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Phenytoin, phenobarbital, ephedrine and rifampicin may enhance the metabolism of corticosteroids resulting in decreased blood levels and lessened physiologic activity, thus requiring adjustment in corticosteroid dosage. Drugs such as barbiturates which induce hepatic microsomal drug metabolizing enzyme activity may enhance metabolism of prednisolone and require the dosage of Prelone to be adjusted.
Co-treatment with CYP3A inhibitors, including cobicistat-containing products, is expected to increase the risk of systemic side-effects. The combination should be avoided unless the benefit outweighs the increased risk of systemic corticosteroid side-effects, in which case patients should be monitored for systemic corticosteroid side-effects.
