18
Tables
(cont'd)
Table 6. Non-oral Glucocorticoid Formulations and Risk of
Glucocorticoid-induced Adrenal Insufficiency
Prevalence of glucocorticoid-induced adrenal insufficiency
1
Percutaneous
(topical)
glucocorticoids
4.7% (CI 1.1–18.5)
Intra-nasal
glucocorticoids
4.2% (CI 0.5–28.9)
1
Based on a systematic review and meta-analysis of studies assessing the prevalence of
biochemical impairment of the HPA axis, regardless of clinical correlates. Systematic
data on the prevalence of signs and symptoms of adrenal insufficiency are lacking.
2
High doses of commonly prescribed inhaled glucocorticoids in adults are:
• Fluticasone propionate >500 μg/day
• Beclometasone dipropionate (standard particle inhalers) >1000 μg/day
• Beclometasone dipropionate (extra fine particle inhalers) >400 μg/day
• Budesonide >800 μg/day
• Ciclesonide >320 μg/day
• Fluticasone furoate >200 μg/day
• Mometasone furoate standard particle >400 μg/day
These doses are expressed as total daily doses and should be seen as a guide only. Doses are
based on information from manufactures' summaries of product characteristics, Global
Initiative for Asthma (2023), and the British National Formulary.
3
Strong inhibitors include boceprevir, ceritinib, clarithromycin, cobicistat, darunavir,
idelalisib, indinavir, itraconazole, ketoconazole, lopinavir, mifepristone, nefazodone,
nelfinavir, posaconazole, ritonavir, saquinavir, telaprevir, telithromycin, and voriconazole.
4
Suggested strategies include consideration of reduced doses, frequencies, and alternative
treatments, but sufficient control of the underlying glucocorticoid dependent disease
remains paramount.
(cont'd)
