Use with caution in heart failure or hypertension (long-term use associated with fluid retention and hypertension). May cause hypercorticism or suppression of hypothalamic-pituitary-adrenal axis, particularly in younger children or in patients receiving high doses for prolonged periods (may lead to adrenal crisis). Bronchospasm may occur with wheezing after inhalation. Use with caution in cataracts and/or glaucoma (increased intraocular pressure, open-angle glaucoma, and cataracts occurred with prolonged use). Should not be used in active ocular herpes simplex. Avoid nasal corticosteroid use in recent nasal septal ulcers, nasal surgery or nasal trauma until healing has occurred. Prolonged use of corticosteroids may also increase incidence of secondary infection, mask acute infection (including fungal infections), prolong or exacerbate viral infections, or limit response to vaccines. Exposure to chickenpox should be avoided. Corticosteroids should not be used to treat ocular herpes simplex, cerebral malaria, or viral hepatitis. Restrict use in active tuberculosis (only in conjunction with antituberculosis treatment). Use with caution in threadworm infection (may cause serious hyperinfection). Prolonged treatment with corticosteroids associated with development of Kaposi’s sarcoma (case reports). Not to be used in status asthmaticus or for relief of acute bronchospasm. Use with caution in diabetes mellitus (may alter glucose production/regulation leading to hyperglycemia), and in GI diseases (diverticulitis, peptic ulcer, ulcerative colitis) due to perforation risk. Corticosteroid use may cause psychiatric disturbances, including depression, euphoria, insomnia, mood swings, and personality changes. Pre-existing psychiatric conditions may be exacerbated by corticosteroid use. Use with caution in hepatic impairment, including cirrhosis (long-term use associated with fluid retention), and in myasthenia gravis (exacerbation of symptoms occurred especially during initial treatment with corticosteroids). Acute myopathy reported with high-dose corticosteroids, usually in neuromuscular transmission disorders. May involve ocular and/or respiratory muscles. Use with caution following acute MI (corticosteroids associated with myocardial rupture). Discontinue if local irritation or sensitization should develop. Use with caution in osteoporosis (high doses and/or long-term use of corticosteroids associated with increased bone loss and osteoporotic fractures). Metabolic clearance of corticosteroids increases in hyperthyroidism and decreases in hypothyroidism. Use with caution in renal impairment (fluid retention and hypertension may occur). Avoid use of high potency steroids on face. Use with caution in history of seizure disorder (seizures reported with adrenal crisis). Restrict corticosteroid use to fulminating or disseminated tuberculosis (must be used in conjunction with appropriate tuberculosis regimen). Patients should not be immunized with live, viral vaccines while receiving immunosuppressive doses of corticosteroids. Orally-inhaled and intranasal corticosteroids may cause reduction in growth velocity in pediatric patients. Some injection suspension formulations contain benzyl alcohol (associated with «gasping syndrome» in neonates and low-birth-weight infants). Withdraw systemic therapy with gradual tapering of dose. Intravitreal injection associated with endophthalmitis and visual disturbances (blindness reported following injection into nasal turbinates and intralesional injections into head). Some formulations should not be administered intravitreally. Do not use in decreased skin circulation.