Skip to content
My WebMD Sign In, Sign Up
Millipred DP

Interactions

Corticosteroids/Selected Macrolide Antibiotics

This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.

Medical warning:

Moderate. These medicines may cause some risk when taken together. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.

How the interaction occurs:

When these two medicines are taken together, your body may not process your corticosteroid properly.

What might happen:

The amount of corticosteroid in your blood may increase and cause harmful effects.

What you should do about this interaction:

If you experience vomiting of blood, black or tarry stools, puffing of the face, swelling of the ankles or feet, unusual weight gain, prolonged sore throat or fever, muscle weakness, breathing difficulties or mood changes, contact your doctor. Your doctor may need to adjust the dose of your steroid.Your healthcare professionals (e.g. doctor or pharmacist) may already be aware of this drug interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.

References:

1.Flovent Diskus (fluticasone propionate) US prescribing information. GlaxoSmithKline March, 2010.

2.Szefler SJ, Rose JQ, Ellis EF, Spector SL, Green AW, Jusko WJ. The effect of troleandomycin on methylprednisolone elimination. J Allergy Clin Immunol 1980 Dec;66(6):447-51.

3.LaForce CF, Szefler SJ, Miller MF, Ebling W, Brenner M. Inhibition of methylprednisolone elimination in the presence of erythromycin therapy. J Allergy Clin Immunol 1983 Jul;72(1):34-9.

4.Szefler SJ, Brenner M, Jusko WJ, Spector SL, Flesher KA, Ellis EF. Dose- and time-related effect of troleandomycin on methylprednisolone elimination. Clin Pharmacol Ther 1982 Aug;32(2):166-71.

5.Szefler SJ, Ellis EF, Brenner M, Rose JQ, Spector SL, Yurchak AM, Andrews F, Jusko WJ. Steroid-specific and anticonvulsant interaction aspects of troleandomycin-steroid therapy. J Allergy Clin Immunol 1982 May; 69(5):455-60.

6.Spector SL, Katz FH, Farr RS. Troleandomycin: effectiveness in steroid-dependent asthma and bronchitis. J Allergy Clin Immunol 1974 Dec; 54(6):367-79.

7.Schatz M, Sperling W, Zeiger RS. Use of troleandomycin (TAO) in outpatients with severe corticosteroid (CS)-dependent asthma. Am Rev Respir Dis 1979 Feb;119(2):167.

8.Zeiger RS, Schatz M, Sperling W, Simon RA, Stevenson DD. Efficacy of troleandomycin in outpatients with severe, corticosteroid- dependent asthma. J Allergy Clin Immunol 1980 Dec;66(6):438-46.

9.Itkin IH, Menzel ML. The use of macrolide antibiotic substances in the treatment of asthma. J Allergy 1970 Mar;45(3):146-62.

10.Edwards D, Wald JA, Dobozin BS, Kirkpatrick CH. Troleandomycin and methylprednisolone for treatment of the hypereosinophilic syndrome. N Engl J Med 1987 Aug 27;317(9):573-4.

11.Lantner R, Rockoff JB, DeMasi J, Boran-Ragotzy R, Middleton E Jr. Fatal varicella in a corticosteroid-dependent asthmatic receiving troleandomycin. Allergy Proc 1990 Mar-Apr;11(2):83-7.

12.De Wachter E, Malfroot A, De Schutter I, Vanbesien J, De Schepper J. Inhaled budesonide induced Cushing's syndrome in cystic fibrosis patients, due to drug inhibition of cytochrome P450. J Cyst Fibros 2003 Jun;2(2):72-5.

13.Finkenbine RD, Frye MD. Case of psychosis due to prednisone-clarithromycin interaction. Gen Hosp Psychiatry 1998 Sep; 20(5):325-6.

14.Finkenbine R, Gill HS. Case of mania due to prednisone-clarithromycin interaction. Can J Psychiatry 1997 Sep;42(7):778.

Selected from data included with permission and copyrighted by First Databank, Inc. This copyrighted material has been downloaded from a licensed data provider and is not for distribution, expect as may be authorized by the applicable terms of use.

CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.

More about Drugs and Medications

URAC: Accredited Health Web Site HONcode Seal AdChoices