AS DRUG CAN BE ABSORBED THROUGH THE SKIN IN SUBSTANTIAL AMOUNTS TO CAUSE SYSTEMIC SIDE EFFECTS IF APPLIED OVER LARGE AREA, THE INTERACTIONS WITH OTHER DRUGS ARE THE SAME AS WITH OTHER CORTICOSTEROIDS. REDUCED EFFICACY WITH CONCURRENT USE OF CARBAMAZEPINE, PHENYTOIN, PRIMIDONE AND BARBITURATES, RIFAMPICIN, EPHEDRINE, GRISEOVIN SINCE THESE INCREASE ITS METABOLISM. PEPTIC ULCER, AND G.I. BLEEDING MORE COMMON WITH CONCURRENT NSAIDS ADMINISTRATION. DECREASES SERUM CONCENTRATION OF SALICYLATES AND ANTIMUSCARINIC AGENTS. CONCURRENT ADMINISTRATION OF CORTICOSTEROIDS WITH PATASSIUM-DEPLETING DIURETICS, SUCH AS THIAZIDES OR FRUSEMIDE,AMPHOTERICIN-B MAY CAUSE EXCESSIVE POTASSIUM LOSS.
REDUSES EFFECT BUT ENHANCES TOXIC EFFECTS OF IMIPRAMINE. REDUCES EFFECT OF ANTICOAGULANTS,HYPOGLYCAEMIC, ANTIHYPERTENSIVE AGENTS. DICUMAROL EFFECT IS DIMINISHED BUT WARFARIN, NICOUMALONE EFFECT IS POTENTIATED. . INCREASES TOXICITY OF CYCLOSPORIN.DECREASED CLEARANCE OF XANTHINES. INCREASED CLEARANCE OF PARACETAMOL, MORPHINE, CLOFIBRATE. NITRAZEPAM AND OTHER BENZODIAZEPAMS EFFECT MAY BE ENHANCED. ESTROGEN CAUSES INCREASED LEVELS OF CORTICOSTEROID-BINDING GLOBULIN, THEREBY INCREASING THE BOUND (INACTIVE) FRACTION; THIS EFFECT IS AT LEAST BALANCED BY DECREASED METABOLISM OF CORTICOSTEROIDS HENCE INCREASED BIOAVAILABILITY WITH OESTROGENS AND ORAL CONTRACEPTIVES. SO WHEN ESTROGEN THERAPY IS INITIATED, A REDUCTION IN CORTICOSTEROID DOSAGE MAY BE REQUIRED, AND INCREASED AMOUNTS MAY BE REQUIRED WHEN ESTROGEN IS TERMINATED. THERE IS AN ENHANCED CORTICOSTEROID EFFECT IN PATIENTS WITH HYPOTHYROIDISM AND IN THOSE WITH CIRRHOSIS.