Encorton – how to apply? Dosage, action, side effects of Encorton

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Encorton is a medicine that contains prednisone, a synthetic glucocorticoid. Prednisone itself is pharmacologically inactive, while in the liver it is converted into an active metabolite called prednisolone. Who is the drug intended for, who should not use it and what are the possible side effects of its use?

Due to the properties that weaken the immune system, the body is at risk of developing infections while taking the drug. Encorton is only used when necessary.

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Prednisone crosses the placenta, therefore pregnancy may also be a contraindication, but this is not always the case – in a situation where the pregnant woman’s condition is so serious that she should take the drug, it is decided by the doctor who must assess the risk associated with taking it. (2) Every woman who is pregnant or trying to conceive must inform the prescribing physician. Drugs are especially dangerous during the first trimester.

Encorton – precautions

During the visit to the doctor, tell him about all diseases, disorders, medications and supplements taken – the use of glucocorticosteroids together with other agents may be associated with serious health complications or interact, such as weakening the effect of the active substance. For some people taking Encorton can be dangerous.

The specialist should know about:

1. any medical condition causing diarrhea
2. ulcers,
3. ulcerative colitis,
4. episodes related to gastrointestinal bleeding,
5. liver or kidney disease
6. heart disease
7. hypertension,
8. low levels of potassium in the body,
9. diabetes
10. thyroid disorders,
11. history of malaria,
12. tuberculosis,
13. osteoporosis,
14. glaucoma,
15. herpetic infection in the eye,
16. myasthenia gravis
17. depression or mental disorders.

Long-term use of Encorton can lead to osteoporosis, especially in smokers, inactive people, in the presence of vitamin D and calcium deficiencies, and with a family history of osteoporosis (3).

Encorton – dosage

The dose of the drug should always be determined individually for each patient. Its size will depend, among others, on on the type of disease. As soon as the patient’s health improves after taking the prescribed dose, it should be gradually reduced. Also, before the drug is completely discontinued, the amount of the drug administered should be limited – in the case of patients on long-term treatment with Encorton, it is recommended that it be 1 mg per month.

When a person is taking the drug at a dose of up to 40 mg per day, he or she may choose not to take the drug without fear that the pituitary-adrenal axis will be suppressed, provided that he or she takes Encorton for less than 7 days. To avoid suppression of the hypothalamic-pituitary-adrenal axis, the drug should be taken in the morning and only once a day – in the morning the secretion of endogenous corticosteroids is highest.

Adults and adolescents are recommended to take single or divided doses of the drug – the size of single doses is from 5 mg to 60 mg per day; the divided dose should not exceed 250 mg per day. Adults suffering from multiple sclerosis during an exacerbation can take 200 mg of the drug a day for a week, and then, every other day for a month, 80 mg.

It is inadvisable to drink alcohol while taking Encorton. Otherwise the risk of gastrointestinal bleeding will increase. Moreover, ulceration may also appear. Pregnant women may use the drug only when the benefits of taking it outweigh the possible health risks to the baby. In turn, the use of the drug is not recommended for women who are breastfeeding.

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Encorton – dosage for children

In children and adolescents, Encorton is given at a dose of 5 to 60 mg a day. However, it should be a single dose or at least divided so that it is no more than 250 mg per day. The usual dose for children is 2 mg per kilogram body weight per day – it should be given every 6 or 8 hours. Alternatively, the child can be given the drug in a single dose.

The suggested dose of the drug for children up to 18 months has not been established. Children from 18 months to 4 years of age should be given the drug in a dose of 7 to 10 mg four times a day. Children (4-10 years of age) may initially take 4 doses of the drug a day, each with 15 mg of the substance. Children over 10 years of age may also take 4 doses of the drug a day, each with 20 mg of the substance.

What to remember while taking Encorton?

Encorton is a drug that patients with systemic fungal infections cannot use. Otherwise, the infection could get worse. Patients treated with corticosteroids at times of increased stress may require a higher dose of glucocorticoid – in their case the dose of Encorton should be reduced gradually. However, it should be remembered that the dose reduction depends on factors such as the type of disease, the patient’s response or the duration of treatment.

The use of Encorton in some patients will make the symptoms of the infection more difficult to locate. What’s more, it will also be difficult to determine the location of the disease. Patients using corticosteroids should not be among people suffering from measles and chickenpox, because in extreme cases it can even be fatal.

Taking Encorton may cause previously latent amoebiasis, a parasitic gastrointestinal disease, to show up. Patients using Encorton should not be vaccinated with viral vaccines as the likelihood of an increase in antibodies will be low. The drug is also administered to patients with active tuberculosis, but when it is disseminated or fulminant tuberculosis and the patient is also treated for tuberculosis.

Caution should also be exercised when treating patients with non-specific ulcerative colitis with Encorton, when there is a risk of e.g. perforation, intestinal diverticulosis and fresh intestinal anastomoses. Long-term use of the drug can cause cataracts, glaucoma with damage to the optic nerves. Moreover, the risk of secondary fungal and viral infections also increases.

Encorton – drug interactions

Using the drug along with non-steroidal anti-inflammatory drugs may increase the risk of gastrointestinal bleeding and the risk of gastrointestinal ulcers. Combining it with the carbonic anhydrase inhibitor amphotericin B may cause hypokalaemia, myocardial hypertrophy and congestive heart failure.

Combining the drug with anabolic steroids or androgens can cause swelling and acne. Interaction with paracetamol may increase the risk of hypocalcaemia and osteoporosis, as well as increase calcium excretion. However, the increase in intraocular pressure may result in taking Encorton together with cholinolytic drugs, in particular atropine.

When Encorton is combined with tricyclic antidepressants, psychiatric problems can be aggravated. Combining it with oral diabetes medications can increase your blood glucose levels. Encorton, when used with drugs used in the treatment of hyperthyroidism or thyroid hormones, can change the function of the thyroid gland – as a result, the patient will either have to reduce the dose of the drug for hyperthyroidism or give it up altogether.

Side effects of using Encorton

The use of this, as well as other corticosteroids, may cause side effects, but this is not the norm, especially when therapy with the drug is short-term. The greatest risk of side effects occurs in patients who use Encorton for a long time. These disorders can be:

1. Musculoskeletal and connective tissue disorders

The patient’s muscles may become weak. Steroid myopathy, loss of muscle mass, osteoporosis, compression fracture of the spine, aseptic necrosis of the femoral and humerus heads may occur. Muscle weakness and the aforementioned steroid myopathy usually occur in women – in the initial stage it begins with the muscles of the pelvic girdle and extends to the proximal muscles of the shoulder and upper arm.

1. Mental disorders

They usually appear within the first two weeks of treatment. Schizophrenia, delirium and mania have been reported in users of the drug. It is worth knowing that these symptoms occur in 15 to 50% of patients. How severe the disorders are depends, for example, on medication dose. These symptoms most often appear in patients taking 40 mg of the drug daily, mostly women and patients with lupus erythematosus.

1. Gastrointestinal disorders

Peptic ulcers develop in people taking medications, resulting in perforation, bleeding, and perforation of the large or small intestine. They most often occur in patients with intestinal inflammation. In addition, stomach and intestinal disorders are also flatulence, digestive problems and ulcerative esophagitis.

A patient taking the drug should immediately inform a doctor when the following occur: eye pain, visual disturbances, seeing halos around light sources, rapid weight gain and shortness of breath. Disturbing symptoms are sudden malaise, changes in behavior, convulsions, bleeding, e.g. blood in the stool, coughing with blood, pancreatitis.

Side effects of taking the drug are also: uneven heart beat, extreme thirst, excessive urination, muscle weakness, increase in blood pressure. Other side effects are also problems with falling asleep, greater appetite, uneven distribution of fat tissue e.g. in the arms, waist, neck and legs, as well as increased sweating, dry skin, bruises, discoloration, abdominal pain and acne.

Does Encorton affect fertility, pregnancy and lactation?

There are still no studies in humans that would clearly state its harmfulness in this matter. Nevertheless, corticosteroids have been studied in animals and it has been established that these drugs contribute to miscarriage, affect the placenta and contribute to its insufficiency and inhibit fetal development. The effect of corticosteroids on human health has not been described, but there is information that taking them also increases the risk of death in a child, affects its birth weight and causes placental insufficiency.

The above-described effects of corticosteroids in humans have been described in the observation of women taking such drugs during pregnancy. The use of corticosteroids in pregnant women is allowed only when there is a specific need, and the benefits of using the drug outweigh the potential risk to the child’s health. There is a thesis that the use of up to 5 mg of Encorton by a pregnant woman has no harmful effects on the fetus.

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