Because corticosteroids reduce the immune response, they should not be used in patients who have active fungal infections. Similarly, patients being treated with corticosteroids should avoid receiving live virus vaccines.

Corticosteroids may mask some signs of infection, and new infections may appear during their use. There may be decreased resistance and inability to localize infection. Any evidence of infection should be treated promptly with appropriate anti-infective therapy.

Corticosteroids may activate latent amebic infections. Therefore, it is recommended that latent or active amebiasis be ruled out before starting corticosteroid therapy in any patient who has spent time in the tropics or any patient with unexplained diarrhea.

Adequate human reproduction studies have not been done with corticosteroids. Use of these drugs in pregnancy or in women of childbearing potential requires that the anticipated benefits be weighed against the possible hazards to the mother and embryo or fetus. Infants born of mothers who have received substantial doses of corticosteroids during pregnancy should be carefully observed for signs of hypoadrenalism.

Corticosteroids have been associated with an increased risk of gastric ulcers, and patients are usually advised to take these drugs either with food or a drug which inhibits gastric acid. Those taking high dose steroids or on maintenance therapy should take the medication with meals or a gastric acid blocker to reduce the risk of gastric ulcers. However, these precautions are probably not needed for patients taking low doses for a short period of time.