZ; Losartan
  • Hydrochlorothiazide, HCTZ; Methyldopa
  • Hydrochlorothiazide, HCTZ; Metoprolol
  • Hydrochlorothiazide, HCTZ; Moexipril
  • Hydrochlorothiazide, HCTZ; Olmesartan
  • Hydrochlorothiazide, HCTZ; Propranolol
  • Hydrochlorothiazide, HCTZ; Quinapril
  • Hydrochlorothiazide, HCTZ; Spironolactone
  • Hydrochlorothiazide, HCTZ; Telmisartan
  • Hydrochlorothiazide, HCTZ; Triamterene
  • Hydrochlorothiazide, HCTZ; Valsartan
  • Hydrocodone; Phenylephrine
  • Hydroxyurea
  • Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate; Sodium Biphosphate
  • Ibritumomab Tiuxetan
  • Incretin Mimetics
  • Indapamide
  • Insulin Degludec; Liraglutide
  • Insulin Glargine; Lixisenatide
  • Insulins
  • Interferon Alfa-2a
  • Interferon Alfa-2b
  • Interferon Alfa-2b; Ribavirin
  • Iohexol
  • Isoproterenol
  • Isotretinoin
  • L-Asparaginase Escherichia coli
  • Levetiracetam
  • Levomethadyl
  • Linagliptin; Metformin
  • Liraglutide
  • Live Vaccines
  • Lixisenatide
  • Lomustine, CCNU
  • Loop diuretics
  • Macimorelin
  • Magnesium Salicylate
  • Mannitol
  • Mecasermin rinfabate
  • Mecasermin, Recombinant, rh-IGF-1
  • Meglitinides
  • Melphalan
  • Mepenzolate
  • Metformin
  • Metformin; Pioglitazone
  • Metformin; Repaglinide
  • Metformin; Rosiglitazone
  • Metformin; Saxagliptin
  • Metformin; Sitagliptin
  • Methacholine
  • Methazolamide
  • Methenamine; Sodium Acid Phosphate
  • Methenamine; Sodium Acid Phosphate; Methylene Blue; Hyoscyamine
  • Methoxsalen
  • Methyclothiazide
  • Metolazone
  • Metyrapone
  • Micafungin
  • Mifepristone
  • Mitoxantrone
  • Mivacurium
  • Moxifloxacin
  • Muromonab-CD3
  • Natalizumab
  • Nateglinide
  • Nelarabine
  • Neostigmine
  • Neuromuscular blockers
  • Nicardipine
  • Nonsteroidal antiinflammatory drugs
  • Ocrelizumab
  • Ondansetron
  • Oxymetholone
  • Pancuronium
  • Pegaspargase
  • Penicillamine
  • Phenylephrine
  • Phenylephrine; Promethazine
  • Photosensitizing agents (topical)
  • Physostigmine
  • Pimozide
  • Potassium
  • Potassium Chloride
  • Potassium Phosphate; Sodium Phosphate
  • Potassium-sparing diuretics
  • Pramlintide
  • Prasterone, Dehydroepiandrosterone, DHEA (Dietary Supplements)
  • Prasterone, Dehydroepiandrosterone, DHEA (FDA-approved)
  • Propranolol
  • Purine analogs
  • Pyridostigmine
  • Quetiapine
  • Rapacuronium
  • Regular Insulin
  • Repaglinide
  • Ritodrine
  • Rituximab
  • Rituximab; Hyaluronidase
  • Rocuronium
  • Salicylates
  • Salsalate
  • Sargramostim, GM-CSF
  • Semaglutide
  • SGLT2 Inhibitors
  • Siponimod
  • Sodium Benzoate; Sodium Phenylacetate
  • Sodium Chloride
  • Sodium Phenylbutyrate
  • Sodium Phosphate Monobasic Monohydrate; Sodium Phosphate Dibasic Anhydrous
  • Somatropin, rh-GH
  • Succinylcholine
  • Sulfonylureas
  • Telbivudine
  • Tesamorelin
  • Testosterone
  • Thiazide diuretics
  • Thiazolidinediones
  • Thyroid hormones
  • Tobramycin
  • Tolazamide
  • Tolbutamide
  • Tositumomab
  • Tranexamic Acid
  • Trastuzumab; Hyaluronidase
  • Tretinoin, ATRA
  • Tuberculin Purified Protein Derivative, PPD
  • Tubocurarine
  • Vancomycin
  • Vecuronium
  • Vigabatrin
  • Vinblastine
  • Vincristine Liposomal
  • Vorinostat
  • Warfarin
  • Zafirlukast
  • Zileuton

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