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Prolonged use of corticosteroids may produce posterior subcapsular cataractsglaucoma with possible damage to the optic nervesand may enhance the establishment of secondary ocular infections due to fungi or viruses.

When fludrocortisone is used in the small dosages recommendedthe glucocorticoid side effects often seen with cortisone and its derivatives are not usually a problemhowever the following untoward effects should be kept in mindparticularly when fludrocortisone is used over a prolonged period of time or in conjunction with cortisone or a similar glucocorticoid.

Growth and development of infants and children on prolonged corticosteroid therapy should be carefully observed.

Corticosteroids are thought to actat least in partby controlling the rate of synthesis of proteinsAlthough there are a number of instances in which the synthesis of specific proteins is known to be induced by corticosteroidsthe links between the initial actions of the hormones and the final metabolic effects have not been completely elucidated.

Corticosteroids should be used with caution in patients with nonspecific ulcerative colitis if there is a probability of impending perforationabscessor other pyogenic infectionCorticosteroids should also be used cautiously in patients with diverticulitisfresh intestinal anastomosesactive or latent peptic ulcerrenal insufficiencyhypertensionosteoporosisand myasthenia gravis.

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