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Average and large doses of hydrocortisone or cortisone can cause elevation of blood pressuresalt and water retentionand increased excretion of potassiumThese effects are less likely to occur with the synthetic derivatives except when used in large dosesHoweversince fludrocortisone acetate is a potent mineralocorticoidboth the dosage and salt intake should be carefully monitored in order to avoid the development of hypertensionedemaor weight gainPeriodic checking of serum electrolyte levels is advisable during prolonged therapydietary salt restriction and potassium supplementation may be necessaryAll corticosteroids increase calcium excretion.

Patients who are on immunosuppressant doses of corticosteroids should be warned to avoid exposure to chicken pox or measles andif exposedto obtain medical advice.

There is an enhanced corticosteroid effect in patients with hypothyroidism and in those with cirrhosis.

Like all medicinesthis medicine can cause side effectsalthough not everybody gets them.

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