The NIAMS gratefully acknowledges the assistance of the following individuals in the preparation and review of previous versions of this publication: Gayle Lester, ., Joan McGowan, ., James Panagis, ., Susana Serrate-Sztein, ., and Bernadette Tyree, ., NIAMS/NIH; Kenneth D. Brandt, ., Indiana University School of Medicine, Indianapolis, IN; Victor M. Goldberg, ., University Hospitals of Cleveland, OH; Marc C. Hochberg, ., ., University of Maryland, Baltimore, MD; John Klippel, ., Arthritis Foundation, Atlanta, GA; and Roland Moskowitz, ., Case Western Reserve University, Cleveland, OH. Special thanks also go to the patients who reviewed this publication and provided valuable input.
Certain drugs such as troleandomycin (TAO), erythromycin ( Ery-Tab , EryPed 200), and clarithromycin ( Biaxin ) and ketoconazole ( Nizoral ) can reduce the ability of the liver to metabolize (breakdown) corticosteroids and this may lead to an increase in the levels and side effects of corticosteroids in the body. On the other hand, phenobarbital, ephedrine , phenytoin ( Dilantin ), and rifampin ( Rifadin , Rimactane ) may reduce the blood levels of corticosteroids by increasing the breakdown of corticosteroids by the liver. This may necessitate an increase of corticosteroid dose when they are used in combination with these drugs.