Glucocorticoids such as prednisone, hydrocortisone, and dexamethasone are similar to natural hormones produced by the adrenal glands. They are used to treat a variety of conditions including many inflammatory diseases such as asthma and some forms of arthritis.
When people are treated with glucocorticoids, the production of adrenal hormones may decrease because of effects on the pituitary, the master gland that controls the adrenals.
If glucocorticoids are stopped or decreased too quickly, the adrenal glands cannot begin making their own hormones again fast enough to meet the body's needs, and symptoms of adrenal insufficiency result. This condition usually occurs when these drugs are used systemically (via pills or intravenous injections), rather than in their topical (on the skin) or inhaled forms. Higher doses and longer treatment increase the risk.
Abrupt cessation of treatment with glucocorticoids is the most common cause of adrenal insufficiency.
Other drugs that may cause adrenal insufficiency include the following:
- megestrol
- ketoconazole
- metyrapone
- aminoglutethimide
- mitotane
These drugs have direct effects on the adrenal glands decreasing glucocorticoid production.
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