OBJECT DRUGS

Corticosteroids:

• Budesonide (Entocort, etc.)
• Cortisone (Cortone)
• Dexamethasone (Decadron, etc.)
• Fluticasone (Flovent, etc.)
• Methylprednisolone (Medrol, etc.)
• Prednisolone (Prelone, etc.)
• Prednisone (Orasone, etc.)
• Triamcinolone (Aristocort, etc.)

PRECIPITANT DRUGS

Enzyme Inducers:

• Barbiturates
• Bosentan (Tracleer)
• Carbamazepine (Tegretol, etc.)
• Dabrafenib (Tafinlar)
• Efavirenz (Sustiva)
• Lumacaftor (Orkambi)
• Nevirapine (Viramune, etc.)
• Oxcarbazepine (Trileptal, etc.)
• Phenytoin (Dilantin, etc.)
• Primidone (Mysoline)
• Rifabutin (Mycobutin)
• Rifampin (Rifadin, etc.)
• Rifapentine (Priftin)
• St. John's wort
• Topiramate (Topamax, etc.)

Comment:

Enzyme inducers can enhance the metabolism and reduce the therapeutic response to systemic corticosteroids. Increased corticosteroid dosage may be necessary. No adverse interaction would be expected if the corticosteroid is given topically or for other local effect, since reduced systemic exposure to the corticosteroid might actually reduce systemic adverse effects.

Class 3: Assess Risk & Take Action if Necessary

• Monitor: Monitor the patient for reduced corticosteroid response if enzyme inducers are given concurrently. Substantial alterations in corticosteroid dosage may be necessary if enzyme inducers are initiated, discontinued, or changed in dosage. Keep in mind that enzyme induction is usually gradual and may take days to weeks for onset and offset.