The main undesirable effects include: arterial hypertension, peripheral edema, hypertrophy of the left ventricle of the heart, circulatory insufficiency, hyponatremia, hypocalcemia.
When applying Cortineff for a long time or simultaneously with other corticosteroids, it is possible to develop the following side effects:
From the side of the musculoskeletal system:
Muscle weakness, steroid myopathy (more common in women and usually begins with the muscles of the femoral belt and extends to the proximal muscles of the arms, rarely affects the respiratory muscles), loss of muscle mass, tendon rupture, muscle, osteoporosis, vertebral compression fracture, aseptic necrosis of the femoral head and humerus, pathological fractures of long tubular bones.
From the side of the cardiovascular system:
Arrhythmia, bradycardia (up to cardiac arrest), ECG changes typical of hypokalemia, hypercoagulation, thrombosis, obliterating endarteritis. In patients with acute and subacute myocardial infarction - the spread of the focus of necrosis, slowing the formation of scar tissue, which can lead to rupture of the heart muscle.
From the digestive system:
Steroid ulcer with possible perforation and bleeding, pancreatitis; flatulence, ulcerative esophagitis, digestive disorders, nausea, increased or decreased appetite, vomiting, hiccough. In rare cases - increased activity of "liver" transaminases and alkaline phosphatase.
From the skin and mucous membranes:
Atrophic bands, acne, delayed healing of wounds; thinning of the skin; petechiae and hematomas, erythema, excessive sweating, allergic dermatitis, urticaria, angioedema, ecchymosis, hyper- or hypopigmentation, a tendency to develop pyoderma and candidiasis.
From the nervous system:
Increase in intracranial pressure with the syndrome of the congestive nipple of the optic nerve (pseudotumor of the brain - most often in children, usually after too rapid reduction of the dose, symptoms - headache, deterioration of visual acuity or double vision); convulsions, dizziness, headache, sleep disturbances.
From the endocrine system:
Secondary adrenal and hypothalamic-pituitary insufficiency (especially during stressful situations such as illness, trauma, surgery); Cushing's syndrome; suppression of growth in children; menstrual cycle disorders; decreased tolerance to carbohydrates; manifestation of latent diabetes mellitus and increased need for insulin or oral hypoglycemic drugs in patients with diabetes mellitus; hirsutism.
From the sense organs:
Posterior subcapsular cataract (usually occurs after discontinuation of treatment, but may need surgical treatment); increased intraocular pressure; glaucoma (usually after treatment for at least a year); exophthalmos, a tendency to develop secondary bacterial, fungal or viral infections of the eyes, trophic changes in the cornea.
Mental disorders:
Most often appear during the first two weeks of treatment; symptoms can mimic schizophrenia, mania, or delirious syndrome; most susceptible to the emergence of mental disorders of women.
From the side of metabolism:
Negative nitrogen balance due to protein catabolism; hyperglycemia; glucosuria, increased excretion of Ca2 +, hypocalcemia. Due to mineralocorticoid activity - hypernatremia, hypokalemic syndrome (hypokalemia, arrhythmia, myalgia or muscle spasm, unusual weakness and fatigue).
Other:
Anaphylactic reactions; increase in body weight; masking the symptoms of infectious diseases; fainting; development or exacerbation of infections (the emergence of this side effect is facilitated by jointly used immunosuppressants and vaccination); leukocyturia; withdrawal syndrome.