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In post-marketing experiencethere have been reports of both increases and decreases in phenytoin levels with dexamethasone co-administrationleading to alterations in seizure control.

Corticosteroids may exacerbate systemic fungal infections and therefore should not be used in the presence of such infections unless they are needed to control life-threatening drug reactionsThere have been cases reported in which concomitant use of amphotericin B and hydrocortisone was followed by cardiac enlargement and congestive heart failuresee PRECAUTIONSDrug InteractionsAmphotericin B injection and potassium-depleting agents

Corticosteroids should be used with great care in patients with known or suspected Strongyloidesthreadworminfestationcorticosteroid-induced immunosuppression may lead to Strongyloides hyperinfection and dissemination with widespread larval migrationoften accompanied by severe enterocolitis and potentially fatal gram-negative septicemianot for use in cerebral malaria.

GastrointestinalAbdominal distentionelevation in serum liver enzyme levelsusually reversible upon discontinuationhepatomegalyincreased appetitenauseapancreatitispeptic ulcer with possible perforation and hemorrhageperforation of the small and large intestineparticularly in patients with inflammatory bowel diseaseulcerative esophagitis.

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