5
Contraindications and Cautions
Corticosteroids are contraindicated in patients with known hypersensitivity to
prednisone or any excipients in the formulation.
Warnings that there is a risk of alterations in endocrine function, increased risk of
infections, alterations in CV and renal function, risk of GI complications, behavioral
and mood disturbances, decreased bone density, ophthalmic effects, neuromuscular
effects, and caution in pregnancy use as fetal harm can occur.
Warnings that systemic absorption of topical corticosteroids has produced reversible
hypothalamic-pituitary-adrenal (HPA) axis suppression, manifestations of Cushing's
syndrome, hyperglycemia, and glucosuria in some patients. Systemic absorption is
typically rare, and is related to potency, body surface area treated, and duration of
therapy.
Conditions that augment systematic absorption include the application of the more
potent steroids, use over large surface areas, prolonged use, and the addition of occlusive
dressings.
No contraindications.
Warnings that concomitant use with a TNF antagonist can increase the risk of
infections and serious infections. Hypersensitivity, anaphylaxis, and anaphylactoid
reactions have been reported. Patients with a history of recurrent infections or
underlying conditions predisposing to infections may experience more infections.
Discontinue if a serious infection develops. Screen for latent TB infection prior
to initiating therapy. Patients testing positive should be treated prior to initiating
abatacept. Live vaccines should not be given concurrently or within 3 months
of discontinuation. Based on its mechanism of action, abatacept may blunt the
effectiveness of some immunizations. COPD patients may develop more frequent
respiratory adverse events.
Alemtuzumab is contraindicated in patients infected with Human Immunodeficiency
Virus.
Warning that alemtuzumab can causes serious, sometimes fatal, autoimmune conditions
such as immune thrombocytopenia and antiglomerular basement membrane disease.
Monitor complete blood counts with differential serum creatinine levels, and urinalysis
with urine counts at periodic intervals for 48 months aer the last dose. Alemtuzumab
may also cause serious and life-threatening infusion reactions and must be administered
in a setting with appropriate equipment and personnel to manage anaphylaxis or serious
infusion reactions. Monitor patients for two hours aer each infusion. Make patients
aware that serious infusion reactions can also occur aer the 2-hour monitoring period.
Alemtuzumab may also cause an increased risk of malignancies, including thyroid
cancer, melanoma, and lymphoproliferative disorders.
