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Anti-inflammatory medications - inhalant, systemic, and topical corticosteroids

Inhalant anti-inflammatory medications include:

  • Beclomethasone (Beclovent, Beconase, Beconase AQ, QVAR, Vancenase, Vancenase AQ, and Vanceril
  • Budesonide (Pulmicort Respules, Pulmicort Turbuhaler, Rhinocort, and Rhinocort Aqua)
  • Ciclesonide (Alvesco, Omnaris, Zetonna)
  • Fluticasone (Cutivate, Flonase, Flovent, Flovent Diskus, and Flovent Rotadisk)
  • Flunisolide (Aerobid, Aerobid-M, Aerospan, Nasalide, Nasarel)
  • Mometasone Furoate (Elocon and Nasonex)

Topical anti-inflammatory medications include:

  • Clobetasol (Clobevate, Clobex, Clodan, Cormax, Embeline)
  • Desonide (DesOwen, Desonate, Desonil, Desonil Plus, LoKara)
  • Desoximetasone (Topicort, Topicort LP)
  • Diflorasone (Apexicon, Apexicon E, Florone, Maxiflor, Psorcon)
  • Halcinonide (Halog, Halog-E)
  • Prednicarbate (Dermatop)
  • Hydrocortisone (A-hydroCort, Ala-Cort, Ala-Scalp, Anucort-HC Suppository, Anusol-HC Suppository, Anusol HC 1[OTC], Anusol HC 2.5% [OTC], Cetacort, Clocort maximum strength, Cort-Dome, Cortaid maximum strength [OTC], Cortaid with Aloe [OTC], Cortef, Cortef Feminine Itch, Cortenema, Corticaine, Cortifoam, Cortizone-10 [OTC], Cortizone-5 [OTC], Delcort, Dermacort, DermiCort, Dermolate [OTC], Dermtex HC with Aloe, Eldecort, Gynecort [OTC], Hemril-HC Uniserts, Hi-Cor 1.0, Hi-Cor 2.5, Hycort, Hydrocort, Hydrocortone Acetate, Hydrocortone Phosphate, HydroTex [OTC], Hytone, LactiCare-HC, Lanacort [OTC], Locoid, Nutracort, Orabase HCA, Pandel, Penecort, Procort[OTC], Proctocort, S-T Cort, Scalpicin, Solu-Cortef, Synacort, Tegrin-HC [OTC], Texacort, Westcort, and Methylprednisolone)
  • Triamcinolone (Amcort, Aristocort, Aristocort A, Aristocort Forte, Aristocort Intralesional, Aristospan Intra-Articular, Aristospan Intralesional, Atolone, Azmacort, Delta-Tritex, Flutex, Kenacort, Kenaject-40, Kenalog-10, Kenalog-40, Kenalog, Kenalog H, Kenalog in Orabase, Kenonel, Nasacort, Nasacort AQ, Tac-3, Tac-40, Tri-Kort, Tri-Nasal, Triacet, Triam Forte, Triam-A, Triderm, Trilog, Trilone, and Tristoject)

Systemic anti- inflammatory medications:

  • Betamethasone (Adbeon, Alphatrex, Beta1 Kit, Beta Derm, Beta-Val)
  • Dexamethasone (AK-Dex ophthalmic, Baldex, Dalalone D.P., Dalalone L.A., Dalalone, Decadron, Decadron Phosphate, Decadron-LA, Decaject-LA, Decaject, Decaspray, Dexacort Phosphate Turbinaire, Dexasone, Dexasone L.A., Dexone, Dexone LA, Hexadrol, Hexadrol Phosphate, Maxidex, Solurex L.A., and Solurex)
  • Prednisone (Deltasone, Liquid Pred, Meticorten, Orasone, and Prednicen-M)
 

Depletions

Calcium

Taking budesonide, dexamethasone, hydrocortisone, prednisone, betamethasone, or triamcinolone may deplete calcium.

Calcium, along with vitamin D, keeps your bones strong and healthy.

Low levels of calcium may cause:

  • Muscle cramps
  • Numbness or tingling in toes and feet
  • Irregular heartbeat
  • Depression
  • Bone pain
  • Spinal problems
  • Seizures
Magnesium

Taking budesonide may deplete magnesium.

Magnesium deficiency affects calcium and vitamin D levels in the body. This may cause:

  • Muscle cramps
  • Muscle weakness
  • Irregular heartbeat
  • Numbness and tingling in feet and toes
  • Seizures
  • Insomnia
  • High blood pressure
Potassium

Taking budesonide, dexamethasone, hydrocortisone, prednisone, betamethasone, flunisolide, or triamcinolone may deplete potassium.

Symptoms of potassium deficiency include:

  • Nausea and vomiting
  • Tiredness
  • Drowsiness
  • Feeling of apprehension
  • Weakness
  • Muscle pain and weakness (mostly in the legs)
  • Muscle cramps
  • Strong, rapid or irregular heartbeat
Vitamin A (Retinol)

Taking betamethasone may deplete vitamin A.

Low levels of vitamin A may cause:

  • Night blindness
  • Rough and dry skin
  • Itchy skin
  • Dull hair
  • Broken nails
  • Increased risk of infections
Vitamin B9 (Folic Acid)

Taking prednisone, betamethasone or triamcinolone may deplete vitamin B9.

Low levels of folic acid in the body may be linked to:

  • Anemia
  • Heart disease
  • Birth defects

Symptoms may include:

  • Weakness
  • Mouth sores
  • Swollen tongue
  • Depression
  • Poor growth
Vitamin C (Ascorbic Acid)

Taking dexamethasone, prednisone, betamethasone, and triamcinolone may deplete vitamin C.

Low levels of vitamin C in your body cause a condition called scurvy. Some common symptoms are:

  • Soft, bleeding gums
  • Injuries that are slow to heal
  • Weakened immune system
  • Fatigue
  • Weight loss
  • Loose teeth
  • Muscle weakness
  • Pain in bones and muscles
  • Anemia
Vitamin D

Taking dexamethasone, hydrocortisone, prednisone, betamethasone, or triamcinolone may deplete vitamin D.

Vitamin D, along with calcium, keeps your bones strong and healthy.

Low levels of vitamin D may cause:

  • Increased risk of osteoporosis
  • Softening of the bones, called rickets in children and osteomalacia in adults
  • Fractures even on minor injury
  • Muscle cramps
  • Seizures
  • Numbness or tingling in toes and feet

Editorial Note

The information presented here covers some of the nutrients that may be affected when you take certain medicines. If you have any of these signs and symptoms, it does not always mean you have low levels of these nutrients.

Factors that affect the level of nutrients are:

  • Your medical history
  • Diet
  • Lifestyle
  • How long you have been taking the medicine

Please talk to your health care provider. They can best address your health care needs and see if you are at risk for low levels of any nutrients.

Supporting Research

Asiedu DK. Vitamin deficiency (Hypovitaminosis). In: Ferri FF, ed. Ferri's Clinical Advisor 2017. Philadelphia, PA: Elsevier; 2017:1359-1360.

Dominiczak MH, Broom JI. Vitamins and minerals. In: Baynes JW, Dominiczak MH, eds. Medical Biochemistry. 4th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 11.

First Consult: Hypomagnesemia. February 20, 2013. www.clinicalkey.com/#!/content/medical_topic/21-s2.0-2001655. Accessed July7, 2016.

Gold Standard Drug Database: Drug Monograph: Beclomethasone, 2016. www.clinicalkey.com/#!/content/drug_monograph/6-s2.0-57. Accessed July7, 2016.

Gold Standard Drug Database: Drug Monograph: Budesonide, 2016. www.clinicalkey.com/#!/content/drug_monograph/6-s2.0-73. Accessed July7, 2016.

Gold Standard Drug Database: Drug Monograph: Dexamethasone, 2016. www.clinicalkey.com/#!/content/drug_monograph/6-s2.0-174. Accessed July7, 2016.

Gold Standard Drug Database: Drug Monograph: Betamethasone, 2016. www.clinicalkey.com/#!/content/drug_monograph/6-s2.0-64. Accessed July20, 2016.

Gold Standard Drug Database: Drug Monograph: Clobetasol 2015. www.clinicalkey.com/#!/content/drug_monograph/6-s2.0-1264. Accessed July20, 2016.

Gold Standard Drug Database: Drug Monograph: Ciclesonide 2015. www.clinicalkey.com/#!/content/drug_monograph/6-s2.0-2824. Accessed July20, 2016.

Gold Standard Drug Database: Drug Monograph: Desonide 2015. www.clinicalkey.com/#!/content/drug_monograph/6-s2.0-1285. Accessed July20, 2016.

Gold Standard Drug Database: Drug Monograph: Desoximetasone 2015. www.clinicalkey.com/#!/content/drug_monograph/6-s2.0-1286. Accessed July20, 2016.

Gold Standard Drug Database: Drug Monograph: Diflorasone 2015. www.clinicalkey.com/#!/content/drug_monograph/6-s2.0-1299. Accessed July20, 2016.

Gold Standard Drug Database: Drug Monograph: Flunisolide 2015. www.clinicalkey.com/#!/content/drug_monograph/6-s2.0-256. Accessed July20, 2016.

Gold Standard Drug Database: Drug Monograph: Halcinonide 2015. www.clinicalkey.com/#!/content/drug_monograph/6-s2.0-1365. Accessed July20, 2016.

Gold Standard Drug Database: Drug Monograph: Prednicarbate 2015. www.clinicalkey.com/#!/content/drug_monograph/6-s2.0-1529. Accessed July20, 2016.

Gold Standard Drug Database: Drug Monograph: Fluticasone, 2016. www.clinicalkey.com/#!/content/drug_monograph/6-s2.0-263. Accessed July7, 2016.

Gold Standard Drug Database: Drug Monograph: Hydrocortisone, 2016. www.clinicalkey.com/#!/content/drug_monograph/6-s2.0-298. Accessed July7, 2016.

Gold Standard Drug Database: Drug Monograph: Mometasone, 2016. www.clinicalkey.com/#!/content/drug_monograph/6-s2.0-1457. Accessed July7, 2016.

Gold Standard Drug Database: Drug Monograph: Prednisone 2016. www.clinicalkey.com/#!/content/drug_monograph/6-s2.0-505. Accessed July7, 2016.

Gold Standard Drug Database: Drug Monograph: Triamcinolone, 2016. www.clinicalkey.com/#!/content/drug_monograph/6-s2.0-625. Accessed July7, 2016.

Leone KA. Calcium, magnesium, and phosphorus. In: Adams JG, ed. Emergency Medicine. 2nd ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 166.

Osborn MB. Potassium. In: Adams JG, ed. Emergency Medicine. 2nd ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 165.

Sachdev HPS, Shah D. Vitamin B complex deficiencies and excess. In: Kliegman RM, Stanton BF, St Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics. 20th ed. Philadelphia, PA: Elsevier; 2016:chap 49.

Shenkin A, Roberts NB. Vitamins and trace elements. In: Burtis CA, Ashwood ER, Bruns DE, eds. Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. 5th ed. St. Louis, MO: Elsevier Saunders; 2012:chap 31.

Smogorzewski MJ, Stubbs JR, Yu ASL. Disorders of calcium, magnesium, and phosphate balance. In: Skorecki K, Chertow GM, Marsden PA, Yu ASL, Taal MW, eds. Brenner and Rector's The Kidney. 10th ed. Philadelphia, PA: Elsevier; 2016:chap 19.

Yu ASL. Disorders of magnesium and phosphorus. In: Lee G, Schafer AI, eds. Goldman's Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier; 2016:chap 119.

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Review Date: 9/19/2016  

Reviewed By: Steven D. Ehrlich, NMD, Solutions Acupuncture, a private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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