Steroid Hormones: Glucocorticoids, Mineralocorticoid Side Effects

By | January 4, 2012

Swelling of feet and ankles is a rare complication of steroid therapy caused by the cross reaction of the glucocorticoid medication with the body's mineralocorticoid receptors.

One of the problems with the pharmacologic uses of cortisone is that it cross-reacts extensively with mineralocorticoid receptors.  In fact the potency of cortisone in stimulating these receptors is equal to that of aldosterone, the major naturally occurring mineralocorticoid hormone.  The significance of this is obvious, salt and water retention and an unwanted increase in blood pressure.  Although we often speak of giving cortisone injections at Schlesinger Pain Centers a synthetic or semisynthetic analogue is almost always used in an attempt to minimize these mineralocorticoid side effects.

Drug Glucocorticoid Potency Mineralocorticoid Potency Duration of Action
Cortisone 1 1 8
Prednisone 3.5-5 0.8 16-36
Methylprednisolone 5-7.5 0.5 18-40
Betamethasone 25-30 0 36-54
Dexamethasone 25-80 0 36-54

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