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Periodic assessment of hepatic function is advisable particularly in patients with pre-existing hepatic impairment. Should only be used for hypertension when other agents have failed or arent suitable. You need a prescription to buy and take it, as it is important that a doctor checks whether you suffer from a bacterial infection that nitrofurantoin is effective for. Cheers! I&2817ve been absent for a while, but now i remember why i used to love this blog. Im q12-24hr documented hypersensitivity to drug or components (eg, lactose monohydrate from cow milk) systemic fungal infection (except intra-articular injection in localized joint conditions) administration of live or live, attenuated vaccines is contraindicated in patients receiving immunosuppressive doses of corticosteroids use with caution in cirrhosis, ocular herpes simplex, hypertension, diverticulitis, hypothyroidism, myasthenia gravis, peptic ulcer disease, osteoporosis, ulcerative colitis, psychotic tendencies, renal insufficiency, pregnancy, diabetes mellitus, history of seizure disorders, multiple sclerosis, thromboembolic disorders, myocardial infarction use in septic shock or sepsis syndrome not proven effective and may increase mortality in some patients including patients with elevated serum creatinine and patients who develop secondary infections clearance of corticosteroids may increase in hyperthyroid patients and decrease in hypothyroid ones dose adjustments may be necessary patients receiving corticosteroids should avoid chickenpox or measles-infected persons if unvaccinated latent tuberculosis may be reactivated (patients with positive tuberculin test should be monitored) some suggestion (not fully substantiated) of slightly increased cleft palate risk if corticosteroids are used in pregnancy may cause hypothalamic-pituitary-adrenal (hpa) axis suppression, cushing syndrome, or hyperglycemia prolonged corticosteroid use may result in elevated iop, glaucoma, or cataracts killed or inactivated vaccines may be administered however, the response to such vaccines cannot be predicted immunization procedures may be undertaken in patients who are receiving corticosteroids as replacement therapy in physiologic doses (eg, for addisons disease) injection may result in dermal andor subdermal changes forming depressions in the skin at injection site to minimize incidence of dermal and subdermal atrophy, care must be exercised not to exceed recommended doses in injections avoid injection into deltoid muscle due to high incidence of subcutaneous atrophy increased dosage of rapidly acting corticosteroids indicated in patients on corticosteroid therapy subjected to any unusual stress before, during, and after the stressful situation average and large doses of corticosteroids can cause elevation of blood pressure, salt and water retention, and increased excretion of potassium dietary salt restriction and potassium supplementation may be necessary all corticosteroids increase calcium excretion drug induced secondary adrenocortical insufficiency may be minimized by gradual reduction of dosage relative insufficiency may persist for months after discontinuation of therapy therefore, in situation of stress occurring during that period, hormone therapy should be reinstituted rarely, high doses of cyclically pulsed intravenous methylprednisolone (usually for the treatment of exacerbations of multiple sclerosis at doses of 1 gday) can induce a toxic form of acute hepatitis discontinue therapy if it occurs since recurrence has occurred after re-challenge, avoid use in patients with a history of toxic hepatitis caused by methylprednisolone with increasing doses of corticosteroids, the rate of occurrence of infectious complications increases corticosteroids may also mask some signs of current infection corticosteroids may exacerbate systemic fungal infections and should not be used in presence of such infections unless needed to control drug reactions latent amebiasis or active amebiasis should be ruled out before initiating corticosteroid therapy patients who have spent time in tropics or patients with unexplained diarrhea lowest possible dose should be used to control condition under treatment when reduction in dosage possible, reduction should be gradual riskbenefit decision must be made in each individual case as to dose and duration of treatment and as to whether daily or intermittent therapy should be used kaposis sarcoma reported in patients receiving corticosteroid therapy, most often for chronic conditions discontinuation of therapy may result in clinical improvement although controlled clinical trials have shown corticosteroids to be effective in speeding the resolution of acute exacerbations of multiple sclerosis, they do not affect the ultimate outcome or natural history of the disease psychic derangements may appear when corticosteroids used, ranging from euphoria, insomnia, mood swings, personality changes, and severe depression, to frank psychotic manifestations also, existing emotional instability or psychotic tendencies may be aggravated by corticosteroids give consideration to potential for hypersensitivity reactions to cows milk ingredients in solumedrol if appropriate, stop administration of injection solution solumedrol and treat patients condition accordingly alternative treatments, including use of corticosteroid formulations that do not contain ingredients produced from cows milk, 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