Alternate day glucocorticoid therapy usually avoids or minimizes this side effect. Host defenses are impaired in patients receiving large doses of glucocorticoids and this effect increases susceptibility to fungus infections as well as bacterial and viral infections. Adequate human reproduction studies have not been done with corticosteroids. Therefore, the use of this drug in pregnancy, nursing mothers or women of childbearing potential requires that the benefits of the drug be carefully weighed against the potential risk to the mother and embryo or fetus. Since there is inadequate evidence of safety in human pregnancy, this drug should be used in pregnancy only if clearly needed.
Corticosteroids readily cross the placenta.
Infants born of mothers who have received substantial doses of corticosteroids during pregnancy must be carefully observed and evaluated for signs of adrenal insufficiency. There are no known effects of corticosteroids on labour and delivery. Corticosteroids are excreted in breast milk. Drug induced secondary adrenocortical insufficiency may be minimized by gradual reduction of dosage. There is an enhanced effect of corticosteroids on patients with hypothyroidism and in those with cirrhosis.