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The lowest possible dose of corticosteroid should be used to control the condition being treatedA gradual reduction in dosage should be made when possible.
Advise the patient to use the medicine onlyas directedto take a missed dose as soon as possibleunless it is almost time for the next doseand not to double the next dose.
Average and large doses of hydrocortisone or cortisone can cause elevation of blood pressuresalt and water retentionand increased excretion of potassiumThese effects are less likely to occur with the synthetic derivatives except when used in large dosesHoweversince fludrocortisone acetate is a potent mineralocorticoidboth the dosage and salt intake should be carefully monitored in order to avoid the development of hypertensionedemaor weight gainPeriodic checking of serum electrolyte levels is advisable during prolonged therapydietary salt restriction and potassium supplementation may be necessaryAll corticosteroids increase calcium excretion.
Corticosteroids may mask some signs of infectionand new infections may appear during their useThere may be decreased resistance and inability to localize infection when corticosteroids are usedIf an infection occurs during fludrocortisone acetate therapyit should be promptly controlled by suitable antimicrobial therapy.
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