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Phenytoin, phenobarbital, carbamazepine, rifampicin, and antithyroid drugs increase the clearance of hydrocortisone and reduce its half-life.
Hydrocortisone may weaken the effect of anticoagulants and antidiabetics.
In combination with anticholinesterase, corticosteroids can cause muscle weakness in patients with myasthenia gravis.
Systemic glucocorticoid therapy increases the risk of hypokalemia in patients receiving diuretics or amphotericin B. Glucocorticoids may increase the risk of anti-inflammatory analgesic-induced peptic ulcer.
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.
