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Drug overview for METHYLPREDNISOLONE (methylprednisolone):
Generic name: methylprednisolone (METH-il-pred-NIS-oh-lone)
Drug class: Glucocorticosteroids
Therapeutic class: Endocrine
Methylprednisolone is a synthetic glucocorticoid.
Methylprednisolone and its derivatives are used principally as anti-inflammatory or immunosuppressant agents. Because methylprednisolone has only minimal mineralocorticoid properties, the drug is inadequate alone for the management of adrenocortical insufficiency. If methylprednisolone is used in the treatment of this condition, concomitant therapy with a mineralocorticoid also is required.
Methylprednisolone has been used as adjunctive therapy in the treatment of serious complications from coronavirus disease 2019 (COVID-19)+. Patients with severe COVID-19 may develop a systemic inflammatory response that can result in lung injury and multisystem organ dysfunction. The potent anti-inflammatory effects of corticosteroids (e.g., methylprednisolone) may prevent or mitigate these deleterious effects. For additional information, see Uses: Coronavirus Disease 2019 (COVID-19), in the Corticosteroids General Statement 68:04.
Generic name: methylprednisolone (METH-il-pred-NIS-oh-lone)
Drug class: Glucocorticosteroids
Therapeutic class: Endocrine
Methylprednisolone is a synthetic glucocorticoid.
Methylprednisolone and its derivatives are used principally as anti-inflammatory or immunosuppressant agents. Because methylprednisolone has only minimal mineralocorticoid properties, the drug is inadequate alone for the management of adrenocortical insufficiency. If methylprednisolone is used in the treatment of this condition, concomitant therapy with a mineralocorticoid also is required.
Methylprednisolone has been used as adjunctive therapy in the treatment of serious complications from coronavirus disease 2019 (COVID-19)+. Patients with severe COVID-19 may develop a systemic inflammatory response that can result in lung injury and multisystem organ dysfunction. The potent anti-inflammatory effects of corticosteroids (e.g., methylprednisolone) may prevent or mitigate these deleterious effects. For additional information, see Uses: Coronavirus Disease 2019 (COVID-19), in the Corticosteroids General Statement 68:04.
DRUG IMAGES
METHYLPREDNISOLONE 4 MG TABLET
METHYLPREDNISOLONE 8 MG TABLET
METHYLPREDNISOLONE 16 MG TAB
METHYLPREDNISOLONE 32 MG TAB
The following indications for METHYLPREDNISOLONE (methylprednisolone) have been approved by the FDA:
Indications:
Acquired thrombocytopenia
Acute exacerbation of multiple sclerosis
Acute gouty arthritis
Acute lymphoid leukemia
Acute rheumatic carditis
Adrenocortical insufficiency
Adrenogenital disorder
Allergic rhinitis
Angioedema
Ankylosing spondylitis
Aspiration pneumonitis
Atopic dermatitis
Autoimmune hemolytic anemia
Berylliosis
Bursitis
Congenital adrenal hyperplasia
Contact dermatitis
Crohn's disease
Dermatitis herpetiformis
Diagnostic test for Cushing's syndrome
Diamond Blackfan anemia
Disseminated tuberculosis
Epicondylitis
Erythema multiforme
Erythroblastic anemia
Exfoliative dermatitis
Follicular lymphoma
Hodgkin's lymphoma
Humoral hypercalcemia of malignancy
Hypersensitivity drug reaction
Idiopathic thrombocytopenic purpura
Inflammatory bowel disease
Juvenile idiopathic arthritis
Loffler syndrome
Mycosis fungoides
Nephrotic syndrome
Non-Hodgkin's lymphoma
Ocular inflammation
Organ transplant rejection
Pemphigus
Post traumatic osteoarthritis
Primary adrenocortical insufficiency
Psoriasis
Psoriatic arthritis
Rheumatoid arthritis
Sarcoidosis
Serum sickness
Severe persistent asthma
Synovitis due to osteoarthritis
Synovitis
Systemic dermatomyositis
Systemic lupus erythematosus
Tendonitis
Tenosynovitis
Thyroiditis
Trichinosis
Professional Synonyms:
Aase syndrome
Acquired hemolytic anemia due to antibodies
Acute articular gout
Acute exacerbation of MS
Acute gout attack
Acute gout flare
Acute lymphatic leukemia
Acute lymphocytic leukemia
Acute lymphogenous leukemia
Acute relapse of MS
Acute relapse of multiple sclerosis
Acute uratic arthritis
Addison melanoderma
Adrenal cortical hypofunction
Adrenal failure
Adrenal insufficiency
Adrenocortical hypofunction
Adrenogenital syndrome
Anemia lymphatica
Angioneurotic edema
Arthritis deformans
Arthrosis deformans
Asthenia pigmentosa
Atopic eczema
Atrophedema
Axial spondyloarthritis with radiographic sacroiliitis
Bannister's disease
Bekhterev's arthritis
Bekhterev's disease
Bekhterev's spondylitis
Besnier-Boeck-Schaumann disease
Besnier-Boeck-Schaumann syndrome
Blackfan Diamond syndrome
Blistering skin disease
Boeck's disease
Boeck's sarcoid
Bullous dermatitis herpetiformis
Chronic adrenocortical insufficiency
Congenital erythroid hypoplastic anemia
Congenital hypoplastic anemia
Congenital pure red cell aplasia
Congenital suprarenal hyperplasia
Constitutional erythroid hypoplasia
Deficiency in bone marrow erythroblasts
Dermatitis venenata
Diagnostic procedure for Cushing's syndrome
Disseminated lupus erythematosus
Disseminated neurodermatitis
Drug hypersensitivity reaction
Drug-induced hypersensitivity reaction
Drug-induced hypersensitivity
Erythema exfoliativa
Erythema polymorphe
Erythroblastopenia
Erythroderma exfoliativa
Erythrogenesis imperfecta
Exfoliative eczema
Exfoliative erythroderma
Follicular B-cell lymphoma
Follicular B-cell non-Hodgkin's lymphoma
Giant urticaria
Hebra's disease
Herpes iris
Hodgkin's disease
Hypercalcemia associated with cancer
Hypercalcemia associated with malignancy
Hypercalcemia of malignancy
Hypoadrenalism
Hypocorticoidism
Immune thrombocytopenia purpura
Inflammation of the synovial membrane
Inflammation of the synovium
Juvenile RA
Juvenile rheumatoid arthritis
Loeffler syndrome
Loffler's syndrome
Lupus erythematosus syndrome
Lymphoblastic leukemia
Malignant hypercalcemia
Marie-Strumpell disease
Marie-Strumpell spondylitis
Melasma addisonii
Mendelson's syndrome
Miliary tuberculosis
Milton's disease
Multiple sclerosis exacerbation
Nodose rheumatism
Non-Hodgkin's type lymphoma
Ophthalmic inflammation
Organ transplant rejection reaction
Periodic urticaria
PIE syndrome
Post infectious thrombocytopenia
Post traumatic OA
Post-traumatic osteoarthritis
Posttraumatic osteoarthritis
Primary adrenal deficiency
Primary adrenal insufficiency
Primary corticoadrenal insufficiency
Primary failure adrenocortical insufficiency
Psoriasis arthropica
Psoriatic arthropathy
Purpura hemorrhagica
Quincke's disease
Quincke's edema
Regional enteritis
Regional ileocolitis
Rheumatic arthritis
Rheumatic gout
Rheumatoid spondylitis
Rhizomelic spondylitis
Rhizomelic spondylosis
Schaumann's syndrome
Secondary thrombocytopenia
Serum sickness-like reaction
Simple pulmonary eosinophilia
Spondylosis deformans
Strumpell-Marie disease
Suprarenal failure
Synovitis due to OA
Synovitis with osteoarthritis
Tendinitis
Tendinous synovitis
Tendosynovitis
Tendovaginitis
Tenontolemmitis
Tenontothecitis
Tenovaginitis
Transplant rejection
Trichinella spiralis infection
Trichinellosis
Trichiniasis
Urticaria tuberosa
Werlhof's disease
Indications:
Acquired thrombocytopenia
Acute exacerbation of multiple sclerosis
Acute gouty arthritis
Acute lymphoid leukemia
Acute rheumatic carditis
Adrenocortical insufficiency
Adrenogenital disorder
Allergic rhinitis
Angioedema
Ankylosing spondylitis
Aspiration pneumonitis
Atopic dermatitis
Autoimmune hemolytic anemia
Berylliosis
Bursitis
Congenital adrenal hyperplasia
Contact dermatitis
Crohn's disease
Dermatitis herpetiformis
Diagnostic test for Cushing's syndrome
Diamond Blackfan anemia
Disseminated tuberculosis
Epicondylitis
Erythema multiforme
Erythroblastic anemia
Exfoliative dermatitis
Follicular lymphoma
Hodgkin's lymphoma
Humoral hypercalcemia of malignancy
Hypersensitivity drug reaction
Idiopathic thrombocytopenic purpura
Inflammatory bowel disease
Juvenile idiopathic arthritis
Loffler syndrome
Mycosis fungoides
Nephrotic syndrome
Non-Hodgkin's lymphoma
Ocular inflammation
Organ transplant rejection
Pemphigus
Post traumatic osteoarthritis
Primary adrenocortical insufficiency
Psoriasis
Psoriatic arthritis
Rheumatoid arthritis
Sarcoidosis
Serum sickness
Severe persistent asthma
Synovitis due to osteoarthritis
Synovitis
Systemic dermatomyositis
Systemic lupus erythematosus
Tendonitis
Tenosynovitis
Thyroiditis
Trichinosis
Professional Synonyms:
Aase syndrome
Acquired hemolytic anemia due to antibodies
Acute articular gout
Acute exacerbation of MS
Acute gout attack
Acute gout flare
Acute lymphatic leukemia
Acute lymphocytic leukemia
Acute lymphogenous leukemia
Acute relapse of MS
Acute relapse of multiple sclerosis
Acute uratic arthritis
Addison melanoderma
Adrenal cortical hypofunction
Adrenal failure
Adrenal insufficiency
Adrenocortical hypofunction
Adrenogenital syndrome
Anemia lymphatica
Angioneurotic edema
Arthritis deformans
Arthrosis deformans
Asthenia pigmentosa
Atopic eczema
Atrophedema
Axial spondyloarthritis with radiographic sacroiliitis
Bannister's disease
Bekhterev's arthritis
Bekhterev's disease
Bekhterev's spondylitis
Besnier-Boeck-Schaumann disease
Besnier-Boeck-Schaumann syndrome
Blackfan Diamond syndrome
Blistering skin disease
Boeck's disease
Boeck's sarcoid
Bullous dermatitis herpetiformis
Chronic adrenocortical insufficiency
Congenital erythroid hypoplastic anemia
Congenital hypoplastic anemia
Congenital pure red cell aplasia
Congenital suprarenal hyperplasia
Constitutional erythroid hypoplasia
Deficiency in bone marrow erythroblasts
Dermatitis venenata
Diagnostic procedure for Cushing's syndrome
Disseminated lupus erythematosus
Disseminated neurodermatitis
Drug hypersensitivity reaction
Drug-induced hypersensitivity reaction
Drug-induced hypersensitivity
Erythema exfoliativa
Erythema polymorphe
Erythroblastopenia
Erythroderma exfoliativa
Erythrogenesis imperfecta
Exfoliative eczema
Exfoliative erythroderma
Follicular B-cell lymphoma
Follicular B-cell non-Hodgkin's lymphoma
Giant urticaria
Hebra's disease
Herpes iris
Hodgkin's disease
Hypercalcemia associated with cancer
Hypercalcemia associated with malignancy
Hypercalcemia of malignancy
Hypoadrenalism
Hypocorticoidism
Immune thrombocytopenia purpura
Inflammation of the synovial membrane
Inflammation of the synovium
Juvenile RA
Juvenile rheumatoid arthritis
Loeffler syndrome
Loffler's syndrome
Lupus erythematosus syndrome
Lymphoblastic leukemia
Malignant hypercalcemia
Marie-Strumpell disease
Marie-Strumpell spondylitis
Melasma addisonii
Mendelson's syndrome
Miliary tuberculosis
Milton's disease
Multiple sclerosis exacerbation
Nodose rheumatism
Non-Hodgkin's type lymphoma
Ophthalmic inflammation
Organ transplant rejection reaction
Periodic urticaria
PIE syndrome
Post infectious thrombocytopenia
Post traumatic OA
Post-traumatic osteoarthritis
Posttraumatic osteoarthritis
Primary adrenal deficiency
Primary adrenal insufficiency
Primary corticoadrenal insufficiency
Primary failure adrenocortical insufficiency
Psoriasis arthropica
Psoriatic arthropathy
Purpura hemorrhagica
Quincke's disease
Quincke's edema
Regional enteritis
Regional ileocolitis
Rheumatic arthritis
Rheumatic gout
Rheumatoid spondylitis
Rhizomelic spondylitis
Rhizomelic spondylosis
Schaumann's syndrome
Secondary thrombocytopenia
Serum sickness-like reaction
Simple pulmonary eosinophilia
Spondylosis deformans
Strumpell-Marie disease
Suprarenal failure
Synovitis due to OA
Synovitis with osteoarthritis
Tendinitis
Tendinous synovitis
Tendosynovitis
Tendovaginitis
Tenontolemmitis
Tenontothecitis
Tenovaginitis
Transplant rejection
Trichinella spiralis infection
Trichinellosis
Trichiniasis
Urticaria tuberosa
Werlhof's disease
The following dosing information is available for METHYLPREDNISOLONE (methylprednisolone):
No enhanced Dosing information available for this drug.
The route of administration and dosage of methylprednisolone and its derivatives depend on the condition being treated and the response of the patient. IM or IV therapy is generally reserved for patients who are unable to take the drug orally or for use in emergency situations. After the initial emergency period, a longer-acting injectable corticosteroid preparation or oral administration of a corticosteroid should be considered.
| DRUG LABEL | DOSING TYPE | DOSING INSTRUCTIONS |
|---|---|---|
| METHYLPREDNISOLONE 4 MG TABLET | Maintenance | Adults take 1 tablet (4 mg) by oral route 4 times per day with food |
| METHYLPREDNISOLONE 4 MG DOSEPK | Maintenance | Adults take by oral route as directed per package instructions |
| METHYLPREDNISOLONE 8 MG TABLET | Maintenance | Adults take 1 tablet (8 mg) by oral route once daily with food |
| METHYLPREDNISOLONE 16 MG TAB | Maintenance | Adults take 1 tablet (16 mg) by oral route once daily with food |
| METHYLPREDNISOLONE 32 MG TAB | Maintenance | Adults take 1 tablet (32 mg) by oral route once daily with food |
| DRUG LABEL | DOSING TYPE | DOSING INSTRUCTIONS |
|---|---|---|
| METHYLPREDNISOLONE 4 MG DOSEPK | Maintenance | Adults take by oral route as directed per package instructions |
| METHYLPREDNISOLONE 4 MG TABLET | Maintenance | Adults take 1 tablet (4 mg) by oral route 4 times per day with food |
| METHYLPREDNISOLONE 8 MG TABLET | Maintenance | Adults take 1 tablet (8 mg) by oral route once daily with food |
| METHYLPREDNISOLONE 16 MG TAB | Maintenance | Adults take 1 tablet (16 mg) by oral route once daily with food |
| METHYLPREDNISOLONE 32 MG TAB | Maintenance | Adults take 1 tablet (32 mg) by oral route once daily with food |
The following drug interaction information is available for METHYLPREDNISOLONE (methylprednisolone):
There are 4 contraindications.
These drug combinations generally should not be dispensed or administered to the same patient. A manufacturer label warning that indicates the contraindication warrants inclusion of a drug combination in this category, regardless of clinical evidence or lack of clinical evidence to support the contraindication.
| Drug Interaction | Drug Names |
|---|---|
| Efalizumab; Natalizumab/Immunosuppressives; Immunomodulators SEVERITY LEVEL: 1-Contraindicated Drug Combination: This drug combination is contraindicated and generally should not be dispensed or administered to the same patient. MECHANISM OF ACTION: Natalizumab,(1-3) efalizumab,(4) immunosuppressives, and immunomodulators all suppress the immune system. CLINICAL EFFECTS: Concurrent use of natalizumab(1-3) or efalizumab(4) with immunosuppressives or immunomodulators may result in an increased risk of infections, including progressive multifocal leukoencephalopathy (PML), an opportunistic infection caused by the JC virus (JCV). PREDISPOSING FACTORS: Previous JCV infection, longer duration of natalizumab treatment - especially if greater than 2 years, and prior or concomitant treatment with immunosuppressant medication are all independent risk factors which increase the risk for PML.(1,5) The FDA has estimated PML incidence stratified by risk factors: If anti-JCV antibody positive, no prior immunosuppressant use and natalizumab treatment less than 25 months, incidence <1/1,000. If anti-JCV antibody positive, history of prior immunosuppressant use and natalizumab treatment less than 25 months, incidence 2/1,000 If anti-JCV antibody positive, no prior immunosuppressant use and natalizumab treatment 25-48 months, incidence 4/1,000 If anti-JCV antibody positive, history of prior immunosuppressant use and natalizumab treatment 25-48 months, incidence 11/1,000. PATIENT MANAGEMENT: The US manufacturer of natalizumab states patients with Crohn's disease should not receive concurrent immunosuppressants, with the exception of limited overlap of corticosteroids, due to the increased risk for PML. For new natalizumab patients currently receiving chronic oral corticosteroids for Crohn's Disease, begin corticosteroid taper when therapeutic response to natalizumab has occurred. If corticosteroids cannot be discontinued within six months of starting natalizumab, discontinue natalizumab.(3) The US manufacturer of natalizumab states that natalizumab should not ordinarily be used in multiple sclerosis patients receiving immunosuppressants or immunomodulators due to the increased risk for PML. Immunosuppressives include, but are not limited to azathioprine, cyclophosphamide, cyclosporine, mercaptopurine, methotrexate, mitoxantrone, mycophenolate, and corticosteroids.(3,6) The UK manufacturer of natalizumab states that concurrent use with immunosuppressives or antineoplastic agents is contraindicated.(1) The Canadian manufacturer of natalizumab states that natalizumab should not be used with immunosuppressive or immunomodulatory agents.(2) The US manufacturer of certolizumab states that concurrent therapy with natalizumab is not recommended.(7) DISCUSSION: Progressive multifocal leukoencephalopathy has been reported in patients receiving concurrent natalizumab were recently or concomitantly taking immunomodulators or immunosuppressants.(1-5,8,9) In a retrospective cohort study of multiple sclerosis patients newly initiated on a disease-modifying therapy, use of high-efficacy agents (alemtuzumab, natalizumab, or ocrelizumab) resulted in the same risk of overall infections as moderate-efficacy agents, but there was an elevated risk of serious infections (adjusted hazard ratio [aHR] = 1.24, 95% confidence interval (CI) = 1.06-1.44) and UTIs (aHR = 1.21, 95% CI = 1.14-1.30).(10) |
TYSABRI |
| Talimogene laherparepvec/Selected Immunosuppressants SEVERITY LEVEL: 1-Contraindicated Drug Combination: This drug combination is contraindicated and generally should not be dispensed or administered to the same patient. MECHANISM OF ACTION: Talimogene laherparepvec is a live, attenuated herpes simplex virus.(1) CLINICAL EFFECTS: Concurrent use of talimogene laherparepvec in patients receiving immunosuppressive therapy may cause a life-threatening disseminated herpetic infection.(1) PREDISPOSING FACTORS: None determined. PATIENT MANAGEMENT: Talimogene laherparepvec is contraindicated in immunosuppressed patients.(1) The magnitude of immunocompromise and associated risks due to immunosuppressant drugs should be determined by a physician. DISCUSSION: Concurrent use of talimogene laherparepvec in patients receiving immunosuppressive therapy may cause a life-threatening disseminated herpetic infection.(1) |
IMLYGIC |
| Desmopressin/Glucocorticoids SEVERITY LEVEL: 1-Contraindicated Drug Combination: This drug combination is contraindicated and generally should not be dispensed or administered to the same patient. MECHANISM OF ACTION: Glucocorticoids increase the risk of hyponatremia.(1-4) CLINICAL EFFECTS: Concurrent use of glucocorticoids may increase the risk of hyponatremia with desmopressin.(1-4) PREDISPOSING FACTORS: Predisposing factors for hyponatremia include: polydipsia, renal impairment (eGFR < 50 ml/min/1.73m2), illnesses that can cause fluid/electrolyte imbalances, age >=65, medications that cause water retention and/or increase the risk of hyponatremia (carbamazepine, chlorpromazine, lamotrigine, loop diuretics, NSAIDs, opioids, SSRIs, thiazide diuretics, and/or tricyclic antidepressants). PATIENT MANAGEMENT: The concurrent use of systemic or inhaled glucocorticoids with desmopressin is contraindicated.(1-4) Desmopressin may be initiated 3 days or 5 half-lives after glucocorticoid discontinuation, whichever is longer. If concurrent use is deemed medically necessary, make sure serum sodium levels are normal before beginning therapy and consider using the desmopressin nasal 0.83 mcg dose. Consider measuring serum sodium levels more frequently than the recommended intervals of: within 7 days of concurrent therapy initiation, one month after concurrent therapy initiation and periodically during treatment. Counsel patients to report symptoms of hyponatremia, which may include: headache, nausea/vomiting, feeling restless, fatigue, drowsiness, dizziness, muscle cramps, changes in mental state (confusion, decreased awareness/alertness), seizures, coma, and trouble breathing. Counsel patients to limit the amount of fluids they drink in the evening and night-time and to stop taking desmopressin if they develop a stomach/intestinal virus with nausea/vomiting or any nose problems (blockage, stuffy/runny nose, drainage).(1) DISCUSSION: In clinical trials of desmopressin for the treatment of nocturia, 4 of 5 patients who developed severe hyponatremia (serum sodium <= 125 mmol/L) were taking systemic or inhaled glucocorticoids. Three of these patients were also taking NSAIDs and one was receiving a thiazide diuretic.(2) Drugs associated with hyponatremia may increase the risk, including loop diuretics, carbamazepine, chlorpromazine, glucocorticoids, lamotrigine, NSAIDs, opioids, SSRIs, thiazide diuretics, and/or tricyclic antidepressants.(1,3-4) |
DDAVP, DESMOPRESSIN ACETATE, NOCDURNA |
| Nadofaragene Firadenovec/Selected Immunosuppressants SEVERITY LEVEL: 1-Contraindicated Drug Combination: This drug combination is contraindicated and generally should not be dispensed or administered to the same patient. MECHANISM OF ACTION: Nadofaragene firadenovec may contain low levels of replication-competent adenovirus.(1) CLINICAL EFFECTS: Concurrent use of nadofaragene firadenovec in patients receiving immunosuppressive therapy may cause disseminated adenovirus infection.(1) PREDISPOSING FACTORS: None determined. PATIENT MANAGEMENT: Individuals who are immunosuppressed or immune-deficient should not receive nadofaragene firadenovec.(1) DISCUSSION: Nadofaragene firadenovec is a non-replicating adenoviral vector-based gene therapy but may contain low levels of replication-competent adenovirus. Immunocompromised persons, including those receiving immunosuppressant therapy, may be at risk for disseminated adenovirus infection.(1) |
ADSTILADRIN |
There are 27 severe interactions.
These drug interactions can produce serious consequences in most patients. Actions required for severe interactions include, but are not limited to, discontinuing one or both agents, adjusting dosage, altering administration scheduling, and providing additional patient monitoring. Review the full interaction monograph for more information.
| Drug Interaction | Drug Names |
|---|---|
| Selected Anticholinesterase/Corticosteroids SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction. MECHANISM OF ACTION: The mechanism of this interaction is unknown. CLINICAL EFFECTS: Concurrent use of these agents may contribute to increased muscle weakness and decreased response to anticholinesterases shortly after onset of corticosteroid therapy in the treatment of myasthenia gravis. Deterioration in muscle strength, including severe muscular depression, has been documented in patients with myasthenia gravis while receiving corticosteroids and anticholinesterases. PREDISPOSING FACTORS: None determined. PATIENT MANAGEMENT: If possible, hold anticholinesterase agents at least 24 hours before initiating corticosteroid therapy. If concurrent use is necessary, close observation of the patient is indicated and life support systems should be available. DISCUSSION: Decreased effectiveness of anticholinesterases during the period of corticosteroid-induced increased weakness probably reflects a temporary increase in the severity of the disease process itself rather than a specific, direct interaction between the two drugs. Despite the initial adverse effect, glucocorticoid (or ACTH) therapy subsequently produces improvement, beyond pre-therapy muscle strength, in most myasthenia gravis patients. In an uncontrolled study involving nine patients receiving therapeutic doses of pyridostigmine, the concurrent administration of methylprednisolone resulted in a decrease in muscle strength in 71% of treatment courses. During 57% of treatment courses, severe muscle weakness occurred, necessitating mechanical ventilation. Improvement in muscle strength and response to pyridostigmine above baseline levels occurred after methylprednisolone was discontinued. Other clinical observations have indicated that the concomitant use of these agents can affect muscle strength, although each agent alone has been used successfully in treating myasthenia gravis. |
ANTICHOLIUM, BLOXIVERZ, DEMECARIUM BROMIDE, EDROPHONIUM CHLORIDE, MESTINON, NEOSTIGMINE METHYLSULFATE, NEOSTIGMINE-STERILE WATER, PREVDUO, PYRIDOSTIGMINE BROMIDE, PYRIDOSTIGMINE BROMIDE ER, REGONOL |
| Mifepristone/Corticosteroids SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction. MECHANISM OF ACTION: Mifepristone is an antagonist of the progesterone and glucocorticoid (GR-II) receptors, but has little effect at the mineralocorticoid (GR-I) receptor. Mifepristone has a higher affinity for the glucocorticoid receptor than either dexamethasone or cortisol and will displace both endogenous and exogenous glucocorticoids from their binding sites. CLINICAL EFFECTS: Although serum cortisol levels rise, antagonism of the glucocorticoid receptor may lead to adrenal insufficiency. Efficacy of locally administered corticosteroids may be diminished. PREDISPOSING FACTORS: None determined. PATIENT MANAGEMENT: The manufacturers of mifepristone states that mifepristone is contraindicated in patients receiving concurrent long-term corticosteroid therapy.(1-2) Due to its long mean half-life of 85 hours(2), even short term mifepristone use may have an extended duration of effect. DISCUSSION: The manufacturers of mifepristone states that mifepristone is contraindicated in patients receiving concurrent long-term corticosteroid therapy.(1-2) |
KORLYM, MIFEPREX, MIFEPRISTONE |
| Aldesleukin/Glucocorticoids SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction. MECHANISM OF ACTION: Corticosteroids may suppress interleukin-2-induced tumor necrosis factor (TNF) synthesis.(1) CLINICAL EFFECTS: Concurrent use of corticosteroids may reduce the antitumor effectiveness of aldesleukin.(2) PREDISPOSING FACTORS: None determined. PATIENT MANAGEMENT: The manufacturer of aldesleukin states that concurrent administration of corticosteroids and aldesleukin should be avoided.(2) DISCUSSION: Corticosteroids have been shown to reduce aldesleukin-related side effects such as fever, renal insufficiency, hyperbilirubinemia, confusion, and dyspnea.(1,2) However, dexamethasone has been shown to reduce aldesleukin-induced TNF synthesis.(1) |
PROLEUKIN |
| Selected Steroids/Antiretroviral CYP3A4 Inhibitors SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction. MECHANISM OF ACTION: Antiretroviral CYP3A4 inhibitors may inhibit the metabolism of corticosteroids metabolized by CYP3A4. Dexamethasone may induce metabolism of agents that are substrates of CYP3A4.(1-13,50) CLINICAL EFFECTS: Concurrent use of antiretroviral CYP3A4 inhibitors may result in increased systemic exposure to and effects from corticosteroids metabolized by CYP3A4, including Cushing's syndrome and adrenal suppression. Concurrent dexamethasone may result in decreased levels and effectiveness of CYP3A4 substrates. PREDISPOSING FACTORS: None determined. PATIENT MANAGEMENT: If possible, avoid concurrent therapy of betamethasone, budesonide, ciclesonide, fluticasone, dexamethasone, methylprednisolone, or triamcinolone with antiretroviral CYP3A4 inhibitors. Alternative corticosteroids that are less affected by CYP3A4 inhibitors should be considered, like beclomethasone, prednisone, and prednisolone. If concurrent therapy is warranted, patients should be closely monitored for systemic effects. The corticosteroid may need to be discontinued. Patients receiving concurrent therapy with dexamethasone and substrates of CYP3A4 should also be monitored for decreased effectiveness of the CYP3A4 substrate. The manufacturers of nasal fluticasone(14-16) and fluticasone for inhalation(17) state that concurrent use of fluticasone and atazanavir, indinavir, nelfinavir, ritonavir or saquinavir is not recommended. The US manufacturers of atazanavir,(1) fosamprenavir,(5) indinavir(6) and nelfinavir(8) recommend caution with concurrent use of inhaled or nasal fluticasone. Consider alternatives to fluticasone if long-term use is required. DISCUSSION: In a study, boceprevir (800 mg TID for 7 days) increased the area-under-curve (AUC) of a single dose of prednisone (40 mg) by 22%. The maximum concentration (Cmax) and AUC of prednisolone increased by 16% and 37%, respectively.(2) A study of 14 healthy adults found that concurrent use of ketoconazole with ciclesonide increased the AUC of ciclesonide's active metabolite, des-ciclesonide, by approximately 3.6-fold at steady state, while levels of ciclesonide remained unchanged. However, the study concluded that no dosage adjustments were required because ciclesonide has a very low potential to cause side effects.(18) A study in 18 healthy subjects examined the effects of ritonavir (100 mg twice daily) on fluticasone nasal spray (200 mcg daily). In most subjects, fluticasone was undetectable (<10 pg/ml) when administered alone. In subjects in whom fluticasone was detectable when given alone, Cmax and area-under-curve AUC averaged 11.9 pg/ml and 8.43 pg x hr/ml, respectively. With concurrent ritonavir, fluticasone Cmax and AUC increased to 318 pg/ml and 3102.6 pg x hr/ml, respectively.(7,11,14) This reflects increases in Cmax and AUC by 25-fold and 350-fold, respectively.(3) The cortisol AUC decreased by 86%.(6,14-16) In a study in 10 healthy subjects, ritonavir (200 mg twice daily for 4 and 14 days) increased the AUC of a single dose of prednisolone by 1.41-fold and 1.30-fold, respectively, after 4 days and 14 days of ritonavir.(19) There have been several case reports of Cushing's syndrome in patients treated concurrently with ritonavir and inhaled budesonide,(19-20) dexamethasone,(22) injectable triamcinolone,(23-26) nasal fluticasone.(28-46) Hepatitis has also been reported with concurrent budesonide and ritonavir.(47) In a study in 9 healthy subjects, mibefradil (50 mg once daily for 3 days) increased the AUC, Cmax, and elimination half-life of methylprednisolone by 3.8-fold, 1.8-fold, and 2.7-fold, respectively.(48) In a study in 8 healthy subjects, following nefazodone administration the following changes were seen with methylprednisolone: mean (+/-SD) area under the concentration-time curve was significantly higher (1393 +/- 343 vs. 2966 +/- 928 ug*h/L; P < 0.005), apparent clearance was lower (28.7 +/- 7.2 vs. 14.6 +/- 7.8 L/h; P < 0.02) and the terminal elimination half-life was longer (2.28 +/- 0.49 vs. 3.32 +/- 0.95 hours; P < 0.02).(49) Selected steroids linked to this monograph include: betamethasone, budesonide, ciclesonide, dexamethasone, fluticasone, methylprednisolone, and triamcinolone.(50) Selected CYP3A4 inhibitors and substrates linked to this monograph include: atazanavir, cobicistat, darunavir, fosamprenavir, indinavir, lenacapavir, lopinavir, nelfinavir, saquinavir, and tipranavir.(50) |
APTIVUS, ATAZANAVIR SULFATE, DARUNAVIR, EVOTAZ, FOSAMPRENAVIR CALCIUM, GENVOYA, KALETRA, LOPINAVIR-RITONAVIR, PREZCOBIX, PREZISTA, REYATAZ, STRIBILD, SUNLENCA, SYMTUZA, TYBOST, VIRACEPT |
| Systemic Corticosteroids; Corticotropin (ACTH)/Live Vaccines SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction. MECHANISM OF ACTION: Corticosteroids and corticotropin suppress the immune system. In severely immunocompromised patients, virus replication after administration of live, attenuated-virus vaccines can be enhanced and/or the immune response to the vaccine may be decreased.(1) CLINICAL EFFECTS: The expected serum antibody response may not be obtained and/or the vaccine may result in illness.(1) PREDISPOSING FACTORS: Patients receiving immunosuppressive doses of corticosteroids or corticotropin for equal to or greater than 14 consecutive days.(1) PATIENT MANAGEMENT: The Centers for Disease Control's (CDC) Advisory Committee on Immunization Practices (ACIP) states that live-virus and live, attenuated vaccines should not be administered to patients who are severely immunosuppressed, including those who are receiving or have received high-dose, systemic steroids for greater than or equal to 14 consecutive days. Live vaccines should be deferred for at least 1 month after discontinuation of high-dose systemic steroids administered for 14 consecutive days. When initiating immunosuppressives doses of corticosteroids, wait 4 weeks after a live vaccines is administered. However, if patients require therapy for chronic inflammatory conditions, do not delay therapy due to past vaccines. Patients who are vaccinated within the 14 days prior to initiating immunosuppressive therapy should be considered unvaccinated and should be revaccinated at least 3 months after immunosuppressive therapy is discontinued.(1) The US manufacturer of corticotropin(2) and triamcinolone(3) and the Australian manufacturer of dexamethasone(4) state that administration of live or live-attenuated vaccines is contraindicated in patients receiving immunosuppressive doses of corticosteroids or corticotropin. The manufacturer of deflazacort states that live or live-attenuated vaccines should be administered at least 4 to 6 weeks prior to initiation of therapy with deflazacort.(5) DISCUSSION: Many clinicians consider a dose equivalent to either 2 mg/kg of body weight or a total of 20 mg/day of prednisone as sufficiently immunosuppressive to raise safety concerns about live-virus vaccines.(1) Immunization procedures may be undertaken in patients receiving corticosteroids when the therapy is short term (less than 2 weeks); low to moderate dose; long-term, alternate-day treatment with short-acting preparations; maintenance physiologic doses (replacement therapy); or administered topically (skin or eyes), by aerosol, or by intra-articular, bursal, or tendon injection.(1) Killed or inactivated vaccines do not pose a danger to immunocompromised patients.(1) |
ACAM2000 (NATIONAL STOCKPILE), ADENOVIRUS TYPE 4, ADENOVIRUS TYPE 4 AND TYPE 7, ADENOVIRUS TYPE 7, BCG (TICE STRAIN), BCG VACCINE (TICE STRAIN), DENGVAXIA, ERVEBO (NATIONAL STOCKPILE), FLUMIST TRIVALENT 2024-2025, IXCHIQ, M-M-R II VACCINE, PRIORIX, PROQUAD, ROTARIX, ROTATEQ, STAMARIL, VARIVAX VACCINE, VAXCHORA ACTIVE COMPONENT, VAXCHORA VACCINE, VIVOTIF, YF-VAX |
| Amphotericin B/Corticosteroids; Corticotropin (ACTH) SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction. MECHANISM OF ACTION: Corticosteroids and corticotropin may potentiate potassium excretion and overload salt and water retention.(1) CLINICAL EFFECTS: Concurrent use of amphotericin b with corticosteroids or corticotropin may potentiate amphotericin b-induced hypokalemia, thereby predisposing patients to cardiac dysfunction.(1-2) PREDISPOSING FACTORS: None determined. PATIENT MANAGEMENT: The US manufacturer of amphotericin b states that concurrent use of corticosteroids or corticotropin should be avoided unless absolutely necessary to avoid side effects. If concurrent use is necessary, serum electrolytes and cardiac function must be monitored closely.(1) DISCUSSION: There are four case reports of cardiac enlargement, hypokalemia, and hypernatremia from concurrent use of amphotericin b and corticosteroids.(2) |
ABELCET, AMBISOME, AMPHOTERICIN B, AMPHOTERICIN B LIPOSOME |
| Radioactive Iodide/Agents that Affect Iodide SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction. MECHANISM OF ACTION: Many compounds can affect iodide protein binding and alter iodide pharmacokinetics and pharmacodynamics.(1) CLINICAL EFFECTS: Compounds that affect iodide pharmacokinetics and pharmacodynamics may impact the effectiveness of radioactive iodide.(1) PREDISPOSING FACTORS: Compounds that affect iodide pharmacokinetics and pharmacodynamics are expected to have the most impact during therapy using radioactive iodide. Diagnostic procedures would be expected to be impacted less. PATIENT MANAGEMENT: Discuss the use of agents that affect iodide pharmacokinetics and pharmacodynamics with the patient's oncologist.(1) Because indocyanine green contains sodium iodide, the iodine-binding capacity of thyroid tissue may be reduced for at least one week following administration. Do not perform radioactive iodine uptake studies for at least one week following administration of indocyanine green.(2) The manufacturer of iopamidol states administration may interfere with thyroid uptake of radioactive iodine and decrease therapeutic and diagnostic efficacy. Avoid thyroid therapy or testing for up to 6 weeks post administration of iopamidol.(3) DISCUSSION: Many agents interact with radioactive iodine. The average duration of effect is: anticoagulants - 1 week antihistamines - 1 week anti-thyroid drugs, e.g: carbimazole, methimazole, propylthiouracil - 3-5 days corticosteroids - 1 week iodide-containing medications, e.g: amiodarone - 1-6 months expectorants - 2 weeks Lugol solution - 3 weeks saturated solution of potassium iodine - 3 weeks vitamins - 10-14 days iodide-containing X-ray contrast agents - up to 1 year lithium - 4 weeks phenylbutazone - 1-2 weeks sulfonamides - 1 week thyroid hormones (natural or synthetic), e.g.: thyroxine - 4 weeks tri-iodothyronine - 2 weeks tolbutamide - 1 week topical iodide - 1-9 months (1) |
ADREVIEW, JEANATOPE, MEGATOPE, SODIUM IODIDE I-123 |
| Tofacitinib/Immunosuppressives; Immunomodulators SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction. MECHANISM OF ACTION: Concurrent use of tofacitinib and azathioprine, other biologic disease-modifying antirheumatic drugs (DMARDs), or potent immunosuppressants may result in additive or synergistic effects on the immune system.(1) CLINICAL EFFECTS: Concurrent use of tofacitinib and azathioprine, other biologic DMARDs, or potent immunosuppressants use may increase the risk of serious infections.(1) PREDISPOSING FACTORS: None determined. PATIENT MANAGEMENT: Tofacitinib should not be used concurrently with azathioprine, other biologic DMARDs, or cyclosporine.(1) Patient should be monitored for decreases in lymphocytes and neutrophils. Therapy should be adjusted based on the indication. - For all indications: If absolute neutrophil count (ANC) or lymphocyte count is less than 500 cells/mm3, discontinue tofacitinib. - For rheumatoid arthritis or psoriatic arthritis and absolute neutrophil count (ANC) 500 to 1000 cells/mm3: interrupt dosing. When ANC is greater than 1000 cells/mm3, resume Xeljanz 5 mg twice daily or Xeljanz XR 11 mg once daily. - For ulcerative colitis and ANC 500 to 1000 cells/mm3: -If taking Xeljanz 10 mg twice daily, decrease to 5 mg twice daily. When ANC is greater than 1000 cells/mm3, increase to 10 mg twice daily based on clinical response. -If taking Xeljanz 5 mg twice daily, interrupt dosing. When ANC is greater than 1000 cells/mm3, resume 5 mg twice daily. -If taking Xeljanz XR 22 mg once daily, decrease to 11 mg once daily. When ANC is greater than 1000 cells/mm3, increase to 22 mg once daily based on clinical response. -If taking Xeljanz XR 11 mg once daily, interrupt dosing. When ANC is greater than 1000 cells/mm3, resume 11 mg once daily. - For polyarticular course juvenile idiopathic arthritis (pcJIA) and ANC 500 to 1000 cells/mm3: interrupt dosing until ANC is greater than 1000 cells/mm3.(1) DISCUSSION: Concurrent use of tofacitinib and azathioprine, other biologic DMARDs, or potent immunosuppressants may increase the risk of infection.(1) |
TOFACITINIB CITRATE, XELJANZ, XELJANZ XR |
| Selected Multiple Sclerosis Agents/Immunosuppressants; Immunomodulators SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction. MECHANISM OF ACTION: Ocrelizumab or ofatumumab in combination with immunosuppressives and immune-modulators all suppress the immune system.(1,2) CLINICAL EFFECTS: Concurrent use of ocrelizumab or ofatumumab with immunosuppressive or immune-modulating agents may result in an increased risk of serious infections, such as disseminated herpetic infection or progressive multifocal leukoencephalopathy (PML), an opportunistic infection caused by the JC virus (JCV).(1,2) PREDISPOSING FACTORS: Incomplete washout of previously prescribed immunosuppressive or immune-modulating medications. PATIENT MANAGEMENT: The ocrelizumab US prescribing information states: - Ocrelizumab and other immune-modulating or immunosuppressive therapies, (including immunosuppressant doses of corticosteroids) are expected to increase the risk of immunosuppression, and the risk of additive immune system effects must be considered if these therapies are coadministered with ocrelizumab. When switching from drugs with prolonged immune effects, such as daclizumab, fingolimod, natalizumab, teriflunomide, or mitoxantrone, the duration and mode of action of these drugs must be considered to avoid unintended additive immunosuppressive effects when initiating ocrelizumab.(1) The ofatumumab US prescribing information states: - Ofatumumab and other immunosuppressive therapies (including systemic corticosteroids) may have the potential for increased immunosuppressive effects and increase the risk of infection. When switching between therapies, the duration and mechanism of action of each therapy should be considered due to the potential for additive immunosuppressive effects. Ofatumumab for MS therapy has not been studied in combination with other MS agents that suppress the immune system.(2) DISCUSSION: Fatal disseminated herpes zoster and herpes simplex infections and cases of progressive multifocal leukoencephalopathy (PML) have been reported in patients who previously received immunomodulators or immunosuppressants.(1,2) In a retrospective cohort study of multiple sclerosis patients newly initiated on a disease-modifying therapy, use of high-efficacy agents (alemtuzumab, natalizumab, or ocrelizumab) resulted in the same risk of overall infections as moderate-efficacy agents, but there was an elevated risk of serious infections (adjusted hazard ratio [aHR] = 1.24, 95% confidence interval (CI) = 1.06-1.44) and UTIs (aHR = 1.21, 95% CI = 1.14-1.30).(3) |
KESIMPTA PEN, OCREVUS, OCREVUS ZUNOVO |
| T Cell Immunotherapies/Corticosteroids SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction. MECHANISM OF ACTION: Corticosteroids suppress the immune system. Concurrent use or premedication with a prophylactic corticosteroid may interfere with the activity of CAR-T cell immunotherapies.(1-6) CLINICAL EFFECTS: Corticosteroids may decrease the efficacy of CAR-T cell immunotherapies.(1-6) PREDISPOSING FACTORS: None determined. PATIENT MANAGEMENT: The manufacturers recommend avoiding concurrent or prophylactic use of corticosteroids as a premedication prior to infusion of CAR-T cell immunotherapy. Corticosteroids may be used and are recommended in the case of a life-threatening emergency, including the management of cytokine release syndrome or neurological toxicities.(1-6) DISCUSSION: Corticosteroids may decrease the efficacy of CAR-T cell immunotherapy.(1-6) The manufacturers recommend avoiding concurrent or prophylactic use of corticosteroids as a premedication prior to infusion of CAR-T cell immunotherapy.(1-6) Corticosteroids may be used and are recommended in the case of a life-threatening emergency, including the management of cytokine release syndrome or neurological toxicities.(1-6) |
ABECMA, AMTAGVI, AUCATZYL, BREYANZI, BREYANZI CD4 COMPONENT, BREYANZI CD8 COMPONENT, CARVYKTI, KYMRIAH, TECARTUS, TECELRA, YESCARTA |
| Cosyntropin/Agents Affecting Plasma Cortisol Levels SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction. MECHANISM OF ACTION: Agents affecting plasma cortisol levels may impact the accuracy of the cosyntropin diagnostic test.(1) CLINICAL EFFECTS: Concurrent use of agents affecting plasma cortisol levels may impact the accuracy of the cosyntropin diagnostic test.(1) PREDISPOSING FACTORS: None determined. PATIENT MANAGEMENT: The US manufacturer of cosyntropin states accuracy of diagnosis using the cosyntropin diagnostic test may be complicated by concomitant medications affecting plasma cortisol levels.(1) Agents affecting plasma cortisol levels and recommendation to stop prior to cosyntropin diagnostic test include: - Glucocorticoids: May elevate plasma cortisol levels. Stop these drugs on the day of testing. Long-acting glucocorticoids may need to be stopped for a longer period before testing. - Spironolactone: May elevate plasma cortisol levels. Stop spironolactone on the day of testing. - Estrogen: May elevate plasma total cortisol levels. Discontinue estrogen containing drugs 4 to 6 weeks prior to testing to allow cortisol binding globulin levels to return to levels within the reference range. Alternatively, concomitant measurement of cortisol binding globulin at the time of testing can be done; if cortisol binding globulin levels are elevated, plasma total cortisol levels are considered inaccurate.(1) DISCUSSION: Concurrent use of agents affecting plasma cortisol levels may impact the accuracy of the cosyntropin diagnostic test.(1) |
CORTROSYN, COSYNTROPIN |
| Upadacitinib/Immunosuppressives; Immunomodulators SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction. MECHANISM OF ACTION: Upadacitinib, immunosuppressives, and immunomodulators all suppress the immune system. CLINICAL EFFECTS: Concurrent use of upadacitinib with immunosuppressives or immunomodulators may result in an increased risk of serious infections. PREDISPOSING FACTORS: None determined. PATIENT MANAGEMENT: The US manufacturer of upadacitinib states that concurrent use of upadacitinib with immunosuppressives or immunomodulators is not recommended. DISCUSSION: Serious infections have been reported in patients receiving upadacitinib. Reported infections included pneumonia, cellulitis, tuberculosis, multidermatomal herpes zoster, oral/esophageal candidiasis, cryptococcosis. Reports of viral reactivation, including herpes virus reactivation and hepatitis B reactivation, were reported in clinical studies with upadacitinib.(1) |
RINVOQ, RINVOQ LQ |
| Inebilizumab/Immunosuppressives; Immunomodulators SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction. MECHANISM OF ACTION: Inebilizumab, immunosuppressives, and immunomodulators all suppress the immune system.(1) CLINICAL EFFECTS: Concurrent use of inebilizumab with immunosuppressive or immunomodulating agents may result in myelosuppression including neutropenia resulting in an increased risk for serious infections.(1) PREDISPOSING FACTORS: None determined. PATIENT MANAGEMENT: The US manufacturer of inebilizumab states that the concurrent use of inebilizumab with immunosuppressive agents, including systemic corticosteroids, may increase the risk of infection. If concurrent therapy is warranted, consider the risk of additive immune suppression and monitor based on prescribing information for both agents.(1) DISCUSSION: Inebilizumab has not been studied in combination with other immunosuppressants. If concurrent therapy is warranted, consider the potential for increased immunosuppressive risks from both agents. The most common infections reported by inebilizumab treated patients in the randomized and open-label clinical trial periods included urinary tract infections (20%), nasopharyngitis (13%), upper respiratory tract infections (8%), and influenza (7%). Although there been no cases of Hepatitis B virus reactivation or progressive multifocal leukoencephalopathy reported in patients taking inebilizumab, these infections have been observed in patients taking other B-cell-depleting antibodies.(1) |
UPLIZNA |
| Baricitinib/Immunosuppressives; Immunomodulators SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction. MECHANISM OF ACTION: Concurrent use of baricitinib with other biologic disease-modifying antirheumatic drugs (DMARDs) or potent immunosuppressants such as azathioprine or cyclosporine may result in additive or synergistic effects on the immune system. CLINICAL EFFECTS: Concurrent use of baricitinib with other biologic DMARDs or potent immunosuppressants such as azathioprine or cyclosporine may increase the risk of serious infections.(1) PREDISPOSING FACTORS: None determined. PATIENT MANAGEMENT: The US manufacturer of baricitinib states that concurrent use of baricitinib with biologic DMARDs or potent immunosuppressants is not recommended.(1) DISCUSSION: Most patients who developed serious infections while being treated with baricitinib were on concomitant immunosuppressants like methotrexate and corticosteroids. The combination of baricitinib with other biologic DMARDs has not been studied.(1) |
OLUMIANT |
| Ponesimod/Immunosuppressives; Immunomodulators SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction. MECHANISM OF ACTION: Ponesimod in combination with immunosuppressives and immune-modulators all suppress the immune system.(1) CLINICAL EFFECTS: Concurrent use of ponesimod with immunosuppressive or immune-modulating agents may result in an increased risk of serious infections, such as disseminated herpetic infection, cryptococcal infection, or progressive multifocal leukoencephalopathy (PML), an opportunistic infection caused by the JC virus (JCV).(1) PREDISPOSING FACTORS: Incomplete washout of previously prescribed immunosuppressive or immune-modulating medications. PATIENT MANAGEMENT: The ponesimod US prescribing information states ponesimod has not been studied in combination with anti-neoplastic, immune-modulating, or immunosuppressive therapies. Caution should be used during concomitant administration because of the risk of additive immune effects during therapy and in the weeks following administration. When switching from drugs with prolonged immune effects, the half-life and mode of action of these drugs must be considered in order to avoid unintended additive immunosuppressive effects. Initiating treatment with ponesimod after alemtuzumab is not recommended. However, ponesimod can generally be started immediately after discontinuation of beta interferon or glatiramer acetate.(1) DISCUSSION: Fatal disseminated herpes zoster and herpes simplex infections, cryptococcal meningitis, disseminated cryptococcal infections, and cases of progressive multifocal leukoencephalopathy (PML) have been reported in patients who previously received immunomodulators or immunosuppressants.(1) |
PONVORY |
| Fingolimod/Immunosuppressives; Immunomodulators SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction. MECHANISM OF ACTION: Fingolimod in combination with immunosuppressives and immune-modulators all suppress the immune system.(1-3) CLINICAL EFFECTS: Concurrent use of fingolimod with immunosuppressive or immune-modulating agents may result in an increased risk of serious infections, such as disseminated herpetic infection or progressive multifocal leukoencephalopathy (PML), an opportunistic infection caused by the JC virus (JCV).(1-3) PREDISPOSING FACTORS: Incomplete washout of previously prescribed immunosuppressive or immune-modulating medications. PATIENT MANAGEMENT: Recommendations for fingolimod regarding this interaction differ between regulatory approving agencies. The fingolimod US prescribing information states: - Antineoplastic, immune-modulating, or immunosuppressive therapies, (including corticosteroids) are expected to increase the risk of immunosuppression, and the risk of additive immune system effects must be considered if these therapies are coadministered with fingolimod. When switching from drugs with prolonged immune effects, such as natalizumab, teriflunomide or mitoxantrone, the duration and mode of action of these drugs must be considered to avoid unintended additive immunosuppressive effects when initiating fingolimod.(1) The fingolimod Canadian prescribing information states: - Concurrent use with immunosuppressive or immunomodulatory agents is contraindicated due to the risk of additive immune system effects. However, co-administration of a short course of corticosteroids (up to 5 days) did not increase the overall rate of infection in patients participating Phase III clinical trials.(2) The fingolimod UK specific product characteristics states: - Fingolimod is contraindicated in patients currently receiving immunosuppressive therapies or those immunocompromised by prior therapies. When switching patients from another disease modifying therapy to Gilenya, the half-life and mode of action of the other therapy must be considered in order to avoid an additive immune effect whilst at the same time minimizing the risk of disease activation.(3) DISCUSSION: Fatal disseminated herpes zoster and herpes simplex infections and cases of progressive multifocal leukoencephalopathy (PML) have been reported in patients who previously received immunomodulators or immunosuppressants.(1-3) |
FINGOLIMOD, GILENYA, TASCENSO ODT |
| Ozanimod/Immunosuppressives; Immunomodulators SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction. MECHANISM OF ACTION: Ozanimod in combination with immunosuppressives and immune-modulators all suppress the immune system.(1) CLINICAL EFFECTS: Concurrent use of ozanimod with immunosuppressive or immune-modulating agents may result in an increased risk of serious infections, such as disseminated herpetic infection or progressive multifocal leukoencephalopathy (PML), an opportunistic infection caused by the JC virus (JCV).(1) PREDISPOSING FACTORS: Incomplete washout of previously prescribed immunosuppressive or immune-modulating medications. PATIENT MANAGEMENT: The ozanimod US prescribing information state this information regarding this interaction: -Ozanimod has not been studied in combination with anti-neoplastic, immune-modulating, or immunosuppressive therapies. Caution should be used during concomitant administration because of the risk of additive immune effects during therapy and in the week following administration. When switching from drugs with prolonged immune effects, the half-life and mode of action of these drugs must be considered in order to avoid unintended additive immunosuppressive effects. Initiating treatment with ozanimod after alemtuzumab is not recommended. However, ozanimod can generally be started immediately after discontinuation of beta interferon or glatiramer acetate.(1) DISCUSSION: Fatal disseminated herpes zoster and herpes simplex infections and cases of progressive multifocal leukoencephalopathy (PML) have been reported in patients who previously received immunomodulators or immunosuppressants.(1) |
ZEPOSIA |
| Siponimod/Immunosuppressives; Immunomodulators SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction. MECHANISM OF ACTION: Siponimod in combination with immunosuppressives and immune-modulators all suppress the immune system.(1) CLINICAL EFFECTS: Concurrent use of siponimod with immunosuppressive or immune-modulating agents may result in an increased risk of serious infections, such as disseminated herpetic infection or progressive multifocal leukoencephalopathy (PML), an opportunistic infection caused by the JC virus (JCV).(1) PREDISPOSING FACTORS: Incomplete washout of previously prescribed immunosuppressive or immune-modulating medications. PATIENT MANAGEMENT: The siponimod US prescribing information state this information regarding this interaction: -Siponimod has not been studied in combination with anti-neoplastic, immune-modulating, or immunosuppressive therapies. Caution should be used during concomitant administration because of the risk of additive immune effects during therapy and in the week following administration. When switching from drugs with prolonged immune effects, the half-life and mode of action of these drugs must be considered in order to avoid unintended additive immunosuppressive effects. Initiating treatment with siponimod after alemtuzumab is not recommended. However, siponimod can generally be started immediately after discontinuation of beta interferon or glatiramer acetate.(1) DISCUSSION: Fatal disseminated herpes zoster and herpes simplex infections and cases of progressive multifocal leukoencephalopathy (PML) have been reported in patients who previously received immunomodulators or immunosuppressants.(1) |
MAYZENT |
| Cladribine/Immunosuppressives; Immunomodulators SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction. MECHANISM OF ACTION: Cladribine in combination with immunosuppressives and immune-modulators all suppress the immune system.(1-2) CLINICAL EFFECTS: Concurrent use of cladribine with immunosuppressive or immune-modulating agents may result in an increased risk of serious infections, such as disseminated herpetic infection or progressive multifocal leukoencephalopathy (PML), an opportunistic infection caused by the JC virus (JCV).(1-2) PREDISPOSING FACTORS: Incomplete washout of previously prescribed immunosuppressive or immune-modulating medications. PATIENT MANAGEMENT: Recommendations for cladribine regarding this interaction differ between regulatory approving agencies. The cladribine US prescribing information states: -Concomitant use with myelosuppressive or other immunosuppressive drugs is not recommended. Acute short-term therapy with corticosteroids can be administered. In patients who have previously been treated with immunomodulatory or immunosuppressive drugs, consider potential additive effect, the mode of action, and duration of effect of the other drugs prior to initiation of cladribine.(1) The cladribine Canadian prescribing information states: -Use of cladribine in immunocompromised patients is contraindicated because of a risk of additive effects on the immune system. Acute short-term therapy with corticosteroids can be administered during cladribine treatment.(2) DISCUSSION: Fatal disseminated herpes zoster and herpes simplex infections and cases of progressive multifocal leukoencephalopathy (PML) have been reported in patients who previously received immunomodulators or immunosuppressants.(1-2) |
CLADRIBINE, MAVENCLAD |
| Atogepant/CYP3A4 Inducers SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction. MECHANISM OF ACTION: Strong, moderate, and weak CYP3A4 inducers may increase the metabolism of atogepant by CYP3A4.(1) CLINICAL EFFECTS: The concurrent use of strong, moderate, or weak CYP3A4 inducers with atogepant may result in decreased levels and clinical effectiveness of atogepant.(1) PREDISPOSING FACTORS: Induction effects may be more likely with regular use of the inducer for longer than 1-2 weeks. PATIENT MANAGEMENT: The manufacturer of atogepant recommends that patients on concomitant strong, moderate, or weak CYP3A4 inducers receive atogepant 30 mg or 60 mg once daily for prevention of episodic migraines and avoid use of atogepant for prevention of chronic migraines.(1) Patients receiving concurrent therapy with CYP3A4 inducers and atogepant should be observed for decreased clinical effectiveness. DISCUSSION: In a study of healthy subjects, rifampin, a strong CYP3A4 inducer, decreased the area-under-curve (AUC) and maximum concentration (Cmax) of atogepant by 60% and 30%, respectively. Topiramate, a weak CYP3A4 inducer, decreased atogepant AUC and Cmax by 25% and 24%, respectively.(1) Strong CYP3A4 inducers linked to this monograph include: apalutamide, barbiturates, carbamazepine, enzalutamide, fosphenytoin, ivosidenib, lumacaftor, mitotane, phenobarbital, phenytoin, primidone, rifampin, rifapentine, and St. John's wort. Moderate CYP3A4 inducers linked to this monograph include: belzutifan, bosentan, cenobamate, dabrafenib, dipyrone, efavirenz, elagolix, etravirine, lesinurad, lorlatinib, mavacamten, mitapivat, modafinil, nafcillin, pacritinib, pexidartinib, repotrectinib, rifabutin, sotorasib, telotristat, thioridazine and tovorafenib. Weak CYP3A4 inducers linked to this monograph include: armodafinil, bexarotene, brigatinib, brivaracetam, clobazam, danshen, darolutamide, dexamethasone, dicloxacillin, echinacea, eslicarbazepine, floxacillin, garlic, genistein, ginseng, glycyrrhizin, methylprednisolone, mobocertinib, nevirapine, omaveloxolone, oritavancin, oxcarbazepine, pioglitazone, pitolisant, quercetin, relugolix, rufinamide, sarilumab, sulfinpyrazone, tazemetostat, tecovirimat, terbinafine, ticlopidine, topiramate, troglitazone, vemurafenib, vinblastine, and zanubrutinib.(1,2) |
QULIPTA |
| Selected Steroids/Selected Strong CYP3A4 Inhibitors SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction. MECHANISM OF ACTION: Strong CYP3A4 inhibitors may inhibit the metabolism of corticosteroids metabolized by CYP3A4. CLINICAL EFFECTS: Concurrent use of strong CYP3A4 inhibitors may result in increased systemic exposure to and effects from corticosteroids metabolized by CYP3A4, including Cushing's syndrome and adrenal suppression. PREDISPOSING FACTORS: None determined. PATIENT MANAGEMENT: If possible, avoid concurrent therapy between betamethasone, budesonide, ciclesonide, fluticasone, dexamethasone, methylprednisolone, or triamcinolone and strong CYP3A4 inhibitors. Alternative corticosteroids that are less affected by CYP3A4 inhibitors should be considered, like beclomethasone, prednisone, and prednisolone. If concurrent therapy is warranted, patients should be closely monitored for systemic effects. The corticosteroid may need to be discontinued. DISCUSSION: In a study, boceprevir (800 mg TID for 7 days) increased the area-under-curve (AUC) of a single dose of prednisone (40 mg) by 22%. The maximum concentration (Cmax) and AUC of prednisolone increased by 16% and 37%, respectively.(3) A study of 14 healthy adults found that concurrent use of ketoconazole with ciclesonide increased the AUC of ciclesonide's active metabolite, des-ciclesonide, by approximately 3.6-fold at steady state, while levels of ciclesonide remained unchanged. However, the study concluded that no dosage adjustments were required because ciclesonide has a very low potential to cause side effects.(4) A study in 18 healthy subjects examined the effects of ritonavir (100 mg twice daily) on fluticasone nasal spray (200 mcg daily). In most subjects, fluticasone was undetectable (<10 pg/ml) when administered alone. In subjects in whom fluticasone was detectable when given alone, Cmax and area-under-curve AUC averaged 11.9 pg/ml and 8.43 pg x hr/ml, respectively. With concurrent ritonavir, fluticasone Cmax and AUC increased to 318 pg/ml and 3102.6 pg x hr/ml, respectively.(6-8) This reflects increases in Cmax and AUC by 25-fold and 350-fold, respectively.(6) The cortisol AUC decreased by 86%.(10-13) In a study in 10 healthy subjects, ritonavir (200 mg twice daily for 4 and 14 days) increased the AUC of a single dose of prednisolone by 1.41-fold and 1.30-fold, respectively, after 4 days and 14 days of ritonavir.(14) There have been several case reports of Cushing's syndrome in patients treated concurrently with ritonavir and inhaled budesonide,(15-16) dexamethasone,(17) injectable triamcinolone,(18-21) nasal fluticasone.(23-41) Hepatitis has also been reported with concurrent budesonide and ritonavir.(42) In a study in 9 healthy subjects, mibefradil (50 mg once daily for 3 days) increased the AUC, Cmax, and elimination half-life of methylprednisolone by 3.8-fold, 1.8-fold, and 2.7-fold, respectively.(43) In a study in 8 healthy subjects, following nefazodone administration the following changes were seen with methylprednisolone: mean (+/-SD) area under the concentration-time curve was significantly higher (1393 +/- 343 vs. 2966 +/- 928 ug*h/L; P < 0.005), apparent clearance was lower (28.7 +/- 7.2 vs. 14.6 +/- 7.8 L/h; P < 0.02) and the terminal elimination half-life was longer (2.28 +/- 0.49 vs. 3.32 +/- 0.95 hours; P < 0.02).(44) Selected steroids linked to this monograph include: betamethasone, budesonide, ciclesonide, dexamethasone, fluticasone, methylprednisolone, and triamcinolone.(45) Selected CYP3A4 inhibitors linked to this monograph include: adagrasib, boceprevir, ceritinib, lonafarnib, mibefradil, nefazodone, ribociclib, paritaprevir, telaprevir, and tucatinib.(1-2,45) |
KISQALI, KRAZATI, NEFAZODONE HCL, TUKYSA, ZOKINVY, ZYKADIA |
| Ritlecitinib/Immunosuppressives; Immunomodulators SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction. MECHANISM OF ACTION: Ritlecitinib, immunosuppressives, and immunomodulators all suppress the immune system. CLINICAL EFFECTS: Concurrent use of ritlecitinib with immunosuppressives or immunomodulators may result in an increased risk of serious infections. PREDISPOSING FACTORS: None determined. PATIENT MANAGEMENT: The US manufacturer of ritlecitinib states that concurrent use of ritlecitinib with other JAK inhibitors, biologic immunomodulators, cyclosporine or other potent immunosuppressants is not recommended.(1) DISCUSSION: Serious infections have been reported in patients receiving ritlecitinib. Reported infections included appendicitis, COVID-19 infection (including pneumonia), and sepsis. Reports of viral reactivation, including herpes virus reactivation was reported in clinical studies with ritlecitinib.(1) |
LITFULO |
| Zuranolone/CYP3A4 Inducers SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction. MECHANISM OF ACTION: Inducers of CYP3A4 may induce the metabolism of zuranolone.(1) CLINICAL EFFECTS: Concurrent use of a CYP3A4 inducer may result in a loss of zuranolone efficacy.(1) PREDISPOSING FACTORS: Induction effects may be more likely with regular use of the inducer for longer than 1-2 weeks. PATIENT MANAGEMENT: Avoid the concurrent use of zuranolone with CYP3A4 inducers.(1) DISCUSSION: Coadministration of zuranolone with rifampin decreased the maximum concentration (Cmax) by 0.31-fold and area-under-curve (AUC) by 0.15-fold.(1) Strong CYP3A4 inducers linked to this monograph include: apalutamide, barbiturates, carbamazepine, encorafenib, enzalutamide, fosphenytoin, ivosidenib, lumacaftor, mitotane, phenobarbital, phenytoin, primidone, rifampin, rifapentine, and St. John's wort. Moderate CYP3A4 inducers linked to this monograph include: belzutifan, bosentan, cenobamate, dabrafenib, dipyrone, efavirenz, elagolix, etravirine, lesinurad, lorlatinib, mavacamten, mitapivat, modafinil, nafcillin, pacritinib, pexidartinib, repotrectinib, rifabutin, sotorasib, telotristat ethyl, thioridazine, and tovorafenib. Weak CYP3A4 inducers linked to this monograph include: armodafinil, bexarotene, brigatinib, brivaracetam, clobazam, danshen, darolutamide, dexamethasone, dicloxacillin, echinacea, eslicarbazepine, flucloxacillin, garlic, genistein, ginseng, glycyrrhizin, methylprednisolone, mobocertinib, nevirapine, omaveloxolone, oritavancin, oxcarbazepine, pioglitazone, pitolisant, quercetin, relugolix, rufinamide, sarilumab, sulfinpyrazone, tazemetostat, tecovirimat, terbinafine, ticlopidine, topiramate, troglitazone, vemurafenib, vinblastine, and zanubrutinib.(2,3) |
ZURZUVAE |
| Erlotinib/Corticosteroids that Induce CYP3A4 SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction. MECHANISM OF ACTION: Inducers of CYP3A4 may induce the metabolism of erlotinib.(1) CLINICAL EFFECTS: Concurrent or recent use of a CYP3A4 inducer may result in decreased levels and effectiveness of erlotinib.(1) In addition, concurrent use of corticosteroids may increase the risk of gastrointestinal perforation in patients receiving erlotinib. Fatalities have been reported.(1) PREDISPOSING FACTORS: Patients with a history of peptic ulceration or diverticular disease or who are receiving concomitant anti-angiogenic, NSAIDs, and/or taxane-based chemotherapy may be an increased risk of gastrointestinal perforation.(1) Induction effects may be more likely with regular use of the inducer for longer than 1-2 weeks. PATIENT MANAGEMENT: Avoid the concurrent use of CYP3A4 inducers in patients receiving therapy with erlotinib. Consider the use of alternative agents with less enzyme induction potential.(1) Consider increasing the dosage of erlotinib by 50 mg increments as tolerated at two week intervals (to a maximum of 450 mg) while closely monitoring the patient. The highest dosage studied with concurrent rifampin is 450 mg. If the dosage of erlotinib is increased, it will need to be decreased when the inducer is discontinued.(1) Monitor patients receiving concurrent therapy for signs of gastrointestinal perforation. Discontinue erlotinib in patients who develop gastrointestinal perforation.(1) DISCUSSION: Pretreatment and concurrent therapy with rifampin increased erlotinib clearance by 3-fold and decreased the erlotinib area-under-curve (AUC) by 66% to 80%. This is equivalent to a dose of about 30 mg to 50 mg in NSCLC.(1) In a study, pretreatment with rifampin for 11 days decreased the AUC of a single 450 mg dose of erlotinib to 57.6% of the AUC observed with a single 150 mg dose of erlotinib.(1) In a case report, coadministration of phenytoin (180mg daily) and erlotinib (150mg daily) increased the phenytoin concentration from 8.2mcg/ml to 24.2mcg/ml and decreased the erlotinib concentration 12-fold (from 1.77mcg/ml to 0.15mcg/ml) and increased the erlotinib clearance by 10-fold (from 3.53 L/h to 41.7 L/h).(2) In a study, concurrent use of sorafenib (400 mg twice daily) and erlotinib (150 mg daily) decreased the concentration minimum (Cmin), concentration maximum (Cmax), and AUC of erlotinib.(3) In an animal study, concurrent use of dexamethasone and erlotinib decreased the AUC of erlotinib by 0.6-fold.(4) In a phase II trial of concurrent bevacizumab plus erlotinib, 2 of 13 patients suffered fatal gastrointestinal perforations.(5) In another phase II trial of concurrent bevacizumab with erlotinib, 1 of 104 patients died of gastrointestinal perforation.(6) Two patients developed gastrointestinal perforations while taking erlotinib, corticosteroids, and ciprofloxacin.(7) Corticosteroids that induce CYP3A4 include: dexamethasone and methylprednisolone.(8,9) |
ERLOTINIB HCL, TARCEVA |
| Etrasimod/Immunosuppressives; Immunomodulators SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction. MECHANISM OF ACTION: Etrasimod causes reversible sequestration of lymphocytes in lymphoid tissues, resulting in a mean 55% decrease in peripheral blood lymphocyte count at 52 weeks.(1) Other immunosuppressives and immune-modulators also suppress the immune system. CLINICAL EFFECTS: Concurrent use of etrasimod with immunosuppressive or immune-modulating agents may result in an increased risk of serious and fatal infections, such as disseminated herpetic infection, cryptococcal infection, or progressive multifocal leukoencephalopathy (PML).(1) PREDISPOSING FACTORS: Incomplete washout of previously prescribed immunosuppressive or immune-modulating medications increases the risk of adverse effects. PATIENT MANAGEMENT: The etrasimod US prescribing information states etrasimod has not been studied in combination with anti-neoplastic, immune-modulating, or immunosuppressive therapies. Concomitant administration of these therapies with etrasimod should be avoided because of the risk of additive immune effects during therapy and in the weeks following administration. Etrasimod's effect on peripheral lymphocytes may persist for up to 5 weeks after discontinuation.(1) When switching from drugs with prolonged immune effects, the half-life and mode of action of these drugs must be considered in order to avoid unintended additive immunosuppressive effects.(1) DISCUSSION: Fatal disseminated herpes zoster and herpes simplex infections, cryptococcal meningitis, disseminated cryptococcal infections, and cases of progressive multifocal leukoencephalopathy (PML) have been reported in patients treated with other sphingosine-1 phosphate receptor modulators.(1) |
VELSIPITY |
| Ropeginterferon alfa-2b/Slt Immunosuppress; Immunomodulator SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction. MECHANISM OF ACTION: Ropeginterferon alfa-2b and immunosuppressives both suppress the immune system. CLINICAL EFFECTS: Concurrent use of ropeginterferon alfa-2b with immunosuppressives may result in an increased risk of serious infections. PREDISPOSING FACTORS: None determined. PATIENT MANAGEMENT: Avoid concurrent use of myelosuppressive agents.(1-2) If concurrent use cannot be avoided, monitor for effects of excessive immunosuppression. DISCUSSION: In clinical trials, 20% of patients experienced leukopenia. Interferon alfa products may cause fatal or life-threatening infections.(1-2) |
BESREMI |
| Sodium Iodide I 131/Myelosuppressives that affect Iodide SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction. MECHANISM OF ACTION: Sodium iodide I 131 can cause depression of the hematopoetic system. Myelosuppressives and immunomodulators also suppress the immune system.(1) Many compounds can affect iodide protein binding and alter iodide pharmacokinetics and pharmacodynamics. CLINICAL EFFECTS: Concurrent use of sodium iodide I 131 with agents that cause bone marrow depression, including myelosuppressives or immunomodulators, may result in an enhanced risk of hematologic disorders, including anemia, blood dyscrasias, bone marrow depression, leukopenia, and thrombocytopenia. Bone marrow depression may increase the risk of serious infections and bleeding.(1) Compounds that affect iodide pharmacokinetics and pharmacodynamics may impact the effectiveness of radioactive iodide.(1,2) PREDISPOSING FACTORS: Compounds that affect iodide pharmacokinetics and pharmacodynamics are expected to have the most impact during therapy using radioactive iodide. Diagnostic procedures would be expected to be impacted less. PATIENT MANAGEMENT: The US manufacturer of sodium iodide I 131 states that concurrent use with bone marrow depressants may enhance the depression of the hematopoetic system caused by large doses of sodium iodide I 131.(1) Sodium iodide I 131 causes a dose-dependent bone marrow suppression, including neutropenia or thrombocytopenia, in the 3 to 5 weeks following administration. Patients may be at increased risk of infections or bleeding during this time. Monitor complete blood counts within one month of therapy. If results indicate leukopenia or thrombocytopenia, dosimetry should be used to determine a safe sodium iodide I 131 activity.(1) Discuss the use of agents that affect iodide pharmacokinetics and pharmacodynamics with the patient's oncologist.(1,2) DISCUSSION: Hematologic disorders including death have been reported with sodium iodide I 131. The most common hematologic disorders reported include anemia, blood dyscrasias, bone marrow depression, leukopenia, and thrombocytopenia.(1) Many agents interact with radioactive iodine. The average duration of effect is: anticoagulants - 1 week antihistamines - 1 week anti-thyroid drugs, e.g: carbimazole, methimazole, propylthiouracil - 3-5 days corticosteroids - 1 week iodide-containing medications, e.g: amiodarone - 1-6 months expectorants - 2 weeks Lugol solution - 3 weeks saturated solution of potassium iodine - 3 weeks vitamins - 10-14 days iodide-containing X-ray contrast agents - up to 1 year lithium - 4 weeks phenylbutazone - 1-2 weeks sulfonamides - 1 week thyroid hormones (natural or synthetic), e.g.: thyroxine - 4 weeks tri-iodothyronine - 2 weeks tolbutamide - 1 week topical iodide - 1-9 months (1,2) |
HICON, SODIUM IODIDE I-131 |
There are 17 moderate interactions.
The clinician should assess the patient’s characteristics and take action as needed. Actions required for moderate interactions include, but are not limited to, discontinuing one or both agents, adjusting dosage, altering administration.
| Drug Interaction | Drug Names |
|---|---|
| Corticosteroids/Hormonal Contraceptives; Estrogens SEVERITY LEVEL: 3-Moderate Interaction: Assess the risk to the patient and take action as needed. MECHANISM OF ACTION: It is speculated that hormonal contraceptives and estrogens inhibit hepatic metabolism of some corticosteroids as well as endogenous cortisol. Competitive protein binding may also contribute to elevations in serum corticosteroids. CLINICAL EFFECTS: Concurrent use of hormonal contraceptives or estrogens may result in an increase in the therapeutic and toxic effects of corticosteroids. PREDISPOSING FACTORS: None determined. PATIENT MANAGEMENT: Patients receiving concurrent hormonal contraceptives or estrogen should be observed for symptoms of corticosteroid toxicity. A lower corticosteroid dose may be required. DISCUSSION: In a study in 6 healthy females controlled on long-term oral contraceptives, subjects received either a placebo or high and low-dose prednisolone (0.53 and 0.14 mg/Kg iv). Both dosages of prednisolone decreased the total clearance, unbound clearance, and volume of distribution (Vd) at maximum concentration (Cmax) of total drug. Significant increases in half-life for free and unbound prednisolone and hydrocortisone concentrations were also observed in comparison to the placebo group. In a study in 8 females controlled on oral contraceptive therapy, 8 females not receiving contraceptive therapy, and 8 males, each subject received prednisolone 40 mg iv. The plasma clearance of total prednisolone in females on OC was 96 ml/min, which was significantly lower than those in both the male and female (205 and 187 ml/min, respectively) control groups. Prednisolone half-life and mean residence times were increased. The oral contraceptive group had a significantly higher (2-fold) concentration of transcortin, resulting in lower clearance, decreased Vd, and a 2-fold increase in the area-under-curve (AUC) for prednisolone. A clinical trial demonstrated the interaction between prednisolone (20 mg) and oral contraceptives containing ethinyl estradiol (30 mcg). The oral contraceptive users had an average plasma concentration of prednisolone 131% higher compared to the control group, and plasma cortisol levels were suppressed by approximately 90%. No differences were reported for ethinyl estradiol levels. In a study in 8 females taking oral contraceptives and 8 females who were were not, subjects received IV doses of prednisolone at 0.1 mg/Kg and 1.0 mg/Kg. Free prednisolone clearance was reduced by approximately 30% in the contraceptive receiving subjects compared to the control group, and plasma cortisol concentrations were reduced 2-fold compared to the control group. One or more of the drug pairs linked to this monograph have been included in a list of interactions that could be considered for classification as "non-interruptive" in EHR systems. This DDI subset was vetted by an expert panel commissioned by the U.S. Office of the National Coordinator (ONC) for Health Information Technology. |
2-METHOXYESTRADIOL, ACTIVELLA, AFIRMELLE, ALTAVERA, ALYACEN, AMETHIA, AMETHYST, ANGELIQ, ANNOVERA, APRI, ARANELLE, ASHLYNA, AUBRA, AUBRA EQ, AUROVELA, AUROVELA 24 FE, AUROVELA FE, AVIANE, AYUNA, AZURETTE, BALCOLTRA, BALZIVA, BEYAZ, BIJUVA, BLISOVI 24 FE, BLISOVI FE, BRIELLYN, CAMRESE, CAMRESE LO, CAZIANT, CHARLOTTE 24 FE, CHATEAL EQ, CLIMARA, CLIMARA PRO, COMBIPATCH, COVARYX, COVARYX H.S., CRYSELLE, CYRED, CYRED EQ, DASETTA, DAYSEE, DELESTROGEN, DEPO-ESTRADIOL, DESOGESTR-ETH ESTRAD ETH ESTRA, DIETHYLSTILBESTROL, DIVIGEL, DOLISHALE, DOTTI, DROSPIRENONE-ETH ESTRA-LEVOMEF, DROSPIRENONE-ETHINYL ESTRADIOL, DUAVEE, EEMT, EEMT H.S., ELESTRIN, ELINEST, ELURYNG, ENILLORING, ENPRESSE, ENSKYCE, ESTARYLLA, ESTRACE, ESTRADIOL, ESTRADIOL (ONCE WEEKLY), ESTRADIOL (TWICE WEEKLY), ESTRADIOL BENZOATE, ESTRADIOL CYPIONATE, ESTRADIOL HEMIHYDRATE, ESTRADIOL HEMIHYDRATE MICRO, ESTRADIOL MICRONIZED, ESTRADIOL VALERATE, ESTRADIOL-NORETHINDRONE ACETAT, ESTRATEST F.S., ESTRATEST H.S., ESTRING, ESTRIOL, ESTRIOL MICRONIZED, ESTROGEL, ESTROGEN-METHYLTESTOSTERONE, ESTRONE, ETHINYL ESTRADIOL, ETHYNODIOL-ETHINYL ESTRADIOL, ETONOGESTREL-ETHINYL ESTRADIOL, EVAMIST, FALMINA, FEMLYV, FEMRING, FINZALA, FYAVOLV, GEMMILY, HAILEY, HAILEY 24 FE, HAILEY FE, HALOETTE, ICLEVIA, ISIBLOOM, JAIMIESS, JASMIEL, JINTELI, JOLESSA, JOYEAUX, JULEBER, JUNEL, JUNEL FE, JUNEL FE 24, KAITLIB FE, KALLIGA, KARIVA, KELNOR 1-35, KELNOR 1-50, KURVELO, LARIN, LARIN 24 FE, LARIN FE, LAYOLIS FE, LEENA, LESSINA, LEVONEST, LEVONORG-ETH ESTRAD ETH ESTRAD, LEVONORG-ETH ESTRAD-FE BISGLYC, LEVONORGESTREL-ETH ESTRADIOL, LEVORA-28, LO LOESTRIN FE, LO-ZUMANDIMINE, LOESTRIN, LOESTRIN FE, LOJAIMIESS, LORYNA, LOW-OGESTREL, LUTERA, LYLLANA, MARLISSA, MENEST, MENOSTAR, MERZEE, MIBELAS 24 FE, MICROGESTIN, MICROGESTIN FE, MILI, MIMVEY, MINIVELLE, MINZOYA, MONO-LINYAH, MYFEMBREE, NATAZIA, NECON, NEXTSTELLIS, NIKKI, NORELGESTROMIN-ETH ESTRADIOL, NORETHIN-ETH ESTRA-FERROUS FUM, NORETHINDRON-ETHINYL ESTRADIOL, NORETHINDRONE-E.ESTRADIOL-IRON, NORGESTIMATE-ETHINYL ESTRADIOL, NORTREL, NUVARING, NYLIA, OCELLA, ORIAHNN, ORTHO TRI-CYCLEN, ORTHO-NOVUM, PHILITH, PIMTREA, PORTIA, PREMARIN, PREMPHASE, PREMPRO, RECLIPSEN, RIVELSA, SAFYRAL, SETLAKIN, SIMLIYA, SIMPESSE, SLYND, SPRINTEC, SRONYX, SYEDA, TARINA 24 FE, TARINA FE, TARINA FE 1-20 EQ, TAYTULLA, TILIA FE, TRI-ESTARYLLA, TRI-LEGEST FE, TRI-LINYAH, TRI-LO-ESTARYLLA, TRI-LO-MARZIA, TRI-LO-MILI, TRI-LO-SPRINTEC, TRI-MILI, TRI-SPRINTEC, TRI-VYLIBRA, TRI-VYLIBRA LO, TRIVORA-28, TURQOZ, TWIRLA, TYBLUME, VAGIFEM, VELIVET, VESTURA, VIENVA, VIORELE, VIVELLE-DOT, VOLNEA, VYFEMLA, VYLIBRA, WERA, WYMZYA FE, XULANE, YASMIN 28, YAZ, YUVAFEM, ZAFEMY, ZARAH, ZOVIA 1-35, ZUMANDIMINE |
| Corticosteroids/Selected Strong CYP3A4 Inducers SEVERITY LEVEL: 3-Moderate Interaction: Assess the risk to the patient and take action as needed. MECHANISM OF ACTION: Strong CYP3A4 inducers may induce the metabolism of corticosteroids. Corticosteroids may affect the metabolism of phenytoin. CLINICAL EFFECTS: Concurrent or recent use of strong CYP3A4 inducers may result in decreased levels and effectiveness of corticosteroids. Dexamethasone has been shown to increase and decrease phenytoin levels. PREDISPOSING FACTORS: Induction effects may be more likely with regular use of the inducer for longer than 1-2 weeks. PATIENT MANAGEMENT: Patients receiving concurrent therapy with a strong CYP3A4 inducer should be monitored for decreased effectiveness of their corticosteroid. Increased dosage of corticosteroid may be required during concurrent therapy and for several weeks after completing concurrent therapy. If concurrent therapy is discontinued, the dosage of the corticosteroid may need to be adjusted. Phenytoin levels should be closely monitored in patients receiving corticosteroids. The dosage of phenytoin may need to be adjusted if corticosteroids are initiated or discontinued. DISCUSSION: Carbamazepine has been shown to increase the metabolism of methylprednisolone, prednisolone, and prednisone, resulting in decreased levels and effectiveness of these agents. Phenobarbital has been shown to increase the metabolism of dexamethasone, methylprednisolone, and prednisolone. Primidone is metabolized to phenobarbital. Phenytoin has been shown to increase the metabolism of dexamethasone, hydrocortisone, methylprednisolone, prednisolone, and prednisone, resulting in decreased levels and effectiveness of these agents Rifampin has been shown to increase the metabolism of cortisol, dexamethasone, methylprednisolone, prednisolone, and prednisone. Strong CYP3A4 inducers linked to this monograph include: apalutamide, barbiturates, carbamazepine, encorafenib, enzalutamide, fosphenytoin, ivosidenib, lumacaftor, mitotane, phenobarbital, phenytoin, primidone, rifabutin, rifapentine, rifampin, and St. John's wort. |
ASA-BUTALB-CAFFEINE-CODEINE, ASCOMP WITH CODEINE, BRAFTOVI, BUTALB-ACETAMINOPH-CAFF-CODEIN, BUTALBITAL, BUTALBITAL-ACETAMINOPHEN, BUTALBITAL-ACETAMINOPHEN-CAFFE, BUTALBITAL-ASPIRIN-CAFFEINE, CARBAMAZEPINE, CARBAMAZEPINE ER, CARBATROL, CEREBYX, DILANTIN, DILANTIN-125, DONNATAL, EPITOL, EQUETRO, ERLEADA, ESGIC, FIORICET, FIORICET WITH CODEINE, FOSPHENYTOIN SODIUM, LYSODREN, MITOTANE, MYSOLINE, ORKAMBI, PENTOBARBITAL SODIUM, PHENOBARBITAL, PHENOBARBITAL SODIUM, PHENOBARBITAL-BELLADONNA, PHENOBARBITAL-HYOSC-ATROP-SCOP, PHENOHYTRO, PHENYTEK, PHENYTOIN, PHENYTOIN SODIUM, PHENYTOIN SODIUM EXTENDED, PRIFTIN, PRIMIDONE, RIFABUTIN, RIFADIN, RIFAMPIN, SEZABY, TALICIA, TEGRETOL, TEGRETOL XR, TENCON, TIBSOVO, XTANDI |
| NSAIDs/Corticosteroids SEVERITY LEVEL: 3-Moderate Interaction: Assess the risk to the patient and take action as needed. MECHANISM OF ACTION: Concurrent use of NSAIDs and corticosteroids result in additive risk of GI ulceration. CLINICAL EFFECTS: Concurrent use of NSAIDs and corticosteroids may increase the incidence and/or severity of GI irritation or ulceration, including increasing the risk for bleeding. PREDISPOSING FACTORS: Risk of GI bleed may be increased in patients who are of older age, in poor health status, or who use alcohol or smoke. Risk may also be increased by concurrent use of anticoagulants, antiplatelets, selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs); with longer duration of NSAID use; and with prior history of peptic ulcer disease and/or GI bleeding. The risk for bleeding episodes may be greater in patients with disease-associated factors (e.g. thrombocytopenia, advanced liver disease). PATIENT MANAGEMENT: Monitor patients receiving concurrent therapy carefully for signs of gastrointestinal ulceration. Use the lowest effective NSAID dose for the shortest duration possible. If concurrent therapy is warranted, monitor patients receiving concurrent therapy for signs of blood loss, including decreased hemoglobin, hematocrit, fecal occult blood, and/or decreased blood pressure and promptly evaluate patients with any symptoms. Instruct patients to report signs of GI bleeding such as black, tarry stools; "coffee ground" vomit; nausea; or stomach/abdominal pain. DISCUSSION: Concurrent use of NSAIDs and corticosteroids increase the risk of GI bleeding. |
ANAPROX DS, ANJESO, ARTHROTEC 50, ARTHROTEC 75, BROMFENAC SODIUM, BUPIVACAINE-KETOROLAC-KETAMINE, CALDOLOR, CAMBIA, CELEBREX, CELECOXIB, COMBOGESIC IV, CONSENSI, COXANTO, DAYPRO, DICLOFENAC, DICLOFENAC POTASSIUM, DICLOFENAC SODIUM, DICLOFENAC SODIUM ER, DICLOFENAC SODIUM MICRONIZED, DICLOFENAC SODIUM-MISOPROSTOL, EC-NAPROSYN, EC-NAPROXEN, ELYXYB, ETODOLAC, ETODOLAC ER, FELDENE, FENOPROFEN CALCIUM, FENOPRON, FLURBIPROFEN, HYDROCODONE-IBUPROFEN, IBU, IBUPAK, IBUPROFEN, IBUPROFEN LYSINE, IBUPROFEN-FAMOTIDINE, INDOCIN, INDOMETHACIN, INDOMETHACIN ER, INFLAMMACIN, INFLATHERM(DICLOFENAC-MENTHOL), KETOPROFEN, KETOPROFEN MICRONIZED, KETOROLAC TROMETHAMINE, KIPROFEN, LODINE, LOFENA, MECLOFENAMATE SODIUM, MEFENAMIC ACID, MELOXICAM, NABUMETONE, NABUMETONE MICRONIZED, NALFON, NAPRELAN, NAPROSYN, NAPROTIN, NAPROXEN, NAPROXEN SODIUM, NAPROXEN SODIUM CR, NAPROXEN SODIUM ER, NAPROXEN-ESOMEPRAZOLE MAG, NEOPROFEN, OXAPROZIN, PHENYLBUTAZONE, PIROXICAM, R.E.C.K.(ROPIV-EPI-CLON-KETOR), RELAFEN DS, ROPIVACAINE-CLONIDINE-KETOROLC, ROPIVACAINE-KETOROLAC-KETAMINE, SULINDAC, SUMATRIPTAN SUCC-NAPROXEN SOD, TOLECTIN 600, TOLMETIN SODIUM, TORONOVA II SUIK, TORONOVA SUIK, TOXICOLOGY SALIVA COLLECTION, TREXIMET, VIMOVO, VIVLODEX, ZIPSOR, ZORVOLEX |
| Salicylates/Corticosteroids SEVERITY LEVEL: 3-Moderate Interaction: Assess the risk to the patient and take action as needed. MECHANISM OF ACTION: Unknown. However, it is speculated that renal and hepatic elimination of salicylates may be increased by corticosteroids. CLINICAL EFFECTS: Decreased serum salicylate levels with reduced therapeutic response. Salicylate intoxication may occur when corticosteroid dosage is decreased in patients taking large doses of salicylates. Gastrointestinal ulceration may be increased as well. PREDISPOSING FACTORS: None determined. PATIENT MANAGEMENT: Adjust the salicylate dose as needed based on salicylate levels and patient response. Caution when discontinuing corticosteroids, as a decrease in salicylate dose may be needed to avoid salicylate toxicity. DISCUSSION: Additional documentation is necessary to confirm this potential interaction. |
5-AMINOSALICYLIC ACID, ACETYL SALICYLIC ACID, APRISO, ASA-BUTALB-CAFFEINE-CODEINE, ASCOMP WITH CODEINE, ASPIRIN, ASPIRIN-DIPYRIDAMOLE ER, AZULFIDINE, BISMUTH SUBSALICYLATE, BUTALBITAL-ASPIRIN-CAFFEINE, CANASA, CARISOPRODOL-ASPIRIN, CARISOPRODOL-ASPIRIN-CODEINE, CHOLINE MAGNESIUM TRISALICYLAT, DELZICOL, DIFLUNISAL, DIPENTUM, DISALCID, DOLOBID, DURLAZA, LIALDA, MESALAMINE, MESALAMINE DR, MESALAMINE ER, NORGESIC, NORGESIC FORTE, ORPHENADRINE-ASPIRIN-CAFFEINE, ORPHENGESIC FORTE, PENTASA, PHENYL SALICYLATE, ROWASA, SALSALATE, SFROWASA, SODIUM SALICYLATE, SULFASALAZINE, SULFASALAZINE DR, URETRON D-S, URIBEL TABS, URIMAR-T, URNEVA, URO-MP, URO-SP, YOSPRALA |
| Corticosteroids/Selected Macrolide Antibiotics SEVERITY LEVEL: 3-Moderate Interaction: Assess the risk to the patient and take action as needed. MECHANISM OF ACTION: Some macrolide antibiotics may inhibit the metabolism of corticosteroids. CLINICAL EFFECTS: Concurrent use of some macrolide antibiotics may result in elevated levels and clinical effects of corticosteroids. Immunosuppression and Cushing's syndrome have been reported during concurrent therapy, including therapy with inhaled corticosteroids. PREDISPOSING FACTORS: Concurrent administration of enzyme inducing drugs. PATIENT MANAGEMENT: Patients receiving concurrent therapy with corticosteroids and macrolide antibiotics should be monitored for increased corticosteroid affects. The dosage of the corticosteroid may need to be adjusted or the macrolide antibiotic may need to be discontinued. One US manufacturer of inhaled fluticasone states that the concurrent use of macrolide antibiotics is not recommended.(1) DISCUSSION: In a study in 10 steroid-dependent asthmatics, concurrent troleandomycin (1 gram/day) decreased methylprednisolone clearance by 60%. All subjects developed adverse effects typical of excessive corticosteroid use such as weight gain, fluid retention, and cushingoid features.(2) Other studies and reports have shown increased methylprednisolone levels with concurrent troleandomycin,(3-10) in some of these reports, the interaction was used to lower steroid dosages.(6-10) There is one report of fatal varicella infection in a patient receiving concurrent therapy with methylprednisolone and troleandomycin.(11) Cushing's syndrome has been reported with concurrent inhaled budesonide and clarithromycin.(12) Psychosis(13) and mania(14) have been reported with concurrent prednisone and clarithromycin. Erythromycin(3-9) and troleandomycin(9) have also been reported to interact with methylprednisolone. |
CLARITHROMYCIN, CLARITHROMYCIN ER, E.E.S. 200, E.E.S. 400, ERY-TAB, ERYPED 200, ERYPED 400, ERYTHROCIN LACTOBIONATE, ERYTHROCIN STEARATE, ERYTHROMYCIN, ERYTHROMYCIN ESTOLATE, ERYTHROMYCIN ETHYLSUCCINATE, ERYTHROMYCIN LACTOBIONATE, LANSOPRAZOL-AMOXICIL-CLARITHRO, OMECLAMOX-PAK, VOQUEZNA TRIPLE PAK |
| Anticoagulants/Corticosteroids SEVERITY LEVEL: 3-Moderate Interaction: Assess the risk to the patient and take action as needed. MECHANISM OF ACTION: Corticosteroids may increase the coagulability of blood, thus decreasing the effect of the anticoagulant.(1,2) Corticosteroids may also lower vascular integrity, which could increase the risk of hemorrhage.(3,4) CLINICAL EFFECTS: Concurrent use of corticosteroids may result in either increased (increased risk of bleeding) or decreased effects (increased risk of treatment failure) of anticoagulants. PREDISPOSING FACTORS: The risk for bleeding episodes may be greater in patients with disease-associated factors (e.g. thrombocytopenia). Drug associated risk factors include concurrent use of multiple drugs which inhibit anticoagulant/antiplatelet metabolism and/or have an inherent risk for bleeding (e.g. NSAIDs). PATIENT MANAGEMENT: The patient's clotting times should be monitored closely, along with any clinical signs of hemorrhage or clot formation. The dosage of the anticoagulant may need to be adjusted accordingly. If concurrent therapy is warranted, monitor patients receiving concurrent therapy for signs of blood loss, including decreased hemoglobin, hematocrit, fecal occult blood, and/or decreased blood pressure and promptly evaluate patients with any symptoms. When applicable, perform agent-specific laboratory test (e.g. INR, aPTT) to monitor efficacy and safety of anticoagulation. Discontinue anticoagulation in patients with active pathologic bleeding. Instruct patients to report any signs and symptoms of bleeding, such as unusual bleeding from the gums or nose; unusual bruising; red or black, tarry stools; red, pink or dark brown urine; acute abdominal or joint pain and/or swelling. The time of highest risk for a coumarin-type drug interaction is when the precipitant drug is initiated or discontinued. Contact the prescriber before initiating, altering the dose or discontinuing either drug. DISCUSSION: Corticotropin and other corticosteroids have been shown to both increase (3,5-11) and decrease (1,12,13) the effects of acenocoumarol, dicumarol, fluindione, and warfarin. Hemorrhagic episodes have been associated with concurrent use of these medications.(3,5) One or more of the drug pairs linked to this monograph have been included in a list of interactions that could be considered for classification as "non-interruptive" in EHR systems. This DDI subset was vetted by an expert panel commissioned by the U.S. Office of the National Coordinator (ONC) for Health Information Technology. |
ANISINDIONE, DICUMAROL, ELMIRON, JANTOVEN, PENTOSAN POLYSULFATE SODIUM, PHENINDIONE, WARFARIN SODIUM |
| Dexamethasone; Methylprednisolone/Aprepitant (Greater Than 40 mg); Fosaprepitant SEVERITY LEVEL: 3-Moderate Interaction: Assess the risk to the patient and take action as needed. MECHANISM OF ACTION: Aprepitant and fosaprepitant may inhibit the metabolism of dexamethasone and methylprednisolone by CYP3A4.(1,2) CLINICAL EFFECTS: Concurrent use with multiple dose of aprepitant or fosaprepitant without dosage adjustments of the corticosteroid may result in elevated levels of the corticosteroids and adverse effects.(1,2) PREDISPOSING FACTORS: The effects of the interaction are greater when the corticosteroids are administered orally versus intravenously.(1) PATIENT MANAGEMENT: The US manufacturer states that the dosage of oral dexamethasone should be reduced by 50% when administered with the 125/80 mg regimen of aprepitant(1) or with fosaprepitant.(2) No dosage adjustment is required with single 40 mg doses of aprepitant.(1) The US manufacturer states that the dosage of oral methylprednisolone should be reduced by 50% and that the dosage of intravenous methylprednisolone should be reduced by 25% when methylprednisolone is administered with the 125/80 mg regimen of aprepitant(1) or with fosaprepitant.(2) No dosage adjustment is required with single 40 mg doses of aprepitant.(1) DISCUSSION: In a clinical trial, the administration of oral dexamethasone (20 mg on Day 1, then 8 mg Days 2-5) and aprepitant (125 mg on Day 1, then 80 mg Days 2-5) increased the dexamethasone area-under-curve (AUC) by 2.2-fold on Days 1 and 5. A single dose of aprepitant (40 mg) increased the AUC of a single dose of dexamethasone (20 mg) by 1.45-fold.(1) In another clinical trial, the administration of methylprednisolone (125 mg intravenously on Day 1, then 40 mg orally Days 2-3) and aprepitant (125 mg on Day 1, then 80 mg Days 2-3) increased methylprednisolone AUC by 1.34-fold on Day 1 and by 2.5-fold on Day 3.(1) In a study in 440 subjects receiving aprepitant (40 mg or 125 mg), the clearance of single dose intravenous dexamethasone was decreased by 24.7% and 47.5% when coadministered with aprepitant 40 mg or 125 mg, respectively, compared to dexamethasone alone.(3) |
APREPITANT, CINVANTI, EMEND, FOCINVEZ, FOSAPREPITANT DIMEGLUMINE |
| Bupropion/Steroids SEVERITY LEVEL: 3-Moderate Interaction: Assess the risk to the patient and take action as needed. MECHANISM OF ACTION: Both bupropion and systemic steroids are known to lower the seizure threshold.(1,2) CLINICAL EFFECTS: Concurrent use of bupropion and systemic steroids may result in additive effects on the seizure threshold, increasing the risk of seizures.(1,2) PREDISPOSING FACTORS: The risk of seizures may be increased in patients with a history of head trauma or prior seizure; CNS tumor; severe hepatic cirrhosis; excessive use of alcohol or sedatives; addiction to opiates, cocaine, or stimulants; use of over-the-counter stimulants an anorectics; a total daily dose of bupropion greater than 450 mg or single doses greater than 150 mg; rapid escalation of bupropion dosage; diabetics treated with oral hypoglycemics or insulin; or with concomitant medications known to lower seizure threshold (antidepressants, antipsychotics, theophylline).(1,2) PATIENT MANAGEMENT: The concurrent use of bupropion and systemic steroids should be undertaken only with extreme caution and with low initial bupropion dosing and small gradual dosage increases.(1,2) Single doses should not exceed 150 mg.(1,2) The maximum daily dose of bupropion should not exceed 300 mg for smoking cessation(2) or 450 mg for depression.(1) DISCUSSION: Because of the risk of seizure from concurrent bupropion and other agents that lower seizure threshold, the manufacturer of bupropion states that the concurrent use of bupropion and systemic steroids should be undertaken only with extreme caution and with low initial bupropion dosing and small gradual dosage increases.(1,2) |
APLENZIN, AUVELITY, BUPROPION HCL, BUPROPION HCL SR, BUPROPION XL, CONTRAVE, FORFIVO XL, WELLBUTRIN SR, WELLBUTRIN XL |
| Quinolones/Corticosteroids SEVERITY LEVEL: 3-Moderate Interaction: Assess the risk to the patient and take action as needed. MECHANISM OF ACTION: Quinolone-induced arthropathy is a class effect of the quinolones.(1) Exactly how corticosteroid use increases the risk of tendon rupture is unknown. CLINICAL EFFECTS: Concurrent use of quinolones and corticosteroids may increase the risk of tendonitis and/or tendon rupture. This affect is most common in the Achilles tendon, but has been reported in the rotator cuff (shoulder), hand, biceps, thumb, and other tendons.(2-9) PREDISPOSING FACTORS: Risk factors for tendinitis and tendon rupture include age greater than 60; a history of kidney, heart, or lung transplantation, strenuous physical activity, renal failure, and previous tendon disorders such as rheumatoid arthritis. PATIENT MANAGEMENT: Quinolone use should be discontinued if the patient experiences pain, inflammation, or rupture of a tendon. Patients should be instructed to rest and refrain from exercise until the diagnosis of tendonitis tendon rupture has been excluded.(2-9) DISCUSSION: Ruptures of the shoulder, hand, Achilles tendon, or other tendons that required surgical repair or resulted in prolonged disability have been reported in patients receiving ciprofloxacin,(2) gatifloxacin,(3) levofloxacin,(4) lomefloxacin,(5) moxifloxacin,(6) nalidixic acid,(7) norfloxacin,(8) and ofloxacin.(9) A retrospective review of the IMS Health database examined quinolone use use from July 1, 1992 to June 30, 1998. The adjusted relative risk of tendon disorder with concurrent quinolone use was 1.9. Relative risk increased to 3.2 in patients aged 60 or older compared to 0.9 in patients aged less than 60. In patients aged 60 or older who used corticosteroids and quinolones concurrently, relative risk increased to 6.2.(10) In contrast, another retrospective review examined patients from a health insurance claims database and found no apparent effect from concurrent quinolone and corticosteroid use.(11) In a review of the follow-up to 42 spontaneously reported case of quinolone-associated tendon disorders in the Netherlands between January, 1988 and January, 1998, risk factors for tendon disorders included age older than 60, oral corticosteroid use, and existing joint problems.(12) In a review of the Swiss Drug Monitoring system, four of seven cases of levofloxacin-associated tendon problems also involved concurrent oral or inhaled corticosteroids.(13) In a review of the Medline database from 1966-2001, 98 case reports of tendinopathy associated with quinolones were located. Thirty-two (32.7%) of the patients had received systemic or inhaled corticosteroids before and during quinolone therapy. Of the 40 patients who suffered a tendon rupture, 21 (52.5%) were receiving corticosteroids.(14) Other authors have reported cases of tendon disorders in patients receiving concurrent corticosteroids and ciprofloxacin,(15) levofloxacin, (16-20) and ofloxacin.(21) |
AVELOX IV, BAXDELA, CIPRO, CIPROFLOXACIN, CIPROFLOXACIN HCL, CIPROFLOXACIN-D5W, GATIFLOXACIN SESQUIHYDRATE, LEVOFLOXACIN, LEVOFLOXACIN HEMIHYDRATE, LEVOFLOXACIN-D5W, MOXIFLOXACIN, MOXIFLOXACIN HCL, NALIDIXIC ACID, OFLOXACIN |
| Selected Corticosteroids/Selected Azole Antifungal Agents SEVERITY LEVEL: 3-Moderate Interaction: Assess the risk to the patient and take action as needed. MECHANISM OF ACTION: Itraconazole, ketoconazole, posaconazole, and voriconazole may inhibit the CYP3A4 mediated metabolism of some corticosteroids, resulting in increased systemic exposure. Itraconazole and ketoconazole may also suppress endogenous cortisol output. CLINICAL EFFECTS: Concurrent use of itraconazole, ketoconazole, posaconazole, or voriconazole may result in elevated levels of and effects from the corticosteroid, including Cushing syndrome. These effects have been seen with systemic as well as inhaled corticosteroids. PREDISPOSING FACTORS: None determined. PATIENT MANAGEMENT: Patients should be carefully monitored with concurrent administration of these agents, or when itraconazole, ketoconazole, posaconazole, or voriconazole is added to corticosteroid therapy. The dose of the corticosteroid may need to be adjusted or alternative therapy considered. DISCUSSION: In a randomized, double-blind, cross-over study in 10 healthy subjects, pretreatment with itraconazole (200 mg daily for 5 days) increased the area-under-curve (AUC) and maximum concentration (Cmax) of a single inhaled dose of budesonide (1000 mcg) by 4.2-fold and 1.6-fold, respectively. Suppression of cortisol production was increased 43%.(1) A study examined adrenal insufficiency in 25 cystic fibrosis patients treated with itraconazole and inhaled budesonide and in 12 patients receiving itraconazole alone. Eleven of the 25 patients receiving concurrent itraconazole and budesonide and none of the patients receiving only itraconazole had adrenal insufficiency.(2) There are case reports of Cushing syndrome in patients receiving concurrent itraconazole (range 200 mg to 800 mg daily) and inhaled budesonide (range 400 mcg to 1400 mcg daily).(3-5) The concurrent use of ketoconazole has been shown to increase budesonide area-under-curve (AUC) by eight-fold.(6) In a study in eight healthy subjects, the simultaneous administration of ketoconazole increased budesonide AUC by 6.5-fold. Administering the two agents 12 hours apart increased budesonide AUC by 3.8-fold.(7) There are case reports of Cushing syndrome in patients receiving concurrent itraconazole (range 100 mg to 400 mg daily) and inhaled fluticasone (range 250 mcg to 1.5 mg daily).(8,9) In a randomized, placebo-controlled, crossover, four phase study in 8 healthy subjects, itraconazole decreased the systemic clearance of intravenous dexamethasone by 68%, increased the area-under-curve (AUC) of dexamethasone by 3.3-fold, and prolonged its half-life by 3.2-fold. The AUC of oral dexamethasone was increased 3.7-fold, maximum concentration (Cmax) was increased by 1.7-fold, and the elimination half-life was prolonged 2.8-fold by itraconazole.(10) In a randomized, cross-over study in 14 healthy subjects, pretreatment with itraconazole (400 mg Day 1, 200 mg Days 2-4) increased the AUC of a single oral dose of methylprednisolone by 1.5-fold. Cortisol levels were significantly lower after concurrent therapy than with methylprednisolone alone.(11) There is a case report of Cushing syndrome following the addition of itraconazole (400 mg daily) to methylprednisolone (12 mg/day).(12) In a study in 6 healthy subjects, pretreatment with ketoconazole (200 mg daily) increased the AUC of a single intravenous dose of methylprednisolone (20 mg) by 135% and decreased its clearance by 60%. Concurrent ketoconazole also increased the reduction in 24-hour cortisol AUC and suppressed morning cortisol concentrations.(13) In a study in 8 healthy subjects, ketoconazole decreased the clearance of methylprednisolone by 46% and increased mean residence time by 37%.(14) In a randomized, cross-over study in 14 healthy subjects, pretreatment with itraconazole (400 mg Day 1, 200 mg Days 2-4) had no effect on the pharmacokinetics of a single oral dose of prednisone (60 mg).(11) In a randomized, cross-over study in 6 healthy subjects, pretreatment with ketoconazole (200 mg daily for 6 days) had no effect on the pharmacokinetics of a single intravenous dose of prednisolone (14.8 mg).(15) In a randomized, double-blind, cross-over study in 10 healthy subjects, pretreatment with itraconazole (200 mg daily for 4 days) increased the AUC and half-life of a single oral dose of prednisolone (20 mg) by 24% and 29%, respectively.(16) In a study, concurrent oral ketoconazole increased the AUC of des-ciclesonide from orally inhaled ciclesonide by 3.6-fold. There were no changes in ciclesonide levels.(17) In a study in 24 healthy subjects, subjects were randomized to receive either ketoconazole (200 mg BID) or placebo on Days 4-9 of a a 9 day course of mometasone (400 mcg BID). No subject had mometasone levels greater than 150 pcg/ml on Day 3. Four of 12 subjects who received ketoconazole had mometasone Cmax levels greater than 200 mcg/ml on Day 9. Plasma cortisol levels appeared to decrease as well.(18) In a cross-over study in 15 healthy subjects, subjects were randomized to receive fluticasone furoate and vilanterol on days 5-11 with either ketoconazole (200mg once daily) or placebo for days 1-11 with a washout period of 7-14 days. Fluticasone furoate AUC was increased by 36%, Cmax was increased by 33%, and decreased systemic cortisol levels by 27%. There were no effects on heart rate and blood potassium levels. There was a small increase in QTc which was 7.6ms greater when compared to placebo; however, ketoconazole has been reported to increase QTc by 5-6ms. Vilanterol AUC was increased by 65% and Cmax was increased by 22%. There were no effects on heart rate and blood potassium levels. No serious adverse events occurred and no subjects withdrew from the study due to adverse events. The most common adverse event reported was headache. (19) Coadministration of orally inhaled fluticasone (1000 mcg) and ketoconazole (200 mg once daily) resulted in a 1.9-fold increase in plasma fluticasone exposure and a 45% decrease in plasma cortisol AUC.(20) There is a case report of Cushing syndrome following the addition of voriconazole (200 mg twice daily for 21 days for 2 courses) to budesonide,(21) as well as voriconazole added to intranasal mometasone(22) and inhaled fluticasone.(22) There is a case report of Cushing syndrome following the addition of posaconazole (200 mg three times daily) to inhaled fluticasone.(23) |
ITRACONAZOLE, ITRACONAZOLE MICRONIZED, KETOCONAZOLE, NOXAFIL, POSACONAZOLE, SPORANOX, TOLSURA, VFEND, VFEND IV, VORICONAZOLE |
| Exemestane/Selected Moderate-Weak CYP3A4 Inducers SEVERITY LEVEL: 3-Moderate Interaction: Assess the risk to the patient and take action as needed. MECHANISM OF ACTION: CYP3A4 inducers may induce the metabolism of exemestane.(1) CLINICAL EFFECTS: Concurrent use of a CYP3A4 inducer may result in decreased levels and effectiveness of exemestane.(1) PREDISPOSING FACTORS: Induction effects may be more likely with regular use of the inducer for longer than 1-2 weeks. PATIENT MANAGEMENT: The US manufacturer of exemestane recommends that patients receiving concurrent therapy with a strong CYP3A4 inducer receive 50 mg of exemestane daily after a meal.(1) It may be prudent to consider a dosage increase for patients receiving weaker CYP3A4 inducers. DISCUSSION: In a study in 10 healthy postmenopausal subjects, pretreatment with rifampin (a strong CYP3A4 inducer, 600 mg daily for 14 days) decreased the area-under-curve (AUC) and maximum concentration (Cmax) of a single dose of exemestane (25 mg) by 54% and 41%, respectively.(1) Strong inducers of CYP3A4 would be expected to decrease the AUC of a sensitive 3A4 substrate by 80% or more and include: carbamazepine, enzalutamide, mitotane, phenobarbital, phenytoin, rifabutin, rifampin, and St. John's wort.(1-3) Moderate inducers of CYP3A4 would be expected to decrease the AUC of a sensitive 3A4 substrate by 50-80% and include: belzutifan, bosentan, cenobamate, dabrafenib, dipyrone, efavirenz, elagolix, etravirine, lesinurad, mavacamten, mitapivat, modafinil, nafcillin, pacritinib, pexidartinib, repotrectinib, rifabutin, sotorasib, telotristat ethyl, thioridazine, and tovorafenib.(2,3) Weak inducers of CYP3A4 would be expected to decrease the AUC of a sensitive 3A4 substrate by 20-50% and include: armodafinil, bexarotene, brigatinib, brivaracetam, clobazam, danshen, darolutamide, dexamethasone, dicloxacillin, echinacea, elafibranor, enasidenib, eslicarbazepine, floxacillin, garlic, gingko, ginseng, glycyrrhizin, lorlatinib, meropenem-vaborbactam, methylprednisolone, nevirapine, omaveloxolone, oritavancin, oxcarbazepine, pioglitazone, pitolisant, quercetin, relugolix, rufinamide, sarilumab, sulfinpyrazone, suzetrigine, tazemetostat, tecovirimat, terbinafine, ticlopidine, topiramate, troglitazone, vemurafenib, vinblastine, and zanubrutinib.(2,3) |
AROMASIN, EXEMESTANE |
| Ubrogepant/Moderate and Weak CYP3A4 Inducers SEVERITY LEVEL: 3-Moderate Interaction: Assess the risk to the patient and take action as needed. MECHANISM OF ACTION: Moderate or weak CYP3A4 inducers may induce the metabolism of ubrogepant.(1) CLINICAL EFFECTS: Concurrent use of a moderate or weak CYP3A4 inducer may result in decreased levels and effectiveness of ubrogepant.(1) PREDISPOSING FACTORS: Induction effects may be more likely with regular use of the inducer for longer than 1-2 weeks. PATIENT MANAGEMENT: The manufacturer recommends a dosage adjustment of ubrogepant when coadministered with moderate or weak CYP3A4 inducers. Initial dose of ubrogepant should be 100 mg. If a second dose is needed, the dose of ubrogepant should be 100 mg.(1) DISCUSSION: Coadministration of ubrogepant with rifampin, a strong CYP3A4 inducer, resulted in an 80% reduction in ubrogepant exposure. No dedicated drug interaction studies were conducted to assess concomitant use with moderate or weak CYP3A4 inducers. Dose adjustment for concomitant use of ubrogepant with moderate or weak CYP3A4 inducers is recommended based on a conservative prediction of 50% reduction in exposure of ubrogepant.(1) Moderate inducers of CYP3A4 would be expected to decrease the AUC of a sensitive 3A4 substrate by 50-80% and include: belzutifan, bosentan, cenobamate, dabrafenib, dipyrone, efavirenz, elagolix, etravirine, lesinurad, lorlatinib, mavacamten, mitapivat, modafinil, nafcillin, pexidartinib, rifabutin, telotristat, thioridazine, and tovorafenib.(2,3) Weak inducers of CYP3A4 would be expected to decrease the AUC of a sensitive 3A4 substrate by 20-50% and include: armodafinil, bexarotene, brigatinib, brivaracetam, clobazam, danshen, dexamethasone, dicloxacillin, echinacea, elafibranor, enasidenib, eslicarbazepine, floxacillin, garlic, genistein, ginseng, glycyrrhizin, meropenem-vaborbactam, methylprednisolone, nevirapine, omaveloxolone, oritavancin, oxcarbazepine, pioglitazone, pitolisant, relugolix, repotrectinib, rufinamide, sarilumab, sulfinpyrazone,suzetrigine, tazemetostat, tecovirimat, terbinafine, ticlopidine, topiramate, troglitazone, vemurafenib, vinblastine, and zanubrutinib.(2,3) |
UBRELVY |
| Gallium Ga 68 Dotatate/Corticosteroids SEVERITY LEVEL: 3-Moderate Interaction: Assess the risk to the patient and take action as needed. MECHANISM OF ACTION: High-dose corticosteroids may down-regulate somatostatin subtype 2 receptors, the main binding site for gallium Ga 68 dotatate.(1) CLINICAL EFFECTS: Repeated use of high doses of corticosteroids before use of gallium Ga 68 dotatate may result in false negative imaging results.(1) PREDISPOSING FACTORS: None determined. PATIENT MANAGEMENT: In patients receiving high-dose corticosteroids prior to use of gallium Ga 68 dotatate, interpret imaging results with caution and in the context of the patient's clinical presentation. DISCUSSION: Repeated use of high doses of corticosteroids before use of gallium Ga 68 dotatate may result in false negative imaging results due to down-regulation of the somatostatin subtype 2 receptor.(1) |
GALLIUM GA-68 DOTATOC, NETSPOT |
| Selected Corticosteroids/Levoketoconazole SEVERITY LEVEL: 3-Moderate Interaction: Assess the risk to the patient and take action as needed. MECHANISM OF ACTION: Levoketoconazole may inhibit the CYP3A4 mediated metabolism of some corticosteroids, resulting in increased systemic exposure. Levoketoconazole may also suppress endogenous cortisol output. Levoketoconazole is the enantiomer of ketoconazole. CLINICAL EFFECTS: Concurrent use of levoketoconazole may result in elevated levels of and effects from the corticosteroid, including Cushing syndrome. These effects have been seen with systemic as well as inhaled corticosteroids. PREDISPOSING FACTORS: None determined. PATIENT MANAGEMENT: Patients should be carefully monitored with concurrent administration of these agents, or when levoketoconazole is added to corticosteroid therapy. The dose of the corticosteroid may need to be adjusted or alternative therapy considered. DISCUSSION: The concurrent use of ketoconazole has been shown to increase budesonide area-under-curve (AUC) by eight-fold. In a study in eight healthy subjects, the simultaneous administration of ketoconazole increased budesonide AUC by 6.5-fold. Administering the two agents 12 hours apart increased budesonide AUC by 3.8-fold. In a study in 6 healthy subjects, pretreatment with ketoconazole (200 mg daily) increased the AUC of a single intravenous dose of methylprednisolone (20 mg) by 135% and decreased its clearance by 60%. Concurrent ketoconazole also increased the reduction in 24-hour cortisol AUC and suppressed morning cortisol concentrations. In a study in 8 healthy subjects, ketoconazole decreased the clearance of methylprednisolone by 46% and increased mean residence time by 37%. In a randomized, cross-over study in 6 healthy subjects, pretreatment with ketoconazole (200 mg daily for 6 days) had no effect on the pharmacokinetics of a single intravenous dose of prednisolone (14.8 mg). In a study, concurrent oral ketoconazole increased the AUC of des-ciclesonide from orally inhaled ciclesonide by 3.6-fold. There were no changes in ciclesonide levels. In a study in 24 healthy subjects, subjects were randomized to receive either ketoconazole (200 mg BID) or placebo on Days 4-9 of a a 9 day course of mometasone (400 mcg BID). No subject had mometasone levels greater than 150 pcg/ml on Day 3. Four of 12 subjects who received ketoconazole had mometasone Cmax levels greater than 200 mcg/ml on Day 9. Plasma cortisol levels appeared to decrease as well. In a cross-over study in 15 healthy subjects, subjects were randomized to receive fluticasone furoate and vilanterol on days 5-11 with either ketoconazole (200mg once daily) or placebo for days 1-11 with a washout period of 7-14 days. Fluticasone furoate AUC was increased by 36%, Cmax was increased by 33%, and decreased systemic cortisol levels by 27%. There were no effects on heart rate and blood potassium levels. There was a small increase in QTc which was 7.6ms greater when compared to placebo; however, ketoconazole has been reported to increase QTc by 5-6ms. Vilanterol AUC was increased by 65% and Cmax was increased by 22%. There were no effects on heart rate and blood potassium levels. No serious adverse events occurred and no subjects withdrew from the study due to adverse events. The most common adverse event reported was headache. Coadministration of orally inhaled fluticasone (1000 mcg) and ketoconazole (200 mg once daily) resulted in a 1.9-fold increase in plasma fluticasone exposure and a 45% decrease in plasma cortisol AUC. |
RECORLEV |
| Selected Steroids/Nirmatrelvir-Ritonavir SEVERITY LEVEL: 3-Moderate Interaction: Assess the risk to the patient and take action as needed. MECHANISM OF ACTION: Nirmatrelvir/ritonavir may inhibit the metabolism of corticosteroids metabolized by CYP3A4.(1) CLINICAL EFFECTS: Nirmatrelvir/ritonavir may result in increased systemic exposure to and effects from corticosteroids metabolized by CYP3A4.(1) PREDISPOSING FACTORS: None determined. PATIENT MANAGEMENT: Coadministration with corticosteroids of all routes of administration of which exposures are significantly increased by strong CYP3A4 inhibitors can increase the risk of Cushing's syndrome and adrenal suppression. However, the risk of Cushing's syndrome and adrenal suppression associated with short-term use of a strong CYP3A4 inhibitor is low.(1) The manufacturer of nirmatrelvir/ritonavir recommends considering alternative corticosteroids including beclomethasone, prednisone, and prednisolone.(1) DISCUSSION: Concurrent use of a single dose of midazolam 2 mg, a CYP3A4 substrate, with nirmatrelvir-ritonavir (300 mg/100 mg twice daily for nine doses) increased the maximum concentration (Cmax) and area-under-curve (AUC) of midazolam by 37% and 143%, respectively.(1) A study in 18 healthy subjects examined the effects of ritonavir (100 mg twice daily) on fluticasone nasal spray (200 mcg daily). In most subjects, fluticasone was undetectable (<10 pg/ml) when administered alone. In subjects in whom fluticasone was detectable when given alone, Cmax and area-under-curve AUC averaged 11.9 pg/ml and 8.43 pg x hr/ml, respectively. With concurrent ritonavir, fluticasone Cmax and AUC increased to 318 pg/ml and 3102.6 pg x hr/ml, respectively.(7,11,13) This reflects increases in Cmax and AUC by 25-fold and 350-fold, respectively.(3) The cortisol AUC decreased by 86%.(3-6) In a study in 10 healthy subjects, ritonavir (200 mg twice daily for 4 and 14 days) increased the AUC of a single dose of prednisolone by 1.41-fold and 1.30-fold, respectively, after 4 days and 14 days of ritonavir.(7) Selected steroids linked to this monograph include: budesonide, ciclesonide, dexamethasone, fluticasone, methylprednisolone, and triamcinolone.(8) |
PAXLOVID |
| Systemic Corticosteroids; Corticotropin/Non-Live Vaccines SEVERITY LEVEL: 3-Moderate Interaction: Assess the risk to the patient and take action as needed. MECHANISM OF ACTION: Corticosteroids and corticotropin suppress the immune system and may alter the immune system's response to vaccines.(1) CLINICAL EFFECTS: Vaccines administered during or within 2 weeks prior to therapy with corticosteroids or corticotropin may result in decreased effectiveness of the vaccine.(1) PREDISPOSING FACTORS: Patients receiving immunosuppressive doses of corticosteroids or corticotropin for equal to or greater than 14 consecutive days.(1) PATIENT MANAGEMENT: The Centers for Disease Control's (CDC) Advisory Committee on Immunization Practices (ACIP) states that non-live vaccines should be used with caution in patients who are severely immunosuppressed, including those who are receiving or have received high-dose, systemic steroids for greater than or equal to 14 consecutive days. When initiating immunosuppressives doses of corticosteroids, wait 2 weeks after a non-live vaccines is administered. However, if patients require therapy for chronic inflammatory conditions, do not delay therapy due to past vaccines.(1) The immune response to non-live vaccines should be monitored in patients receiving corticosteroids. Vaccinations given during corticosteroid therapy may need to be repeated.(1) Patients who are vaccinated within the 14 days prior to initiating immunosuppressive therapy should be considered unvaccinated and should be revaccinated at least 3 months after immunosuppressive therapy is discontinued when immune competence is restored.(1) DISCUSSION: Vaccinations given during and within 2 weeks prior to corticosteroid therapy may be less effective. However they are considered safe to administer.(1) Many clinicians consider a dose equivalent to either 2 mg/kg of body weight or a total of 20 mg/day of prednisone as sufficiently immunosuppressive to raise safety concerns about live-virus vaccines.(1) Immunization procedures may be undertaken in patients receiving corticosteroids when the therapy is short term (less than 2 weeks); low to moderate dose; long-term, alternate-day treatment with short-acting preparations; maintenance physiologic doses (replacement therapy); or administered topically (skin or eyes), by aerosol, or by intra-articular, bursal, or tendon injection.(1) |
ACTHIB, ADACEL TDAP, AREXVY, AREXVY ANTIGEN COMPONENT, BEXSERO, BIOTHRAX, BOOSTRIX TDAP, CAPVAXIVE, COMIRNATY 2024-2025, CYFENDUS (NATIONAL STOCKPILE), DAPTACEL DTAP, ENGERIX-B ADULT, ENGERIX-B PEDIATRIC-ADOLESCENT, GARDASIL 9, HAVRIX, HEPLISAV-B, HIBERIX, IMOVAX RABIES VACCINE, INFANRIX DTAP, IPOL, IXIARO, JYNNEOS, JYNNEOS (NATIONAL STOCKPILE), KINRIX, MENQUADFI, MENVEO A-C-Y-W-135-DIP, MENVEO MENA COMPONENT, MENVEO MENCYW-135 COMPONENT, MODERNA COVID 24-25(6M-11Y)EUA, MRESVIA, NOVAVAX COVID 2024-2025 (EUA), PEDIARIX, PEDVAXHIB, PENBRAYA, PENBRAYA MENACWY COMPONENT, PENBRAYA MENB COMPONENT, PENTACEL, PENTACEL ACTHIB COMPONENT, PENTACEL DTAP-IPV COMPONENT, PFIZER COVID 2024-25(5-11Y)EUA, PFIZER COVID 2024-25(6M-4Y)EUA, PNEUMOVAX 23, PREVNAR 20, QUADRACEL DTAP-IPV, RABAVERT, RECOMBIVAX HB, SHINGRIX, SHINGRIX GE ANTIGEN COMPONENT, SPIKEVAX 2024-2025, TDVAX, TENIVAC, TICOVAC, TRUMENBA, TWINRIX, TYPHIM VI, VAQTA, VAXELIS, VAXNEUVANCE |
| Capivasertib/Corticosteroids SEVERITY LEVEL: 3-Moderate Interaction: Assess the risk to the patient and take action as needed. MECHANISM OF ACTION: Capivasertib may cause severe hyperglycemia. Corticosteroids also cause hyperglycemia.(1) CLINICAL EFFECTS: Concurrent use of capivasertib with corticosteroids may cause severe hyperglycemia.(1) PREDISPOSING FACTORS: Patients with a medical history of diabetes mellitus and in patients with risk factors for hyperglycemia, such as obesity (BMI >= 30), elevated fasting glucose of > 160 mg/dL, HbA1c at or above the upper limit of normal, or intercurrent infections, may be at increased risk for hyperglycemia.(1) PATIENT MANAGEMENT: The US manufacturer of capivasertib recommends monitoring fasting blood glucose more frequently in patients on concomitant systemic corticosteroids.(1) If hyperglycemia occurs after starting capivasertib, monitor fasting glucose as clinically indicated and at least twice weekly until fasting glucose returns to normal.(1) DISCUSSION: Because capivasertib has been associated with severe hyperglycemia, fasting blood glucose should be monitored closely during the concurrent use of corticosteroids with capivasertib therapy.(1) In clinical studies, hyperglycemia occurred in 18% of patients treated with capivasertib. Grade 3 (insulin therapy initiated; hospitalization indicated) or Grade 4 (life-threatening consequences; urgent intervention indicated) hyperglycemia occurred in 2.8% of patients. Diabetic ketoacidosis occurred in 0.3% of patients and diabetic metabolic decompensation in 0.6% of patients. Dose reduction for hyperglycemia was required in 0.6% of patients and permanent discontinuation was required in 0.6% of patients. The median time to first occurrence of hyperglycemia was 15 days (range: 1 to 367).(1) In the 65 patients with hyperglycemia, 45% required treatment with anti-hyperglycemic medication (insulin in 15%, and metformin in 29%). Of the 29 patients who required anti-hyperglycemic medication during treatment with capivasertib, 66% (19/29) remained on these medications at treatment discontinuation or last follow up.(1) |
TRUQAP |
The following contraindication information is available for METHYLPREDNISOLONE (methylprednisolone):
Drug contraindication overview.
No enhanced Contraindications information available for this drug.
No enhanced Contraindications information available for this drug.
There are 7 contraindications.
Absolute contraindication.
| Contraindication List |
|---|
| Arginase deficiency |
| Argininosuccinate lyase deficiency |
| Carbamoyl phosphate synthetase deficiency |
| Cerebral malaria |
| Citrullinemia |
| Hyperammonemia associated with n-acetylglutamate synthase deficiency |
| Ornithine carbamoyltransferase deficiency |
There are 18 severe contraindications.
Adequate patient monitoring is recommended for safer drug use.
| Severe List |
|---|
| Avascular necrosis of bone |
| Chronic heart failure |
| Fungal infection |
| Gastritis |
| Inactive tuberculosis |
| Intestinal anastomosis |
| Measles |
| Measles contact |
| Ocular herpes simplex |
| Ocular hypertension |
| Osteoporosis |
| Pathological fracture |
| Pheochromocytoma |
| Strongyloidiasis |
| Tendon rupture |
| Untreated active tuberculosis |
| Varicella contact |
| Varicella zoster virus infection |
There are 19 moderate contraindications.
Clinically significant contraindication, where the condition can be managed or treated before the drug may be given safely.
| Moderate List |
|---|
| Cataracts |
| Diabetes mellitus |
| Diverticulitis of gastrointestinal tract |
| Edema |
| Hepatic cirrhosis |
| Hypercholesterolemia |
| Hypertension |
| Hypokalemia |
| Hypothalamic-pituitary insufficiency |
| Hypothyroidism |
| Immunosuppression |
| Muscle atrophy |
| Myopathy |
| Myopathy with CK elevation |
| Open angle glaucoma |
| Osteopenia |
| Peptic ulcer |
| Psychotic disorder |
| Seizure disorder |
The following adverse reaction information is available for METHYLPREDNISOLONE (methylprednisolone):
Adverse reaction overview.
No enhanced Common Adverse Effects information available for this drug.
No enhanced Common Adverse Effects information available for this drug.
There are 55 severe adverse reactions.
| More Frequent | Less Frequent |
|---|---|
|
Infection Mood changes |
Diabetes mellitus Gastrointestinal hemorrhage Hypercortisolism Hypocalcemia Leukocytosis Skin atrophy |
| Rare/Very Rare |
|---|
|
Abnormal hepatic function tests Acute pancreatitis Anaphylaxis Anemia Angioedema Avascular necrosis of bone Bradycardia Cardiac arrest Cardiac arrhythmia Cataracts Central serous chorioretinopathy Chronic heart failure Delirium Drug-induced psychosis Dyspnea Epidural lipomatosis Esophageal ulcer Fat embolism Fracture Gastrointestinal perforation Glaucoma Hallucinations Hepatomegaly Hypernatremia Hypertension Hypokalemia Hypothalamic-pituitary insufficiency Idiopathic intracranial hypertension Impaired wound healing Kaposi's sarcoma Lupus-like syndrome Metabolic acidosis Myopathy Ocular hypertension Osteoporosis Paranoid disorder Peptic ulcer Pheochromocytoma Pruritus of skin Pulmonary edema Purpura Seizure disorder Tendon rupture Thromboembolic disorder Thrombophlebitis Tumor lysis syndrome Vasculitis |
There are 55 less severe adverse reactions.
| More Frequent | Less Frequent |
|---|---|
|
Body fluid retention Gastric acid hypersecretory conditions Increased appetite Insomnia Nervousness Weight gain |
Dry skin Facial edema Irregular menstrual periods Steroid-induced hyperglycemia Telangiectasia |
| Rare/Very Rare |
|---|
|
Abdominal distension Acne vulgaris Acute cognitive impairment Allergic dermatitis Amenorrhea Anticholinergic toxicity Arthralgia Asthenozoospermia Blurred vision Depression Dizziness Ecchymosis Edema Erythema Euphoria Excitement Exophthalmos Glycosuria Headache disorder Hiccups Hirsutism Hyperglycemia Hyperhidrosis Hyperthyroidism Hypothyroidism Lipodystrophy Malaise Memory impairment Menstrual disorder Muscle weakness Nausea Papilledema Paresthesia Peripheral edema Peripheral sensory neuropathy Personality disorders Petechiae Skin rash Skin scaling Skin striae Syncope Tachycardia Urticaria Vertigo |
The following precautions are available for METHYLPREDNISOLONE (methylprednisolone):
No enhanced Pediatric Use information available for this drug.
Contraindicated
Severe Precaution
Management or Monitoring Precaution
Contraindicated
| None |
Severe Precaution
| None |
Management or Monitoring Precaution
| None |
No enhanced Pregnancy information available for this drug.
No enhanced Lactation information available for this drug.
No enhanced Geriatric Use information available for this drug.
The following prioritized warning is available for METHYLPREDNISOLONE (methylprednisolone):
No warning message for this drug.
No warning message for this drug.
The following icd codes are available for METHYLPREDNISOLONE (methylprednisolone)'s list of indications:
| Acquired thrombocytopenia | |
| D69.5 | Secondary thrombocytopenia |
| D69.59 | Other secondary thrombocytopenia |
| Acute exacerbation of multiple sclerosis | |
| G35 | Multiple sclerosis |
| Acute gouty arthritis | |
| M10 | Gout |
| M10.0 | Idiopathic gout |
| M10.00 | Idiopathic gout, unspecified site |
| M10.01 | Idiopathic gout, shoulder |
| M10.011 | Idiopathic gout, right shoulder |
| M10.012 | Idiopathic gout, left shoulder |
| M10.019 | Idiopathic gout, unspecified shoulder |
| M10.02 | Idiopathic gout, elbow |
| M10.021 | Idiopathic gout, right elbow |
| M10.022 | Idiopathic gout, left elbow |
| M10.029 | Idiopathic gout, unspecified elbow |
| M10.03 | Idiopathic gout, wrist |
| M10.031 | Idiopathic gout, right wrist |
| M10.032 | Idiopathic gout, left wrist |
| M10.039 | Idiopathic gout, unspecified wrist |
| M10.04 | Idiopathic gout, hand |
| M10.041 | Idiopathic gout, right hand |
| M10.042 | Idiopathic gout, left hand |
| M10.049 | Idiopathic gout, unspecified hand |
| M10.05 | Idiopathic gout, hip |
| M10.051 | Idiopathic gout, right hip |
| M10.052 | Idiopathic gout, left hip |
| M10.059 | Idiopathic gout, unspecified hip |
| M10.06 | Idiopathic gout, knee |
| M10.061 | Idiopathic gout, right knee |
| M10.062 | Idiopathic gout, left knee |
| M10.069 | Idiopathic gout, unspecified knee |
| M10.07 | Idiopathic gout, ankle and foot |
| M10.071 | Idiopathic gout, right ankle and foot |
| M10.072 | Idiopathic gout, left ankle and foot |
| M10.079 | Idiopathic gout, unspecified ankle and foot |
| M10.08 | Idiopathic gout, vertebrae |
| M10.09 | Idiopathic gout, multiple sites |
| M10.1 | Lead-induced gout |
| M10.10 | Lead-induced gout, unspecified site |
| M10.11 | Lead-induced gout, shoulder |
| M10.111 | Lead-induced gout, right shoulder |
| M10.112 | Lead-induced gout, left shoulder |
| M10.119 | Lead-induced gout, unspecified shoulder |
| M10.12 | Lead-induced gout, elbow |
| M10.121 | Lead-induced gout, right elbow |
| M10.122 | Lead-induced gout, left elbow |
| M10.129 | Lead-induced gout, unspecified elbow |
| M10.13 | Lead-induced gout, wrist |
| M10.131 | Lead-induced gout, right wrist |
| M10.132 | Lead-induced gout, left wrist |
| M10.139 | Lead-induced gout, unspecified wrist |
| M10.14 | Lead-induced gout, hand |
| M10.141 | Lead-induced gout, right hand |
| M10.142 | Lead-induced gout, left hand |
| M10.149 | Lead-induced gout, unspecified hand |
| M10.15 | Lead-induced gout, hip |
| M10.151 | Lead-induced gout, right hip |
| M10.152 | Lead-induced gout, left hip |
| M10.159 | Lead-induced gout, unspecified hip |
| M10.16 | Lead-induced gout, knee |
| M10.161 | Lead-induced gout, right knee |
| M10.162 | Lead-induced gout, left knee |
| M10.169 | Lead-induced gout, unspecified knee |
| M10.17 | Lead-induced gout, ankle and foot |
| M10.171 | Lead-induced gout, right ankle and foot |
| M10.172 | Lead-induced gout, left ankle and foot |
| M10.179 | Lead-induced gout, unspecified ankle and foot |
| M10.18 | Lead-induced gout, vertebrae |
| M10.19 | Lead-induced gout, multiple sites |
| M10.2 | Drug-induced gout |
| M10.20 | Drug-induced gout, unspecified site |
| M10.21 | Drug-induced gout, shoulder |
| M10.211 | Drug-induced gout, right shoulder |
| M10.212 | Drug-induced gout, left shoulder |
| M10.219 | Drug-induced gout, unspecified shoulder |
| M10.22 | Drug-induced gout, elbow |
| M10.221 | Drug-induced gout, right elbow |
| M10.222 | Drug-induced gout, left elbow |
| M10.229 | Drug-induced gout, unspecified elbow |
| M10.23 | Drug-induced gout, wrist |
| M10.231 | Drug-induced gout, right wrist |
| M10.232 | Drug-induced gout, left wrist |
| M10.239 | Drug-induced gout, unspecified wrist |
| M10.24 | Drug-induced gout, hand |
| M10.241 | Drug-induced gout, right hand |
| M10.242 | Drug-induced gout, left hand |
| M10.249 | Drug-induced gout, unspecified hand |
| M10.25 | Drug-induced gout, hip |
| M10.251 | Drug-induced gout, right hip |
| M10.252 | Drug-induced gout, left hip |
| M10.259 | Drug-induced gout, unspecified hip |
| M10.26 | Drug-induced gout, knee |
| M10.261 | Drug-induced gout, right knee |
| M10.262 | Drug-induced gout, left knee |
| M10.269 | Drug-induced gout, unspecified knee |
| M10.27 | Drug-induced gout, ankle and foot |
| M10.271 | Drug-induced gout, right ankle and foot |
| M10.272 | Drug-induced gout, left ankle and foot |
| M10.279 | Drug-induced gout, unspecified ankle and foot |
| M10.28 | Drug-induced gout, vertebrae |
| M10.29 | Drug-induced gout, multiple sites |
| M10.3 | Gout due to renal impairment |
| M10.30 | Gout due to renal impairment, unspecified site |
| M10.31 | Gout due to renal impairment, shoulder |
| M10.311 | Gout due to renal impairment, right shoulder |
| M10.312 | Gout due to renal impairment, left shoulder |
| M10.319 | Gout due to renal impairment, unspecified shoulder |
| M10.32 | Gout due to renal impairment, elbow |
| M10.321 | Gout due to renal impairment, right elbow |
| M10.322 | Gout due to renal impairment, left elbow |
| M10.329 | Gout due to renal impairment, unspecified elbow |
| M10.33 | Gout due to renal impairment, wrist |
| M10.331 | Gout due to renal impairment, right wrist |
| M10.332 | Gout due to renal impairment, left wrist |
| M10.339 | Gout due to renal impairment, unspecified wrist |
| M10.34 | Gout due to renal impairment, hand |
| M10.341 | Gout due to renal impairment, right hand |
| M10.342 | Gout due to renal impairment, left hand |
| M10.349 | Gout due to renal impairment, unspecified hand |
| M10.35 | Gout due to renal impairment, hip |
| M10.351 | Gout due to renal impairment, right hip |
| M10.352 | Gout due to renal impairment, left hip |
| M10.359 | Gout due to renal impairment, unspecified hip |
| M10.36 | Gout due to renal impairment, knee |
| M10.361 | Gout due to renal impairment, right knee |
| M10.362 | Gout due to renal impairment, left knee |
| M10.369 | Gout due to renal impairment, unspecified knee |
| M10.37 | Gout due to renal impairment, ankle and foot |
| M10.371 | Gout due to renal impairment, right ankle and foot |
| M10.372 | Gout due to renal impairment, left ankle and foot |
| M10.379 | Gout due to renal impairment, unspecified ankle and foot |
| M10.38 | Gout due to renal impairment, vertebrae |
| M10.39 | Gout due to renal impairment, multiple sites |
| M10.4 | Other secondary gout |
| M10.40 | Other secondary gout, unspecified site |
| M10.41 | Other secondary gout, shoulder |
| M10.411 | Other secondary gout, right shoulder |
| M10.412 | Other secondary gout, left shoulder |
| M10.419 | Other secondary gout, unspecified shoulder |
| M10.42 | Other secondary gout, elbow |
| M10.421 | Other secondary gout, right elbow |
| M10.422 | Other secondary gout, left elbow |
| M10.429 | Other secondary gout, unspecified elbow |
| M10.43 | Other secondary gout, wrist |
| M10.431 | Other secondary gout, right wrist |
| M10.432 | Other secondary gout, left wrist |
| M10.439 | Other secondary gout, unspecified wrist |
| M10.44 | Other secondary gout, hand |
| M10.441 | Other secondary gout, right hand |
| M10.442 | Other secondary gout, left hand |
| M10.449 | Other secondary gout, unspecified hand |
| M10.45 | Other secondary gout, hip |
| M10.451 | Other secondary gout, right hip |
| M10.452 | Other secondary gout, left hip |
| M10.459 | Other secondary gout, unspecified hip |
| M10.46 | Other secondary gout, knee |
| M10.461 | Other secondary gout, right knee |
| M10.462 | Other secondary gout, left knee |
| M10.469 | Other secondary gout, unspecified knee |
| M10.47 | Other secondary gout, ankle and foot |
| M10.471 | Other secondary gout, right ankle and foot |
| M10.472 | Other secondary gout, left ankle and foot |
| M10.479 | Other secondary gout, unspecified ankle and foot |
| M10.48 | Other secondary gout, vertebrae |
| M10.49 | Other secondary gout, multiple sites |
| M10.9 | Gout, unspecified |
| Acute lymphoid leukemia | |
| C91.0 | Acute lymphoblastic leukemia [ALl] |
| C91.00 | Acute lymphoblastic leukemia not having achieved remission |
| C91.02 | Acute lymphoblastic leukemia, in relapse |
| Acute rheumatic carditis | |
| I01 | Rheumatic fever with heart involvement |
| I01.0 | Acute rheumatic pericarditis |
| I01.1 | Acute rheumatic endocarditis |
| I01.2 | Acute rheumatic myocarditis |
| I01.8 | Other acute rheumatic heart disease |
| I01.9 | Acute rheumatic heart disease, unspecified |
| Adrenocortical insufficiency | |
| E27.1 | Primary adrenocortical insufficiency |
| E27.2 | Addisonian crisis |
| E27.3 | Drug-induced adrenocortical insufficiency |
| E27.4 | Other and unspecified adrenocortical insufficiency |
| E27.40 | Unspecified adrenocortical insufficiency |
| E27.49 | Other adrenocortical insufficiency |
| Adrenogenital disorder | |
| E25 | Adrenogenital disorders |
| E25.0 | Congenital adrenogenital disorders associated with enzyme deficiency |
| E25.8 | Other adrenogenital disorders |
| E25.9 | Adrenogenital disorder, unspecified |
| Allergic rhinitis | |
| J30.1 | Allergic rhinitis due to pollen |
| J30.2 | Other seasonal allergic rhinitis |
| J30.5 | Allergic rhinitis due to food |
| J30.8 | Other allergic rhinitis |
| J30.81 | Allergic rhinitis due to animal (cat) (dog) hair and dander |
| J30.89 | Other allergic rhinitis |
| J30.9 | Allergic rhinitis, unspecified |
| Angioedema | |
| T78.3xxA | Angioneurotic edema, initial encounter |
| Ankylosing spondylitis | |
| M08.1 | Juvenile ankylosing spondylitis |
| M45 | Ankylosing spondylitis |
| M45.0 | Ankylosing spondylitis of multiple sites in spine |
| M45.1 | Ankylosing spondylitis of occipito-atlanto-axial region |
| M45.2 | Ankylosing spondylitis of cervical region |
| M45.3 | Ankylosing spondylitis of cervicothoracic region |
| M45.4 | Ankylosing spondylitis of thoracic region |
| M45.5 | Ankylosing spondylitis of thoracolumbar region |
| M45.6 | Ankylosing spondylitis lumbar region |
| M45.7 | Ankylosing spondylitis of lumbosacral region |
| M45.8 | Ankylosing spondylitis sacral and sacrococcygeal region |
| M45.9 | Ankylosing spondylitis of unspecified sites in spine |
| Aspiration pneumonitis | |
| J69 | Pneumonitis due to solids and liquids |
| J69.0 | Pneumonitis due to inhalation of food and vomit |
| J69.1 | Pneumonitis due to inhalation of oils and essences |
| J69.8 | Pneumonitis due to inhalation of other solids and liquids |
| O29.01 | Aspiration pneumonitis due to anesthesia during pregnancy |
| O29.011 | Aspiration pneumonitis due to anesthesia during pregnancy, first trimester |
| O29.012 | Aspiration pneumonitis due to anesthesia during pregnancy, second trimester |
| O29.013 | Aspiration pneumonitis due to anesthesia during pregnancy, third trimester |
| O29.019 | Aspiration pneumonitis due to anesthesia during pregnancy, unspecified trimester |
| O74.0 | Aspiration pneumonitis due to anesthesia during labor and delivery |
| O89.01 | Aspiration pneumonitis due to anesthesia during the puerperium |
| P24.01 | Meconium aspiration with respiratory symptoms |
| P24.11 | Neonatal aspiration of (clear) amniotic fluid and mucus with respiratory symptoms |
| P24.21 | Neonatal aspiration of blood with respiratory symptoms |
| P24.31 | Neonatal aspiration of milk and regurgitated food with respiratory symptoms |
| P24.81 | Other neonatal aspiration with respiratory symptoms |
| Atopic dermatitis | |
| L20 | Atopic dermatitis |
| L20.0 | Besnier's prurigo |
| L20.8 | Other atopic dermatitis |
| L20.81 | Atopic neurodermatitis |
| L20.82 | Flexural eczema |
| L20.84 | Intrinsic (allergic) eczema |
| L20.89 | Other atopic dermatitis |
| L20.9 | Atopic dermatitis, unspecified |
| Autoimmune hemolytic anemia | |
| D59.0 | Drug-induced autoimmune hemolytic anemia |
| D59.1 | Other autoimmune hemolytic anemias |
| D59.10 | Autoimmune hemolytic anemia, unspecified |
| D59.11 | Warm autoimmune hemolytic anemia |
| D59.12 | Cold autoimmune hemolytic anemia |
| D59.13 | Mixed type autoimmune hemolytic anemia |
| D59.19 | Other autoimmune hemolytic anemia |
| Berylliosis | |
| J63.2 | Berylliosis |
| Bursitis | |
| M70.1 | Bursitis of hand |
| M70.10 | Bursitis, unspecified hand |
| M70.11 | Bursitis, right hand |
| M70.12 | Bursitis, left hand |
| M70.2 | Olecranon bursitis |
| M70.20 | Olecranon bursitis, unspecified elbow |
| M70.21 | Olecranon bursitis, right elbow |
| M70.22 | Olecranon bursitis, left elbow |
| M70.3 | Other bursitis of elbow |
| M70.30 | Other bursitis of elbow, unspecified elbow |
| M70.31 | Other bursitis of elbow, right elbow |
| M70.32 | Other bursitis of elbow, left elbow |
| M70.4 | Prepatellar bursitis |
| M70.40 | Prepatellar bursitis, unspecified knee |
| M70.41 | Prepatellar bursitis, right knee |
| M70.42 | Prepatellar bursitis, left knee |
| M70.5 | Other bursitis of knee |
| M70.50 | Other bursitis of knee, unspecified knee |
| M70.51 | Other bursitis of knee, right knee |
| M70.52 | Other bursitis of knee, left knee |
| M70.6 | Trochanteric bursitis |
| M70.60 | Trochanteric bursitis, unspecified hip |
| M70.61 | Trochanteric bursitis, right hip |
| M70.62 | Trochanteric bursitis, left hip |
| M70.7 | Other bursitis of hip |
| M70.70 | Other bursitis of hip, unspecified hip |
| M70.71 | Other bursitis of hip, right hip |
| M70.72 | Other bursitis of hip, left hip |
| M71.5 | Other bursitis, not elsewhere classified |
| M71.50 | Other bursitis, not elsewhere classified, unspecified site |
| M71.52 | Other bursitis, not elsewhere classified, elbow |
| M71.521 | Other bursitis, not elsewhere classified, right elbow |
| M71.522 | Other bursitis, not elsewhere classified, left elbow |
| M71.529 | Other bursitis, not elsewhere classified, unspecified elbow |
| M71.53 | Other bursitis, not elsewhere classified, wrist |
| M71.531 | Other bursitis, not elsewhere classified, right wrist |
| M71.532 | Other bursitis, not elsewhere classified, left wrist |
| M71.539 | Other bursitis, not elsewhere classified, unspecified wrist |
| M71.54 | Other bursitis, not elsewhere classified, hand |
| M71.541 | Other bursitis, not elsewhere classified, right hand |
| M71.542 | Other bursitis, not elsewhere classified, left hand |
| M71.549 | Other bursitis, not elsewhere classified, unspecified hand |
| M71.55 | Other bursitis, not elsewhere classified, hip |
| M71.551 | Other bursitis, not elsewhere classified, right hip |
| M71.552 | Other bursitis, not elsewhere classified, left hip |
| M71.559 | Other bursitis, not elsewhere classified, unspecified hip |
| M71.56 | Other bursitis, not elsewhere classified, knee |
| M71.561 | Other bursitis, not elsewhere classified, right knee |
| M71.562 | Other bursitis, not elsewhere classified, left knee |
| M71.569 | Other bursitis, not elsewhere classified, unspecified knee |
| M71.57 | Other bursitis, not elsewhere classified, ankle and foot |
| M71.571 | Other bursitis, not elsewhere classified, right ankle and foot |
| M71.572 | Other bursitis, not elsewhere classified, left ankle and foot |
| M71.579 | Other bursitis, not elsewhere classified, unspecified ankle and foot |
| M71.58 | Other bursitis, not elsewhere classified, other site |
| M75.5 | Bursitis of shoulder |
| M75.50 | Bursitis of unspecified shoulder |
| M75.51 | Bursitis of right shoulder |
| M75.52 | Bursitis of left shoulder |
| M76.4 | Tibial collateral bursitis [pellegrini-stieda] |
| M76.40 | Tibial collateral bursitis [pellegrini-stieda], unspecified leg |
| M76.41 | Tibial collateral bursitis [pellegrini-stieda], right leg |
| M76.42 | Tibial collateral bursitis [pellegrini-stieda], left leg |
| Congenital adrenal hyperplasia | |
| E25.0 | Congenital adrenogenital disorders associated with enzyme deficiency |
| Contact dermatitis | |
| L23 | Allergic contact dermatitis |
| L23.0 | Allergic contact dermatitis due to metals |
| L23.1 | Allergic contact dermatitis due to adhesives |
| L23.2 | Allergic contact dermatitis due to cosmetics |
| L23.3 | Allergic contact dermatitis due to drugs in contact with skin |
| L23.4 | Allergic contact dermatitis due to dyes |
| L23.5 | Allergic contact dermatitis due to other chemical products |
| L23.6 | Allergic contact dermatitis due to food in contact with the skin |
| L23.7 | Allergic contact dermatitis due to plants, except food |
| L23.8 | Allergic contact dermatitis due to other agents |
| L23.81 | Allergic contact dermatitis due to animal (cat) (dog) dander |
| L23.89 | Allergic contact dermatitis due to other agents |
| L23.9 | Allergic contact dermatitis, unspecified cause |
| L24 | Irritant contact dermatitis |
| L24.0 | Irritant contact dermatitis due to detergents |
| L24.1 | Irritant contact dermatitis due to oils and greases |
| L24.2 | Irritant contact dermatitis due to solvents |
| L24.3 | Irritant contact dermatitis due to cosmetics |
| L24.4 | Irritant contact dermatitis due to drugs in contact with skin |
| L24.5 | Irritant contact dermatitis due to other chemical products |
| L24.6 | Irritant contact dermatitis due to food in contact with skin |
| L24.7 | Irritant contact dermatitis due to plants, except food |
| L24.8 | Irritant contact dermatitis due to other agents |
| L24.81 | Irritant contact dermatitis due to metals |
| L24.89 | Irritant contact dermatitis due to other agents |
| L24.9 | Irritant contact dermatitis, unspecified cause |
| L24.A0 | Irritant contact dermatitis due to friction or contact with body fluids, unspecified |
| L24.A1 | Irritant contact dermatitis due to saliva |
| L24.A2 | Irritant contact dermatitis due to fecal, urinary or dual incontinence |
| L24.A9 | Irritant contact dermatitis due friction or contact with other specified body fluids |
| L24.B | Irritant contact dermatitis related to stoma or fistula |
| L24.B0 | Irritant contact dermatitis related to unspecified stoma or fistula |
| L24.B1 | Irritant contact dermatitis related to digestive stoma or fistula |
| L24.B2 | Irritant contact dermatitis related to respiratory stoma or fistula |
| L24.B3 | Irritant contact dermatitis related to fecal or urinary stoma or fistula |
| L25 | Unspecified contact dermatitis |
| L25.0 | Unspecified contact dermatitis due to cosmetics |
| L25.1 | Unspecified contact dermatitis due to drugs in contact with skin |
| L25.2 | Unspecified contact dermatitis due to dyes |
| L25.3 | Unspecified contact dermatitis due to other chemical products |
| L25.4 | Unspecified contact dermatitis due to food in contact with skin |
| L25.5 | Unspecified contact dermatitis due to plants, except food |
| L25.8 | Unspecified contact dermatitis due to other agents |
| L25.9 | Unspecified contact dermatitis, unspecified cause |
| Crohn's disease | |
| K50 | Crohn's disease [regional enteritis] |
| K50.0 | Crohn's disease of small intestine |
| K50.00 | Crohn's disease of small intestine without complications |
| K50.01 | Crohn's disease of small intestine with complications |
| K50.011 | Crohn's disease of small intestine with rectal bleeding |
| K50.012 | Crohn's disease of small intestine with intestinal obstruction |
| K50.013 | Crohn's disease of small intestine with fistula |
| K50.014 | Crohn's disease of small intestine with abscess |
| K50.018 | Crohn's disease of small intestine with other complication |
| K50.019 | Crohn's disease of small intestine with unspecified complications |
| K50.1 | Crohn's disease of large intestine |
| K50.10 | Crohn's disease of large intestine without complications |
| K50.11 | Crohn's disease of large intestine with complications |
| K50.111 | Crohn's disease of large intestine with rectal bleeding |
| K50.112 | Crohn's disease of large intestine with intestinal obstruction |
| K50.113 | Crohn's disease of large intestine with fistula |
| K50.114 | Crohn's disease of large intestine with abscess |
| K50.118 | Crohn's disease of large intestine with other complication |
| K50.119 | Crohn's disease of large intestine with unspecified complications |
| K50.8 | Crohn's disease of both small and large intestine |
| K50.80 | Crohn's disease of both small and large intestine without complications |
| K50.81 | Crohn's disease of both small and large intestine with complications |
| K50.811 | Crohn's disease of both small and large intestine with rectal bleeding |
| K50.812 | Crohn's disease of both small and large intestine with intestinal obstruction |
| K50.813 | Crohn's disease of both small and large intestine with fistula |
| K50.814 | Crohn's disease of both small and large intestine with abscess |
| K50.818 | Crohn's disease of both small and large intestine with other complication |
| K50.819 | Crohn's disease of both small and large intestine with unspecified complications |
| K50.9 | Crohn's disease, unspecified |
| K50.90 | Crohn's disease, unspecified, without complications |
| K50.91 | Crohn's disease, unspecified, with complications |
| K50.911 | Crohn's disease, unspecified, with rectal bleeding |
| K50.912 | Crohn's disease, unspecified, with intestinal obstruction |
| K50.913 | Crohn's disease, unspecified, with fistula |
| K50.914 | Crohn's disease, unspecified, with abscess |
| K50.918 | Crohn's disease, unspecified, with other complication |
| K50.919 | Crohn's disease, unspecified, with unspecified complications |
| Dermatitis herpetiformis | |
| L12.2 | Chronic bullous disease of childhood |
| L13.0 | Dermatitis herpetiformis |
| Diamond blackfan anemia | |
| D61.01 | Constitutional (pure) red blood cell aplasia |
| Disseminated tuberculosis | |
| A19 | Miliary tuberculosis |
| A19.0 | Acute miliary tuberculosis of a single specified site |
| A19.1 | Acute miliary tuberculosis of multiple sites |
| A19.2 | Acute miliary tuberculosis, unspecified |
| A19.8 | Other miliary tuberculosis |
| A19.9 | Miliary tuberculosis, unspecified |
| Epicondylitis | |
| M77.0 | Medial epicondylitis |
| M77.00 | Medial epicondylitis, unspecified elbow |
| M77.01 | Medial epicondylitis, right elbow |
| M77.02 | Medial epicondylitis, left elbow |
| M77.1 | Lateral epicondylitis |
| M77.10 | Lateral epicondylitis, unspecified elbow |
| M77.11 | Lateral epicondylitis, right elbow |
| M77.12 | Lateral epicondylitis, left elbow |
| Erythema multiforme | |
| L51 | Erythema multiforme |
| L51.0 | Nonbullous erythema multiforme |
| L51.1 | Stevens-johnson syndrome |
| L51.2 | Toxic epidermal necrolysis [lyell] |
| L51.3 | Stevens-johnson syndrome-toxic epidermal necrolysis overlap syndrome |
| L51.8 | Other erythema multiforme |
| L51.9 | Erythema multiforme, unspecified |
| Erythroblastic anemia | |
| D60 | Acquired pure red cell aplasia [erythroblastopenia] |
| D60.0 | Chronic acquired pure red cell aplasia |
| D60.1 | Transient acquired pure red cell aplasia |
| D60.8 | Other acquired pure red cell aplasias |
| D60.9 | Acquired pure red cell aplasia, unspecified |
| D61.01 | Constitutional (pure) red blood cell aplasia |
| Exfoliative dermatitis | |
| L26 | Exfoliative dermatitis |
| Follicular lymphoma | |
| C82 | Follicular lymphoma |
| C82.0 | Follicular lymphoma grade I |
| C82.00 | Follicular lymphoma grade i, unspecified site |
| C82.01 | Follicular lymphoma grade i, lymph nodes of head, face, and neck |
| C82.02 | Follicular lymphoma grade i, intrathoracic lymph nodes |
| C82.03 | Follicular lymphoma grade i, intra-abdominal lymph nodes |
| C82.04 | Follicular lymphoma grade i, lymph nodes of axilla and upper limb |
| C82.05 | Follicular lymphoma grade i, lymph nodes of inguinal region and lower limb |
| C82.06 | Follicular lymphoma grade i, intrapelvic lymph nodes |
| C82.07 | Follicular lymphoma grade i, spleen |
| C82.08 | Follicular lymphoma grade i, lymph nodes of multiple sites |
| C82.09 | Follicular lymphoma grade i, extranodal and solid organ sites |
| C82.1 | Follicular lymphoma grade II |
| C82.10 | Follicular lymphoma grade Ii, unspecified site |
| C82.11 | Follicular lymphoma grade Ii, lymph nodes of head, face, and neck |
| C82.12 | Follicular lymphoma grade Ii, intrathoracic lymph nodes |
| C82.13 | Follicular lymphoma grade Ii, intra-abdominal lymph nodes |
| C82.14 | Follicular lymphoma grade Ii, lymph nodes of axilla and upper limb |
| C82.15 | Follicular lymphoma grade Ii, lymph nodes of inguinal region and lower limb |
| C82.16 | Follicular lymphoma grade Ii, intrapelvic lymph nodes |
| C82.17 | Follicular lymphoma grade Ii, spleen |
| C82.18 | Follicular lymphoma grade Ii, lymph nodes of multiple sites |
| C82.19 | Follicular lymphoma grade Ii, extranodal and solid organ sites |
| C82.2 | Follicular lymphoma grade IIi, unspecified |
| C82.20 | Follicular lymphoma grade IIi, unspecified, unspecified site |
| C82.21 | Follicular lymphoma grade IIi, unspecified, lymph nodes of head, face, and neck |
| C82.22 | Follicular lymphoma grade IIi, unspecified, intrathoracic lymph nodes |
| C82.23 | Follicular lymphoma grade IIi, unspecified, intra-abdominal lymph nodes |
| C82.24 | Follicular lymphoma grade IIi, unspecified, lymph nodes of axilla and upper limb |
| C82.25 | Follicular lymphoma grade IIi, unspecified, lymph nodes of inguinal region and lower limb |
| C82.26 | Follicular lymphoma grade IIi, unspecified, intrapelvic lymph nodes |
| C82.27 | Follicular lymphoma grade IIi, unspecified, spleen |
| C82.28 | Follicular lymphoma grade IIi, unspecified, lymph nodes of multiple sites |
| C82.29 | Follicular lymphoma grade IIi, unspecified, extranodal and solid organ sites |
| C82.3 | Follicular lymphoma grade IIia |
| C82.30 | Follicular lymphoma grade IIia, unspecified site |
| C82.31 | Follicular lymphoma grade IIia, lymph nodes of head, face, and neck |
| C82.32 | Follicular lymphoma grade IIia, intrathoracic lymph nodes |
| C82.33 | Follicular lymphoma grade IIia, intra-abdominal lymph nodes |
| C82.34 | Follicular lymphoma grade IIia, lymph nodes of axilla and upper limb |
| C82.35 | Follicular lymphoma grade IIia, lymph nodes of inguinal region and lower limb |
| C82.36 | Follicular lymphoma grade IIia, intrapelvic lymph nodes |
| C82.37 | Follicular lymphoma grade IIia, spleen |
| C82.38 | Follicular lymphoma grade IIia, lymph nodes of multiple sites |
| C82.39 | Follicular lymphoma grade IIia, extranodal and solid organ sites |
| C82.4 | Follicular lymphoma grade IIib |
| C82.40 | Follicular lymphoma grade IIib, unspecified site |
| C82.41 | Follicular lymphoma grade IIib, lymph nodes of head, face, and neck |
| C82.42 | Follicular lymphoma grade IIib, intrathoracic lymph nodes |
| C82.43 | Follicular lymphoma grade IIib, intra-abdominal lymph nodes |
| C82.44 | Follicular lymphoma grade IIib, lymph nodes of axilla and upper limb |
| C82.45 | Follicular lymphoma grade IIib, lymph nodes of inguinal region and lower limb |
| C82.46 | Follicular lymphoma grade IIib, intrapelvic lymph nodes |
| C82.47 | Follicular lymphoma grade IIib, spleen |
| C82.48 | Follicular lymphoma grade IIib, lymph nodes of multiple sites |
| C82.49 | Follicular lymphoma grade IIib, extranodal and solid organ sites |
| C82.5 | Diffuse follicle center lymphoma |
| C82.50 | Diffuse follicle center lymphoma, unspecified site |
| C82.51 | Diffuse follicle center lymphoma, lymph nodes of head, face, and neck |
| C82.52 | Diffuse follicle center lymphoma, intrathoracic lymph nodes |
| C82.53 | Diffuse follicle center lymphoma, intra-abdominal lymph nodes |
| C82.54 | Diffuse follicle center lymphoma, lymph nodes of axilla and upper limb |
| C82.55 | Diffuse follicle center lymphoma, lymph nodes of inguinal region and lower limb |
| C82.56 | Diffuse follicle center lymphoma, intrapelvic lymph nodes |
| C82.57 | Diffuse follicle center lymphoma, spleen |
| C82.58 | Diffuse follicle center lymphoma, lymph nodes of multiple sites |
| C82.59 | Diffuse follicle center lymphoma, extranodal and solid organ sites |
| C82.6 | Cutaneous follicle center lymphoma |
| C82.60 | Cutaneous follicle center lymphoma, unspecified site |
| C82.61 | Cutaneous follicle center lymphoma, lymph nodes of head, face, and neck |
| C82.62 | Cutaneous follicle center lymphoma, intrathoracic lymph nodes |
| C82.63 | Cutaneous follicle center lymphoma, intra-abdominal lymph nodes |
| C82.64 | Cutaneous follicle center lymphoma, lymph nodes of axilla and upper limb |
| C82.65 | Cutaneous follicle center lymphoma, lymph nodes of inguinal region and lower limb |
| C82.66 | Cutaneous follicle center lymphoma, intrapelvic lymph nodes |
| C82.67 | Cutaneous follicle center lymphoma, spleen |
| C82.68 | Cutaneous follicle center lymphoma, lymph nodes of multiple sites |
| C82.69 | Cutaneous follicle center lymphoma, extranodal and solid organ sites |
| C82.8 | Other types of follicular lymphoma |
| C82.80 | Other types of follicular lymphoma, unspecified site |
| C82.81 | Other types of follicular lymphoma, lymph nodes of head, face, and neck |
| C82.82 | Other types of follicular lymphoma, intrathoracic lymph nodes |
| C82.83 | Other types of follicular lymphoma, intra-abdominal lymph nodes |
| C82.84 | Other types of follicular lymphoma, lymph nodes of axilla and upper limb |
| C82.85 | Other types of follicular lymphoma, lymph nodes of inguinal region and lower limb |
| C82.86 | Other types of follicular lymphoma, intrapelvic lymph nodes |
| C82.87 | Other types of follicular lymphoma, spleen |
| C82.88 | Other types of follicular lymphoma, lymph nodes of multiple sites |
| C82.89 | Other types of follicular lymphoma, extranodal and solid organ sites |
| C82.9 | Follicular lymphoma, unspecified |
| C82.90 | Follicular lymphoma, unspecified, unspecified site |
| C82.91 | Follicular lymphoma, unspecified, lymph nodes of head, face, and neck |
| C82.92 | Follicular lymphoma, unspecified, intrathoracic lymph nodes |
| C82.93 | Follicular lymphoma, unspecified, intra-abdominal lymph nodes |
| C82.94 | Follicular lymphoma, unspecified, lymph nodes of axilla and upper limb |
| C82.95 | Follicular lymphoma, unspecified, lymph nodes of inguinal region and lower limb |
| C82.96 | Follicular lymphoma, unspecified, intrapelvic lymph nodes |
| C82.97 | Follicular lymphoma, unspecified, spleen |
| C82.98 | Follicular lymphoma, unspecified, lymph nodes of multiple sites |
| C82.99 | Follicular lymphoma, unspecified, extranodal and solid organ sites |
| Hodgkin's lymphoma | |
| C81 | Hodgkin lymphoma |
| C81.0 | Nodular lymphocyte predominant hodgkin lymphoma |
| C81.00 | Nodular lymphocyte predominant hodgkin lymphoma, unspecified site |
| C81.01 | Nodular lymphocyte predominant hodgkin lymphoma, lymph nodes of head, face, and neck |
| C81.02 | Nodular lymphocyte predominant hodgkin lymphoma, intrathoracic lymph nodes |
| C81.03 | Nodular lymphocyte predominant hodgkin lymphoma, intra-abdominal lymph nodes |
| C81.04 | Nodular lymphocyte predominant hodgkin lymphoma, lymph nodes of axilla and upper limb |
| C81.05 | Nodular lymphocyte predominant hodgkin lymphoma, lymph nodes of inguinal region and lower limb |
| C81.06 | Nodular lymphocyte predominant hodgkin lymphoma, intrapelvic lymph nodes |
| C81.07 | Nodular lymphocyte predominant hodgkin lymphoma, spleen |
| C81.08 | Nodular lymphocyte predominant hodgkin lymphoma, lymph nodes of multiple sites |
| C81.09 | Nodular lymphocyte predominant hodgkin lymphoma, extranodal and solid organ sites |
| C81.1 | Nodular sclerosis hodgkin lymphoma |
| C81.10 | Nodular sclerosis hodgkin lymphoma, unspecified site |
| C81.11 | Nodular sclerosis hodgkin lymphoma, lymph nodes of head, face, and neck |
| C81.12 | Nodular sclerosis hodgkin lymphoma, intrathoracic lymph nodes |
| C81.13 | Nodular sclerosis hodgkin lymphoma, intra-abdominal lymph nodes |
| C81.14 | Nodular sclerosis hodgkin lymphoma, lymph nodes of axilla and upper limb |
| C81.15 | Nodular sclerosis hodgkin lymphoma, lymph nodes of inguinal region and lower limb |
| C81.16 | Nodular sclerosis hodgkin lymphoma, intrapelvic lymph nodes |
| C81.17 | Nodular sclerosis hodgkin lymphoma, spleen |
| C81.18 | Nodular sclerosis hodgkin lymphoma, lymph nodes of multiple sites |
| C81.19 | Nodular sclerosis hodgkin lymphoma, extranodal and solid organ sites |
| C81.2 | Mixed cellularity hodgkin lymphoma |
| C81.20 | Mixed cellularity hodgkin lymphoma, unspecified site |
| C81.21 | Mixed cellularity hodgkin lymphoma, lymph nodes of head, face, and neck |
| C81.22 | Mixed cellularity hodgkin lymphoma, intrathoracic lymph nodes |
| C81.23 | Mixed cellularity hodgkin lymphoma, intra-abdominal lymph nodes |
| C81.24 | Mixed cellularity hodgkin lymphoma, lymph nodes of axilla and upper limb |
| C81.25 | Mixed cellularity hodgkin lymphoma, lymph nodes of inguinal region and lower limb |
| C81.26 | Mixed cellularity hodgkin lymphoma, intrapelvic lymph nodes |
| C81.27 | Mixed cellularity hodgkin lymphoma, spleen |
| C81.28 | Mixed cellularity hodgkin lymphoma, lymph nodes of multiple sites |
| C81.29 | Mixed cellularity hodgkin lymphoma, extranodal and solid organ sites |
| C81.3 | Lymphocyte depleted hodgkin lymphoma |
| C81.30 | Lymphocyte depleted hodgkin lymphoma, unspecified site |
| C81.31 | Lymphocyte depleted hodgkin lymphoma, lymph nodes of head, face, and neck |
| C81.32 | Lymphocyte depleted hodgkin lymphoma, intrathoracic lymph nodes |
| C81.33 | Lymphocyte depleted hodgkin lymphoma, intra-abdominal lymph nodes |
| C81.34 | Lymphocyte depleted hodgkin lymphoma, lymph nodes of axilla and upper limb |
| C81.35 | Lymphocyte depleted hodgkin lymphoma, lymph nodes of inguinal region and lower limb |
| C81.36 | Lymphocyte depleted hodgkin lymphoma, intrapelvic lymph nodes |
| C81.37 | Lymphocyte depleted hodgkin lymphoma, spleen |
| C81.38 | Lymphocyte depleted hodgkin lymphoma, lymph nodes of multiple sites |
| C81.39 | Lymphocyte depleted hodgkin lymphoma, extranodal and solid organ sites |
| C81.4 | Lymphocyte-rich hodgkin lymphoma |
| C81.40 | Lymphocyte-rich hodgkin lymphoma, unspecified site |
| C81.41 | Lymphocyte-rich hodgkin lymphoma, lymph nodes of head, face, and neck |
| C81.42 | Lymphocyte-rich hodgkin lymphoma, intrathoracic lymph nodes |
| C81.43 | Lymphocyte-rich hodgkin lymphoma, intra-abdominal lymph nodes |
| C81.44 | Lymphocyte-rich hodgkin lymphoma, lymph nodes of axilla and upper limb |
| C81.45 | Lymphocyte-rich hodgkin lymphoma, lymph nodes of inguinal region and lower limb |
| C81.46 | Lymphocyte-rich hodgkin lymphoma, intrapelvic lymph nodes |
| C81.47 | Lymphocyte-rich hodgkin lymphoma, spleen |
| C81.48 | Lymphocyte-rich hodgkin lymphoma, lymph nodes of multiple sites |
| C81.49 | Lymphocyte-rich hodgkin lymphoma, extranodal and solid organ sites |
| C81.7 | Other hodgkin lymphoma |
| C81.70 | Other hodgkin lymphoma, unspecified site |
| C81.71 | Other hodgkin lymphoma, lymph nodes of head, face, and neck |
| C81.72 | Other hodgkin lymphoma, intrathoracic lymph nodes |
| C81.73 | Other hodgkin lymphoma, intra-abdominal lymph nodes |
| C81.74 | Other hodgkin lymphoma, lymph nodes of axilla and upper limb |
| C81.75 | Other hodgkin lymphoma, lymph nodes of inguinal region and lower limb |
| C81.76 | Other hodgkin lymphoma, intrapelvic lymph nodes |
| C81.77 | Other hodgkin lymphoma, spleen |
| C81.78 | Other hodgkin lymphoma, lymph nodes of multiple sites |
| C81.79 | Other hodgkin lymphoma, extranodal and solid organ sites |
| C81.9 | Hodgkin lymphoma, unspecified |
| C81.90 | Hodgkin lymphoma, unspecified, unspecified site |
| C81.91 | Hodgkin lymphoma, unspecified, lymph nodes of head, face, and neck |
| C81.92 | Hodgkin lymphoma, unspecified, intrathoracic lymph nodes |
| C81.93 | Hodgkin lymphoma, unspecified, intra-abdominal lymph nodes |
| C81.94 | Hodgkin lymphoma, unspecified, lymph nodes of axilla and upper limb |
| C81.95 | Hodgkin lymphoma, unspecified, lymph nodes of inguinal region and lower limb |
| C81.96 | Hodgkin lymphoma, unspecified, intrapelvic lymph nodes |
| C81.97 | Hodgkin lymphoma, unspecified, spleen |
| C81.98 | Hodgkin lymphoma, unspecified, lymph nodes of multiple sites |
| C81.99 | Hodgkin lymphoma, unspecified, extranodal and solid organ sites |
| Humoral hypercalcemia of malignancy | |
| E83.52 | Hypercalcemia |
| Hypersensitivity drug reaction | |
| T88.7xxA | Unspecified adverse effect of drug or medicament, initial encounter |
| Idiopathic thrombocytopenic purpura | |
| D69.3 | Immune thrombocytopenic purpura |
| Inflammatory bowel disease | |
| K50 | Crohn's disease [regional enteritis] |
| K50.0 | Crohn's disease of small intestine |
| K50.01 | Crohn's disease of small intestine with complications |
| K50.011 | Crohn's disease of small intestine with rectal bleeding |
| K50.012 | Crohn's disease of small intestine with intestinal obstruction |
| K50.013 | Crohn's disease of small intestine with fistula |
| K50.014 | Crohn's disease of small intestine with abscess |
| K50.018 | Crohn's disease of small intestine with other complication |
| K50.019 | Crohn's disease of small intestine with unspecified complications |
| K50.1 | Crohn's disease of large intestine |
| K50.11 | Crohn's disease of large intestine with complications |
| K50.111 | Crohn's disease of large intestine with rectal bleeding |
| K50.112 | Crohn's disease of large intestine with intestinal obstruction |
| K50.113 | Crohn's disease of large intestine with fistula |
| K50.114 | Crohn's disease of large intestine with abscess |
| K50.118 | Crohn's disease of large intestine with other complication |
| K50.119 | Crohn's disease of large intestine with unspecified complications |
| K50.8 | Crohn's disease of both small and large intestine |
| K50.81 | Crohn's disease of both small and large intestine with complications |
| K50.811 | Crohn's disease of both small and large intestine with rectal bleeding |
| K50.812 | Crohn's disease of both small and large intestine with intestinal obstruction |
| K50.813 | Crohn's disease of both small and large intestine with fistula |
| K50.814 | Crohn's disease of both small and large intestine with abscess |
| K50.818 | Crohn's disease of both small and large intestine with other complication |
| K50.819 | Crohn's disease of both small and large intestine with unspecified complications |
| K50.9 | Crohn's disease, unspecified |
| K50.91 | Crohn's disease, unspecified, with complications |
| K50.911 | Crohn's disease, unspecified, with rectal bleeding |
| K50.912 | Crohn's disease, unspecified, with intestinal obstruction |
| K50.913 | Crohn's disease, unspecified, with fistula |
| K50.914 | Crohn's disease, unspecified, with abscess |
| K50.918 | Crohn's disease, unspecified, with other complication |
| K50.919 | Crohn's disease, unspecified, with unspecified complications |
| K51 | Ulcerative colitis |
| K51.0 | Ulcerative (chronic) pancolitis |
| K51.01 | Ulcerative (chronic) pancolitis with complications |
| K51.011 | Ulcerative (chronic) pancolitis with rectal bleeding |
| K51.012 | Ulcerative (chronic) pancolitis with intestinal obstruction |
| K51.013 | Ulcerative (chronic) pancolitis with fistula |
| K51.014 | Ulcerative (chronic) pancolitis with abscess |
| K51.018 | Ulcerative (chronic) pancolitis with other complication |
| K51.019 | Ulcerative (chronic) pancolitis with unspecified complications |
| K51.2 | Ulcerative (chronic) proctitis |
| K51.21 | Ulcerative (chronic) proctitis with complications |
| K51.211 | Ulcerative (chronic) proctitis with rectal bleeding |
| K51.212 | Ulcerative (chronic) proctitis with intestinal obstruction |
| K51.213 | Ulcerative (chronic) proctitis with fistula |
| K51.214 | Ulcerative (chronic) proctitis with abscess |
| K51.218 | Ulcerative (chronic) proctitis with other complication |
| K51.219 | Ulcerative (chronic) proctitis with unspecified complications |
| K51.3 | Ulcerative (chronic) rectosigmoiditis |
| K51.31 | Ulcerative (chronic) rectosigmoiditis with complications |
| K51.311 | Ulcerative (chronic) rectosigmoiditis with rectal bleeding |
| K51.312 | Ulcerative (chronic) rectosigmoiditis with intestinal obstruction |
| K51.313 | Ulcerative (chronic) rectosigmoiditis with fistula |
| K51.314 | Ulcerative (chronic) rectosigmoiditis with abscess |
| K51.318 | Ulcerative (chronic) rectosigmoiditis with other complication |
| K51.319 | Ulcerative (chronic) rectosigmoiditis with unspecified complications |
| K51.4 | Inflammatory polyps of colon |
| K51.41 | Inflammatory polyps of colon with complications |
| K51.411 | Inflammatory polyps of colon with rectal bleeding |
| K51.412 | Inflammatory polyps of colon with intestinal obstruction |
| K51.413 | Inflammatory polyps of colon with fistula |
| K51.414 | Inflammatory polyps of colon with abscess |
| K51.418 | Inflammatory polyps of colon with other complication |
| K51.419 | Inflammatory polyps of colon with unspecified complications |
| K51.5 | Left sided colitis |
| K51.51 | Left sided colitis with complications |
| K51.511 | Left sided colitis with rectal bleeding |
| K51.512 | Left sided colitis with intestinal obstruction |
| K51.513 | Left sided colitis with fistula |
| K51.514 | Left sided colitis with abscess |
| K51.518 | Left sided colitis with other complication |
| K51.519 | Left sided colitis with unspecified complications |
| K51.8 | Other ulcerative colitis |
| K51.81 | Other ulcerative colitis with complications |
| K51.811 | Other ulcerative colitis with rectal bleeding |
| K51.812 | Other ulcerative colitis with intestinal obstruction |
| K51.813 | Other ulcerative colitis with fistula |
| K51.814 | Other ulcerative colitis with abscess |
| K51.818 | Other ulcerative colitis with other complication |
| K51.819 | Other ulcerative colitis with unspecified complications |
| K51.9 | Ulcerative colitis, unspecified |
| K51.91 | Ulcerative colitis, unspecified, with complications |
| K51.911 | Ulcerative colitis, unspecified with rectal bleeding |
| K51.912 | Ulcerative colitis, unspecified with intestinal obstruction |
| K51.913 | Ulcerative colitis, unspecified with fistula |
| K51.914 | Ulcerative colitis, unspecified with abscess |
| K51.918 | Ulcerative colitis, unspecified with other complication |
| K51.919 | Ulcerative colitis, unspecified with unspecified complications |
| K52.3 | Indeterminate colitis |
| Juvenile idiopathic arthritis | |
| M08.0 | Unspecified juvenile rheumatoid arthritis |
| M08.00 | Unspecified juvenile rheumatoid arthritis of unspecified site |
| M08.01 | Unspecified juvenile rheumatoid arthritis, shoulder |
| M08.011 | Unspecified juvenile rheumatoid arthritis, right shoulder |
| M08.012 | Unspecified juvenile rheumatoid arthritis, left shoulder |
| M08.019 | Unspecified juvenile rheumatoid arthritis, unspecified shoulder |
| M08.02 | Unspecified juvenile rheumatoid arthritis of elbow |
| M08.021 | Unspecified juvenile rheumatoid arthritis, right elbow |
| M08.022 | Unspecified juvenile rheumatoid arthritis, left elbow |
| M08.029 | Unspecified juvenile rheumatoid arthritis, unspecified elbow |
| M08.03 | Unspecified juvenile rheumatoid arthritis, wrist |
| M08.031 | Unspecified juvenile rheumatoid arthritis, right wrist |
| M08.032 | Unspecified juvenile rheumatoid arthritis, left wrist |
| M08.039 | Unspecified juvenile rheumatoid arthritis, unspecified wrist |
| M08.04 | Unspecified juvenile rheumatoid arthritis, hand |
| M08.041 | Unspecified juvenile rheumatoid arthritis, right hand |
| M08.042 | Unspecified juvenile rheumatoid arthritis, left hand |
| M08.049 | Unspecified juvenile rheumatoid arthritis, unspecified hand |
| M08.05 | Unspecified juvenile rheumatoid arthritis, hip |
| M08.051 | Unspecified juvenile rheumatoid arthritis, right hip |
| M08.052 | Unspecified juvenile rheumatoid arthritis, left hip |
| M08.059 | Unspecified juvenile rheumatoid arthritis, unspecified hip |
| M08.06 | Unspecified juvenile rheumatoid arthritis, knee |
| M08.061 | Unspecified juvenile rheumatoid arthritis, right knee |
| M08.062 | Unspecified juvenile rheumatoid arthritis, left knee |
| M08.069 | Unspecified juvenile rheumatoid arthritis, unspecified knee |
| M08.07 | Unspecified juvenile rheumatoid arthritis, ankle and foot |
| M08.071 | Unspecified juvenile rheumatoid arthritis, right ankle and foot |
| M08.072 | Unspecified juvenile rheumatoid arthritis, left ankle and foot |
| M08.079 | Unspecified juvenile rheumatoid arthritis, unspecified ankle and foot |
| M08.08 | Unspecified juvenile rheumatoid arthritis, vertebrae |
| M08.09 | Unspecified juvenile rheumatoid arthritis, multiple sites |
| M08.0A | Unspecified juvenile rheumatoid arthritis, other specified site |
| M08.2 | Juvenile rheumatoid arthritis with systemic onset |
| M08.20 | Juvenile rheumatoid arthritis with systemic onset, unspecified site |
| M08.21 | Juvenile rheumatoid arthritis with systemic onset, shoulder |
| M08.211 | Juvenile rheumatoid arthritis with systemic onset, right shoulder |
| M08.212 | Juvenile rheumatoid arthritis with systemic onset, left shoulder |
| M08.219 | Juvenile rheumatoid arthritis with systemic onset, unspecified shoulder |
| M08.22 | Juvenile rheumatoid arthritis with systemic onset, elbow |
| M08.221 | Juvenile rheumatoid arthritis with systemic onset, right elbow |
| M08.222 | Juvenile rheumatoid arthritis with systemic onset, left elbow |
| M08.229 | Juvenile rheumatoid arthritis with systemic onset, unspecified elbow |
| M08.23 | Juvenile rheumatoid arthritis with systemic onset, wrist |
| M08.231 | Juvenile rheumatoid arthritis with systemic onset, right wrist |
| M08.232 | Juvenile rheumatoid arthritis with systemic onset, left wrist |
| M08.239 | Juvenile rheumatoid arthritis with systemic onset, unspecified wrist |
| M08.24 | Juvenile rheumatoid arthritis with systemic onset, hand |
| M08.241 | Juvenile rheumatoid arthritis with systemic onset, right hand |
| M08.242 | Juvenile rheumatoid arthritis with systemic onset, left hand |
| M08.249 | Juvenile rheumatoid arthritis with systemic onset, unspecified hand |
| M08.25 | Juvenile rheumatoid arthritis with systemic onset, hip |
| M08.251 | Juvenile rheumatoid arthritis with systemic onset, right hip |
| M08.252 | Juvenile rheumatoid arthritis with systemic onset, left hip |
| M08.259 | Juvenile rheumatoid arthritis with systemic onset, unspecified hip |
| M08.26 | Juvenile rheumatoid arthritis with systemic onset, knee |
| M08.261 | Juvenile rheumatoid arthritis with systemic onset, right knee |
| M08.262 | Juvenile rheumatoid arthritis with systemic onset, left knee |
| M08.269 | Juvenile rheumatoid arthritis with systemic onset, unspecified knee |
| M08.27 | Juvenile rheumatoid arthritis with systemic onset, ankle and foot |
| M08.271 | Juvenile rheumatoid arthritis with systemic onset, right ankle and foot |
| M08.272 | Juvenile rheumatoid arthritis with systemic onset, left ankle and foot |
| M08.279 | Juvenile rheumatoid arthritis with systemic onset, unspecified ankle and foot |
| M08.28 | Juvenile rheumatoid arthritis with systemic onset, vertebrae |
| M08.29 | Juvenile rheumatoid arthritis with systemic onset, multiple sites |
| M08.2A | Juvenile rheumatoid arthritis with systemic onset, other specified site |
| M08.3 | Juvenile rheumatoid polyarthritis (seronegative) |
| M08.4 | Pauciarticular juvenile rheumatoid arthritis |
| M08.40 | Pauciarticular juvenile rheumatoid arthritis, unspecified site |
| M08.41 | Pauciarticular juvenile rheumatoid arthritis, shoulder |
| M08.411 | Pauciarticular juvenile rheumatoid arthritis, right shoulder |
| M08.412 | Pauciarticular juvenile rheumatoid arthritis, left shoulder |
| M08.419 | Pauciarticular juvenile rheumatoid arthritis, unspecified shoulder |
| M08.42 | Pauciarticular juvenile rheumatoid arthritis, elbow |
| M08.421 | Pauciarticular juvenile rheumatoid arthritis, right elbow |
| M08.422 | Pauciarticular juvenile rheumatoid arthritis, left elbow |
| M08.429 | Pauciarticular juvenile rheumatoid arthritis, unspecified elbow |
| M08.43 | Pauciarticular juvenile rheumatoid arthritis, wrist |
| M08.431 | Pauciarticular juvenile rheumatoid arthritis, right wrist |
| M08.432 | Pauciarticular juvenile rheumatoid arthritis, left wrist |
| M08.439 | Pauciarticular juvenile rheumatoid arthritis, unspecified wrist |
| M08.44 | Pauciarticular juvenile rheumatoid arthritis, hand |
| M08.441 | Pauciarticular juvenile rheumatoid arthritis, right hand |
| M08.442 | Pauciarticular juvenile rheumatoid arthritis, left hand |
| M08.449 | Pauciarticular juvenile rheumatoid arthritis, unspecified hand |
| M08.45 | Pauciarticular juvenile rheumatoid arthritis, hip |
| M08.451 | Pauciarticular juvenile rheumatoid arthritis, right hip |
| M08.452 | Pauciarticular juvenile rheumatoid arthritis, left hip |
| M08.459 | Pauciarticular juvenile rheumatoid arthritis, unspecified hip |
| M08.46 | Pauciarticular juvenile rheumatoid arthritis, knee |
| M08.461 | Pauciarticular juvenile rheumatoid arthritis, right knee |
| M08.462 | Pauciarticular juvenile rheumatoid arthritis, left knee |
| M08.469 | Pauciarticular juvenile rheumatoid arthritis, unspecified knee |
| M08.47 | Pauciarticular juvenile rheumatoid arthritis, ankle and foot |
| M08.471 | Pauciarticular juvenile rheumatoid arthritis, right ankle and foot |
| M08.472 | Pauciarticular juvenile rheumatoid arthritis, left ankle and foot |
| M08.479 | Pauciarticular juvenile rheumatoid arthritis, unspecified ankle and foot |
| M08.48 | Pauciarticular juvenile rheumatoid arthritis, vertebrae |
| M08.4A | Pauciarticular juvenile rheumatoid arthritis, other specified site |
| Loffler syndrome | |
| J82.82 | Acute eosinophilic pneumonia |
| Mycosis fungoides | |
| C84.0 | Mycosis fungoides |
| C84.00 | Mycosis fungoides, unspecified site |
| C84.01 | Mycosis fungoides, lymph nodes of head, face, and neck |
| C84.02 | Mycosis fungoides, intrathoracic lymph nodes |
| C84.03 | Mycosis fungoides, intra-abdominal lymph nodes |
| C84.04 | Mycosis fungoides, lymph nodes of axilla and upper limb |
| C84.05 | Mycosis fungoides, lymph nodes of inguinal region and lower limb |
| C84.06 | Mycosis fungoides, intrapelvic lymph nodes |
| C84.07 | Mycosis fungoides, spleen |
| C84.08 | Mycosis fungoides, lymph nodes of multiple sites |
| C84.09 | Mycosis fungoides, extranodal and solid organ sites |
| Nephrotic syndrome | |
| N04 | Nephrotic syndrome |
| N04.0 | Nephrotic syndrome with minor glomerular abnormality |
| N04.1 | Nephrotic syndrome with focal and segmental glomerular lesions |
| N04.2 | Nephrotic syndrome with diffuse membranous glomerulonephritis |
| N04.20 | Nephrotic syndrome with diffuse membranous glomerulonephritis, unspecified |
| N04.21 | Primary membranous nephropathy with nephrotic syndrome |
| N04.22 | Secondary membranous nephropathy with nephrotic syndrome |
| N04.29 | Other nephrotic syndrome with diffuse membranous glomerulonephritis |
| N04.3 | Nephrotic syndrome with diffuse mesangial proliferative glomerulonephritis |
| N04.4 | Nephrotic syndrome with diffuse endocapillary proliferative glomerulonephritis |
| N04.5 | Nephrotic syndrome with diffuse mesangiocapillary glomerulonephritis |
| N04.6 | Nephrotic syndrome with dense deposit disease |
| N04.7 | Nephrotic syndrome with diffuse crescentic glomerulonephritis |
| N04.8 | Nephrotic syndrome with other morphologic changes |
| N04.9 | Nephrotic syndrome with unspecified morphologic changes |
| N04.A | Nephrotic syndrome with c3 glomerulonephritis |
| Non-hodgkin's lymphoma | |
| C82 | Follicular lymphoma |
| C82.0 | Follicular lymphoma grade I |
| C82.00 | Follicular lymphoma grade i, unspecified site |
| C82.01 | Follicular lymphoma grade i, lymph nodes of head, face, and neck |
| C82.02 | Follicular lymphoma grade i, intrathoracic lymph nodes |
| C82.03 | Follicular lymphoma grade i, intra-abdominal lymph nodes |
| C82.04 | Follicular lymphoma grade i, lymph nodes of axilla and upper limb |
| C82.05 | Follicular lymphoma grade i, lymph nodes of inguinal region and lower limb |
| C82.06 | Follicular lymphoma grade i, intrapelvic lymph nodes |
| C82.07 | Follicular lymphoma grade i, spleen |
| C82.08 | Follicular lymphoma grade i, lymph nodes of multiple sites |
| C82.09 | Follicular lymphoma grade i, extranodal and solid organ sites |
| C82.1 | Follicular lymphoma grade II |
| C82.10 | Follicular lymphoma grade Ii, unspecified site |
| C82.11 | Follicular lymphoma grade Ii, lymph nodes of head, face, and neck |
| C82.12 | Follicular lymphoma grade Ii, intrathoracic lymph nodes |
| C82.13 | Follicular lymphoma grade Ii, intra-abdominal lymph nodes |
| C82.14 | Follicular lymphoma grade Ii, lymph nodes of axilla and upper limb |
| C82.15 | Follicular lymphoma grade Ii, lymph nodes of inguinal region and lower limb |
| C82.16 | Follicular lymphoma grade Ii, intrapelvic lymph nodes |
| C82.17 | Follicular lymphoma grade Ii, spleen |
| C82.18 | Follicular lymphoma grade Ii, lymph nodes of multiple sites |
| C82.19 | Follicular lymphoma grade Ii, extranodal and solid organ sites |
| C82.2 | Follicular lymphoma grade IIi, unspecified |
| C82.20 | Follicular lymphoma grade IIi, unspecified, unspecified site |
| C82.21 | Follicular lymphoma grade IIi, unspecified, lymph nodes of head, face, and neck |
| C82.22 | Follicular lymphoma grade IIi, unspecified, intrathoracic lymph nodes |
| C82.23 | Follicular lymphoma grade IIi, unspecified, intra-abdominal lymph nodes |
| C82.24 | Follicular lymphoma grade IIi, unspecified, lymph nodes of axilla and upper limb |
| C82.25 | Follicular lymphoma grade IIi, unspecified, lymph nodes of inguinal region and lower limb |
| C82.26 | Follicular lymphoma grade IIi, unspecified, intrapelvic lymph nodes |
| C82.27 | Follicular lymphoma grade IIi, unspecified, spleen |
| C82.28 | Follicular lymphoma grade IIi, unspecified, lymph nodes of multiple sites |
| C82.29 | Follicular lymphoma grade IIi, unspecified, extranodal and solid organ sites |
| C82.3 | Follicular lymphoma grade IIia |
| C82.30 | Follicular lymphoma grade IIia, unspecified site |
| C82.31 | Follicular lymphoma grade IIia, lymph nodes of head, face, and neck |
| C82.32 | Follicular lymphoma grade IIia, intrathoracic lymph nodes |
| C82.33 | Follicular lymphoma grade IIia, intra-abdominal lymph nodes |
| C82.34 | Follicular lymphoma grade IIia, lymph nodes of axilla and upper limb |
| C82.35 | Follicular lymphoma grade IIia, lymph nodes of inguinal region and lower limb |
| C82.36 | Follicular lymphoma grade IIia, intrapelvic lymph nodes |
| C82.37 | Follicular lymphoma grade IIia, spleen |
| C82.38 | Follicular lymphoma grade IIia, lymph nodes of multiple sites |
| C82.39 | Follicular lymphoma grade IIia, extranodal and solid organ sites |
| C82.4 | Follicular lymphoma grade IIib |
| C82.40 | Follicular lymphoma grade IIib, unspecified site |
| C82.41 | Follicular lymphoma grade IIib, lymph nodes of head, face, and neck |
| C82.42 | Follicular lymphoma grade IIib, intrathoracic lymph nodes |
| C82.43 | Follicular lymphoma grade IIib, intra-abdominal lymph nodes |
| C82.44 | Follicular lymphoma grade IIib, lymph nodes of axilla and upper limb |
| C82.45 | Follicular lymphoma grade IIib, lymph nodes of inguinal region and lower limb |
| C82.46 | Follicular lymphoma grade IIib, intrapelvic lymph nodes |
| C82.47 | Follicular lymphoma grade IIib, spleen |
| C82.48 | Follicular lymphoma grade IIib, lymph nodes of multiple sites |
| C82.49 | Follicular lymphoma grade IIib, extranodal and solid organ sites |
| C82.5 | Diffuse follicle center lymphoma |
| C82.50 | Diffuse follicle center lymphoma, unspecified site |
| C82.51 | Diffuse follicle center lymphoma, lymph nodes of head, face, and neck |
| C82.52 | Diffuse follicle center lymphoma, intrathoracic lymph nodes |
| C82.53 | Diffuse follicle center lymphoma, intra-abdominal lymph nodes |
| C82.54 | Diffuse follicle center lymphoma, lymph nodes of axilla and upper limb |
| C82.55 | Diffuse follicle center lymphoma, lymph nodes of inguinal region and lower limb |
| C82.56 | Diffuse follicle center lymphoma, intrapelvic lymph nodes |
| C82.57 | Diffuse follicle center lymphoma, spleen |
| C82.58 | Diffuse follicle center lymphoma, lymph nodes of multiple sites |
| C82.59 | Diffuse follicle center lymphoma, extranodal and solid organ sites |
| C82.6 | Cutaneous follicle center lymphoma |
| C82.60 | Cutaneous follicle center lymphoma, unspecified site |
| C82.61 | Cutaneous follicle center lymphoma, lymph nodes of head, face, and neck |
| C82.62 | Cutaneous follicle center lymphoma, intrathoracic lymph nodes |
| C82.63 | Cutaneous follicle center lymphoma, intra-abdominal lymph nodes |
| C82.64 | Cutaneous follicle center lymphoma, lymph nodes of axilla and upper limb |
| C82.65 | Cutaneous follicle center lymphoma, lymph nodes of inguinal region and lower limb |
| C82.66 | Cutaneous follicle center lymphoma, intrapelvic lymph nodes |
| C82.67 | Cutaneous follicle center lymphoma, spleen |
| C82.68 | Cutaneous follicle center lymphoma, lymph nodes of multiple sites |
| C82.69 | Cutaneous follicle center lymphoma, extranodal and solid organ sites |
| C82.8 | Other types of follicular lymphoma |
| C82.80 | Other types of follicular lymphoma, unspecified site |
| C82.81 | Other types of follicular lymphoma, lymph nodes of head, face, and neck |
| C82.82 | Other types of follicular lymphoma, intrathoracic lymph nodes |
| C82.83 | Other types of follicular lymphoma, intra-abdominal lymph nodes |
| C82.84 | Other types of follicular lymphoma, lymph nodes of axilla and upper limb |
| C82.85 | Other types of follicular lymphoma, lymph nodes of inguinal region and lower limb |
| C82.86 | Other types of follicular lymphoma, intrapelvic lymph nodes |
| C82.87 | Other types of follicular lymphoma, spleen |
| C82.88 | Other types of follicular lymphoma, lymph nodes of multiple sites |
| C82.89 | Other types of follicular lymphoma, extranodal and solid organ sites |
| C82.9 | Follicular lymphoma, unspecified |
| C82.90 | Follicular lymphoma, unspecified, unspecified site |
| C82.91 | Follicular lymphoma, unspecified, lymph nodes of head, face, and neck |
| C82.92 | Follicular lymphoma, unspecified, intrathoracic lymph nodes |
| C82.93 | Follicular lymphoma, unspecified, intra-abdominal lymph nodes |
| C82.94 | Follicular lymphoma, unspecified, lymph nodes of axilla and upper limb |
| C82.95 | Follicular lymphoma, unspecified, lymph nodes of inguinal region and lower limb |
| C82.96 | Follicular lymphoma, unspecified, intrapelvic lymph nodes |
| C82.97 | Follicular lymphoma, unspecified, spleen |
| C82.98 | Follicular lymphoma, unspecified, lymph nodes of multiple sites |
| C82.99 | Follicular lymphoma, unspecified, extranodal and solid organ sites |
| C83 | Non-follicular lymphoma |
| C83.0 | Small cell b-cell lymphoma |
| C83.00 | Small cell b-cell lymphoma, unspecified site |
| C83.01 | Small cell b-cell lymphoma, lymph nodes of head, face, and neck |
| C83.02 | Small cell b-cell lymphoma, intrathoracic lymph nodes |
| C83.03 | Small cell b-cell lymphoma, intra-abdominal lymph nodes |
| C83.04 | Small cell b-cell lymphoma, lymph nodes of axilla and upper limb |
| C83.05 | Small cell b-cell lymphoma, lymph nodes of inguinal region and lower limb |
| C83.06 | Small cell b-cell lymphoma, intrapelvic lymph nodes |
| C83.07 | Small cell b-cell lymphoma, spleen |
| C83.08 | Small cell b-cell lymphoma, lymph nodes of multiple sites |
| C83.09 | Small cell b-cell lymphoma, extranodal and solid organ sites |
| C83.1 | Mantle cell lymphoma |
| C83.10 | Mantle cell lymphoma, unspecified site |
| C83.11 | Mantle cell lymphoma, lymph nodes of head, face, and neck |
| C83.12 | Mantle cell lymphoma, intrathoracic lymph nodes |
| C83.13 | Mantle cell lymphoma, intra-abdominal lymph nodes |
| C83.14 | Mantle cell lymphoma, lymph nodes of axilla and upper limb |
| C83.15 | Mantle cell lymphoma, lymph nodes of inguinal region and lower limb |
| C83.16 | Mantle cell lymphoma, intrapelvic lymph nodes |
| C83.17 | Mantle cell lymphoma, spleen |
| C83.18 | Mantle cell lymphoma, lymph nodes of multiple sites |
| C83.19 | Mantle cell lymphoma, extranodal and solid organ sites |
| C83.3 | Diffuse large b-cell lymphoma |
| C83.30 | Diffuse large b-cell lymphoma, unspecified site |
| C83.31 | Diffuse large b-cell lymphoma, lymph nodes of head, face, and neck |
| C83.32 | Diffuse large b-cell lymphoma, intrathoracic lymph nodes |
| C83.33 | Diffuse large b-cell lymphoma, intra-abdominal lymph nodes |
| C83.34 | Diffuse large b-cell lymphoma, lymph nodes of axilla and upper limb |
| C83.35 | Diffuse large b-cell lymphoma, lymph nodes of inguinal region and lower limb |
| C83.36 | Diffuse large b-cell lymphoma, intrapelvic lymph nodes |
| C83.37 | Diffuse large b-cell lymphoma, spleen |
| C83.38 | Diffuse large b-cell lymphoma, lymph nodes of multiple sites |
| C83.39 | Diffuse large b-cell lymphoma, extranodal and solid organ sites |
| C83.5 | Lymphoblastic (diffuse) lymphoma |
| C83.50 | Lymphoblastic (diffuse) lymphoma, unspecified site |
| C83.51 | Lymphoblastic (diffuse) lymphoma, lymph nodes of head, face, and neck |
| C83.52 | Lymphoblastic (diffuse) lymphoma, intrathoracic lymph nodes |
| C83.53 | Lymphoblastic (diffuse) lymphoma, intra-abdominal lymph nodes |
| C83.54 | Lymphoblastic (diffuse) lymphoma, lymph nodes of axilla and upper limb |
| C83.55 | Lymphoblastic (diffuse) lymphoma, lymph nodes of inguinal region and lower limb |
| C83.56 | Lymphoblastic (diffuse) lymphoma, intrapelvic lymph nodes |
| C83.57 | Lymphoblastic (diffuse) lymphoma, spleen |
| C83.58 | Lymphoblastic (diffuse) lymphoma, lymph nodes of multiple sites |
| C83.59 | Lymphoblastic (diffuse) lymphoma, extranodal and solid organ sites |
| C83.7 | Burkitt lymphoma |
| C83.70 | Burkitt lymphoma, unspecified site |
| C83.71 | Burkitt lymphoma, lymph nodes of head, face, and neck |
| C83.72 | Burkitt lymphoma, intrathoracic lymph nodes |
| C83.73 | Burkitt lymphoma, intra-abdominal lymph nodes |
| C83.74 | Burkitt lymphoma, lymph nodes of axilla and upper limb |
| C83.75 | Burkitt lymphoma, lymph nodes of inguinal region and lower limb |
| C83.76 | Burkitt lymphoma, intrapelvic lymph nodes |
| C83.77 | Burkitt lymphoma, spleen |
| C83.78 | Burkitt lymphoma, lymph nodes of multiple sites |
| C83.79 | Burkitt lymphoma, extranodal and solid organ sites |
| C83.8 | Other non-follicular lymphoma |
| C83.80 | Other non-follicular lymphoma, unspecified site |
| C83.81 | Other non-follicular lymphoma, lymph nodes of head, face, and neck |
| C83.82 | Other non-follicular lymphoma, intrathoracic lymph nodes |
| C83.83 | Other non-follicular lymphoma, intra-abdominal lymph nodes |
| C83.84 | Other non-follicular lymphoma, lymph nodes of axilla and upper limb |
| C83.85 | Other non-follicular lymphoma, lymph nodes of inguinal region and lower limb |
| C83.86 | Other non-follicular lymphoma, intrapelvic lymph nodes |
| C83.87 | Other non-follicular lymphoma, spleen |
| C83.88 | Other non-follicular lymphoma, lymph nodes of multiple sites |
| C83.89 | Other non-follicular lymphoma, extranodal and solid organ sites |
| C83.9 | Non-follicular (diffuse) lymphoma, unspecified |
| C83.90 | Non-follicular (diffuse) lymphoma, unspecified, unspecified site |
| C83.91 | Non-follicular (diffuse) lymphoma, unspecified, lymph nodes of head, face, and neck |
| C83.92 | Non-follicular (diffuse) lymphoma, unspecified, intrathoracic lymph nodes |
| C83.93 | Non-follicular (diffuse) lymphoma, unspecified, intra-abdominal lymph nodes |
| C83.94 | Non-follicular (diffuse) lymphoma, unspecified, lymph nodes of axilla and upper limb |
| C83.95 | Non-follicular (diffuse) lymphoma, unspecified, lymph nodes of inguinal region and lower limb |
| C83.96 | Non-follicular (diffuse) lymphoma, unspecified, intrapelvic lymph nodes |
| C83.97 | Non-follicular (diffuse) lymphoma, unspecified, spleen |
| C83.98 | Non-follicular (diffuse) lymphoma, unspecified, lymph nodes of multiple sites |
| C83.99 | Non-follicular (diffuse) lymphoma, unspecified, extranodal and solid organ sites |
| C84 | Mature t/Nk-cell lymphomas |
| C84.0 | Mycosis fungoides |
| C84.00 | Mycosis fungoides, unspecified site |
| C84.01 | Mycosis fungoides, lymph nodes of head, face, and neck |
| C84.02 | Mycosis fungoides, intrathoracic lymph nodes |
| C84.03 | Mycosis fungoides, intra-abdominal lymph nodes |
| C84.04 | Mycosis fungoides, lymph nodes of axilla and upper limb |
| C84.05 | Mycosis fungoides, lymph nodes of inguinal region and lower limb |
| C84.06 | Mycosis fungoides, intrapelvic lymph nodes |
| C84.07 | Mycosis fungoides, spleen |
| C84.08 | Mycosis fungoides, lymph nodes of multiple sites |
| C84.09 | Mycosis fungoides, extranodal and solid organ sites |
| C84.1 | Sezary disease |
| C84.10 | Sezary disease, unspecified site |
| C84.11 | Sezary disease, lymph nodes of head, face, and neck |
| C84.12 | Sezary disease, intrathoracic lymph nodes |
| C84.13 | Sezary disease, intra-abdominal lymph nodes |
| C84.14 | Sezary disease, lymph nodes of axilla and upper limb |
| C84.15 | Sezary disease, lymph nodes of inguinal region and lower limb |
| C84.16 | Sezary disease, intrapelvic lymph nodes |
| C84.17 | Sezary disease, spleen |
| C84.18 | Sezary disease, lymph nodes of multiple sites |
| C84.19 | Sezary disease, extranodal and solid organ sites |
| C84.4 | Peripheral t-cell lymphoma, not elsewhere classified |
| C84.40 | Peripheral t-cell lymphoma, not elsewhere classified, unspecified site |
| C84.41 | Peripheral t-cell lymphoma, not elsewhere classified, lymph nodes of head, face, and neck |
| C84.42 | Peripheral t-cell lymphoma, not elsewhere classified, intrathoracic lymph nodes |
| C84.43 | Peripheral t-cell lymphoma, not elsewhere classified, intra-abdominal lymph nodes |
| C84.44 | Peripheral t-cell lymphoma, not elsewhere classified, lymph nodes of axilla and upper limb |
| C84.45 | Peripheral t-cell lymphoma, not elsewhere classified, lymph nodes of inguinal region and lower limb |
| C84.46 | Peripheral t-cell lymphoma, not elsewhere classified, intrapelvic lymph nodes |
| C84.47 | Peripheral t-cell lymphoma, not elsewhere classified, spleen |
| C84.48 | Peripheral t-cell lymphoma, not elsewhere classified, lymph nodes of multiple sites |
| C84.49 | Peripheral t-cell lymphoma, not elsewhere classified, extranodal and solid organ sites |
| C84.6 | Anaplastic large cell lymphoma, ALk-positive |
| C84.60 | Anaplastic large cell lymphoma, ALk-positive, unspecified site |
| C84.61 | Anaplastic large cell lymphoma, ALk-positive, lymph nodes of head, face, and neck |
| C84.62 | Anaplastic large cell lymphoma, ALk-positive, intrathoracic lymph nodes |
| C84.63 | Anaplastic large cell lymphoma, ALk-positive, intra-abdominal lymph nodes |
| C84.64 | Anaplastic large cell lymphoma, ALk-positive, lymph nodes of axilla and upper limb |
| C84.65 | Anaplastic large cell lymphoma, ALk-positive, lymph nodes of inguinal region and lower limb |
| C84.66 | Anaplastic large cell lymphoma, ALk-positive, intrapelvic lymph nodes |
| C84.67 | Anaplastic large cell lymphoma, ALk-positive, spleen |
| C84.68 | Anaplastic large cell lymphoma, ALk-positive, lymph nodes of multiple sites |
| C84.69 | Anaplastic large cell lymphoma, ALk-positive, extranodal and solid organ sites |
| C84.7 | Anaplastic large cell lymphoma, ALk-negative |
| C84.70 | Anaplastic large cell lymphoma, ALk-negative, unspecified site |
| C84.71 | Anaplastic large cell lymphoma, ALk-negative, lymph nodes of head, face, and neck |
| C84.72 | Anaplastic large cell lymphoma, ALk-negative, intrathoracic lymph nodes |
| C84.73 | Anaplastic large cell lymphoma, ALk-negative, intra-abdominal lymph nodes |
| C84.74 | Anaplastic large cell lymphoma, ALk-negative, lymph nodes of axilla and upper limb |
| C84.75 | Anaplastic large cell lymphoma, ALk-negative, lymph nodes of inguinal region and lower limb |
| C84.76 | Anaplastic large cell lymphoma, ALk-negative, intrapelvic lymph nodes |
| C84.77 | Anaplastic large cell lymphoma, ALk-negative, spleen |
| C84.78 | Anaplastic large cell lymphoma, ALk-negative, lymph nodes of multiple sites |
| C84.79 | Anaplastic large cell lymphoma, ALk-negative, extranodal and solid organ sites |
| C84.7A | Anaplastic large cell lymphoma, ALk-negative, breast |
| C84.9 | Mature t/Nk-cell lymphomas, unspecified |
| C84.90 | Mature t/Nk-cell lymphomas, unspecified, unspecified site |
| C84.91 | Mature t/Nk-cell lymphomas, unspecified, lymph nodes of head, face, and neck |
| C84.92 | Mature t/Nk-cell lymphomas, unspecified, intrathoracic lymph nodes |
| C84.93 | Mature t/Nk-cell lymphomas, unspecified, intra-abdominal lymph nodes |
| C84.94 | Mature t/Nk-cell lymphomas, unspecified, lymph nodes of axilla and upper limb |
| C84.95 | Mature t/Nk-cell lymphomas, unspecified, lymph nodes of inguinal region and lower limb |
| C84.96 | Mature t/Nk-cell lymphomas, unspecified, intrapelvic lymph nodes |
| C84.97 | Mature t/Nk-cell lymphomas, unspecified, spleen |
| C84.98 | Mature t/Nk-cell lymphomas, unspecified, lymph nodes of multiple sites |
| C84.99 | Mature t/Nk-cell lymphomas, unspecified, extranodal and solid organ sites |
| C84.A | Cutaneous t-cell lymphoma, unspecified |
| C84.A0 | Cutaneous t-cell lymphoma, unspecified, unspecified site |
| C84.A1 | Cutaneous t-cell lymphoma, unspecified lymph nodes of head, face, and neck |
| C84.A2 | Cutaneous t-cell lymphoma, unspecified, intrathoracic lymph nodes |
| C84.A3 | Cutaneous t-cell lymphoma, unspecified, intra-abdominal lymph nodes |
| C84.A4 | Cutaneous t-cell lymphoma, unspecified, lymph nodes of axilla and upper limb |
| C84.A5 | Cutaneous t-cell lymphoma, unspecified, lymph nodes of inguinal region and lower limb |
| C84.A6 | Cutaneous t-cell lymphoma, unspecified, intrapelvic lymph nodes |
| C84.A7 | Cutaneous t-cell lymphoma, unspecified, spleen |
| C84.A8 | Cutaneous t-cell lymphoma, unspecified, lymph nodes of multiple sites |
| C84.A9 | Cutaneous t-cell lymphoma, unspecified, extranodal and solid organ sites |
| C84.Z | Other mature t/Nk-cell lymphomas |
| C84.Z0 | Other mature t/Nk-cell lymphomas, unspecified site |
| C84.Z1 | Other mature t/Nk-cell lymphomas, lymph nodes of head, face, and neck |
| C84.Z2 | Other mature t/Nk-cell lymphomas, intrathoracic lymph nodes |
| C84.Z3 | Other mature t/Nk-cell lymphomas, intra-abdominal lymph nodes |
| C84.Z4 | Other mature t/Nk-cell lymphomas, lymph nodes of axilla and upper limb |
| C84.Z5 | Other mature t/Nk-cell lymphomas, lymph nodes of inguinal region and lower limb |
| C84.Z6 | Other mature t/Nk-cell lymphomas, intrapelvic lymph nodes |
| C84.Z7 | Other mature t/Nk-cell lymphomas, spleen |
| C84.Z8 | Other mature t/Nk-cell lymphomas, lymph nodes of multiple sites |
| C84.Z9 | Other mature t/Nk-cell lymphomas, extranodal and solid organ sites |
| C85 | Other specified and unspecified types of non-hodgkin lymphoma |
| C85.1 | Unspecified b-cell lymphoma |
| C85.10 | Unspecified b-cell lymphoma, unspecified site |
| C85.11 | Unspecified b-cell lymphoma, lymph nodes of head, face, and neck |
| C85.12 | Unspecified b-cell lymphoma, intrathoracic lymph nodes |
| C85.13 | Unspecified b-cell lymphoma, intra-abdominal lymph nodes |
| C85.14 | Unspecified b-cell lymphoma, lymph nodes of axilla and upper limb |
| C85.15 | Unspecified b-cell lymphoma, lymph nodes of inguinal region and lower limb |
| C85.16 | Unspecified b-cell lymphoma, intrapelvic lymph nodes |
| C85.17 | Unspecified b-cell lymphoma, spleen |
| C85.18 | Unspecified b-cell lymphoma, lymph nodes of multiple sites |
| C85.19 | Unspecified b-cell lymphoma, extranodal and solid organ sites |
| C85.2 | Mediastinal (thymic) large b-cell lymphoma |
| C85.20 | Mediastinal (thymic) large b-cell lymphoma, unspecified site |
| C85.21 | Mediastinal (thymic) large b-cell lymphoma, lymph nodes of head, face, and neck |
| C85.22 | Mediastinal (thymic) large b-cell lymphoma, intrathoracic lymph nodes |
| C85.23 | Mediastinal (thymic) large b-cell lymphoma, intra-abdominal lymph nodes |
| C85.24 | Mediastinal (thymic) large b-cell lymphoma, lymph nodes of axilla and upper limb |
| C85.25 | Mediastinal (thymic) large b-cell lymphoma, lymph nodes of inguinal region and lower limb |
| C85.26 | Mediastinal (thymic) large b-cell lymphoma, intrapelvic lymph nodes |
| C85.27 | Mediastinal (thymic) large b-cell lymphoma, spleen |
| C85.28 | Mediastinal (thymic) large b-cell lymphoma, lymph nodes of multiple sites |
| C85.29 | Mediastinal (thymic) large b-cell lymphoma, extranodal and solid organ sites |
| C85.8 | Other specified types of non-hodgkin lymphoma |
| C85.80 | Other specified types of non-hodgkin lymphoma, unspecified site |
| C85.81 | Other specified types of non-hodgkin lymphoma, lymph nodes of head, face, and neck |
| C85.82 | Other specified types of non-hodgkin lymphoma, intrathoracic lymph nodes |
| C85.83 | Other specified types of non-hodgkin lymphoma, intra-abdominal lymph nodes |
| C85.84 | Other specified types of non-hodgkin lymphoma, lymph nodes of axilla and upper limb |
| C85.85 | Other specified types of non-hodgkin lymphoma, lymph nodes of inguinal region and lower limb |
| C85.86 | Other specified types of non-hodgkin lymphoma, intrapelvic lymph nodes |
| C85.87 | Other specified types of non-hodgkin lymphoma, spleen |
| C85.88 | Other specified types of non-hodgkin lymphoma, lymph nodes of multiple sites |
| C85.89 | Other specified types of non-hodgkin lymphoma, extranodal and solid organ sites |
| C85.9 | Non-hodgkin lymphoma, unspecified |
| C85.90 | Non-hodgkin lymphoma, unspecified, unspecified site |
| C85.91 | Non-hodgkin lymphoma, unspecified, lymph nodes of head, face, and neck |
| C85.92 | Non-hodgkin lymphoma, unspecified, intrathoracic lymph nodes |
| C85.93 | Non-hodgkin lymphoma, unspecified, intra-abdominal lymph nodes |
| C85.94 | Non-hodgkin lymphoma, unspecified, lymph nodes of axilla and upper limb |
| C85.95 | Non-hodgkin lymphoma, unspecified, lymph nodes of inguinal region and lower limb |
| C85.96 | Non-hodgkin lymphoma, unspecified, intrapelvic lymph nodes |
| C85.97 | Non-hodgkin lymphoma, unspecified, spleen |
| C85.98 | Non-hodgkin lymphoma, unspecified, lymph nodes of multiple sites |
| C85.99 | Non-hodgkin lymphoma, unspecified, extranodal and solid organ sites |
| C86 | Other specified types of t/Nk-cell lymphoma |
| C86.0 | Extranodal Nk/t-cell lymphoma, nasal type |
| C86.1 | Hepatosplenic t-cell lymphoma |
| C86.2 | Enteropathy-type (intestinal) t-cell lymphoma |
| C86.3 | Subcutaneous panniculitis-like t-cell lymphoma |
| C86.4 | Blastic Nk-cell lymphoma |
| C86.5 | Angioimmunoblastic t-cell lymphoma |
| C86.6 | Primary cutaneous Cd30-positive t-cell proliferations |
| C88.0 | Waldenstrom macroglobulinemia |
| C88.4 | Extranodal marginal zone b-cell lymphoma of mucosa-associated lymphoid tissue [MALt-lymphoma] |
| C91.5 | Adult t-cell lymphoma/leukemia (HTLv-1-associated) |
| C91.50 | Adult t-cell lymphoma/leukemia (HTLv-1-associated) not having achieved remission |
| Ocular inflammation | |
| H57.8 | Other specified disorders of eye and adnexa |
| T86.840 | Corneal transplant rejection |
| T86.8401 | Corneal transplant rejection, right eye |
| T86.8402 | Corneal transplant rejection, left eye |
| T86.8403 | Corneal transplant rejection, bilateral |
| T86.8409 | Corneal transplant rejection, unspecified eye |
| T86.841 | Corneal transplant failure |
| T86.8411 | Corneal transplant failure, right eye |
| T86.8412 | Corneal transplant failure, left eye |
| T86.8413 | Corneal transplant failure, bilateral |
| T86.8419 | Corneal transplant failure, unspecified eye |
| T86.842 | Corneal transplant infection |
| T86.8421 | Corneal transplant infection, right eye |
| T86.8422 | Corneal transplant infection, left eye |
| T86.8423 | Corneal transplant infection, bilateral |
| T86.8429 | Corneal transplant infection, unspecified eye |
| Organ transplant rejection | |
| T86.01 | Bone marrow transplant rejection |
| T86.11 | Kidney transplant rejection |
| T86.21 | Heart transplant rejection |
| T86.31 | Heart-lung transplant rejection |
| T86.41 | Liver transplant rejection |
| T86.810 | Lung transplant rejection |
| T86.820 | Skin graft (allograft) rejection |
| T86.830 | Bone graft rejection |
| T86.840 | Corneal transplant rejection |
| T86.850 | Intestine transplant rejection |
| T86.890 | Other transplanted tissue rejection |
| T86.91 | Unspecified transplanted organ and tissue rejection |
| Pemphigus | |
| L10 | Pemphigus |
| L10.0 | Pemphigus vulgaris |
| L10.1 | Pemphigus vegetans |
| L10.2 | Pemphigus foliaceous |
| L10.3 | Brazilian pemphigus [fogo selvagem] |
| L10.4 | Pemphigus erythematosus |
| L10.5 | Drug-induced pemphigus |
| L10.8 | Other pemphigus |
| L10.81 | Paraneoplastic pemphigus |
| L10.89 | Other pemphigus |
| L10.9 | Pemphigus, unspecified |
| Post traumatic osteoarthritis | |
| M16.4 | Bilateral post-traumatic osteoarthritis of hip |
| M16.5 | Unilateral post-traumatic osteoarthritis of hip |
| M16.50 | Unilateral post-traumatic osteoarthritis, unspecified hip |
| M16.51 | Unilateral post-traumatic osteoarthritis, right hip |
| M16.52 | Unilateral post-traumatic osteoarthritis, left hip |
| M17.2 | Bilateral post-traumatic osteoarthritis of knee |
| M17.3 | Unilateral post-traumatic osteoarthritis of knee |
| M17.30 | Unilateral post-traumatic osteoarthritis, unspecified knee |
| M17.31 | Unilateral post-traumatic osteoarthritis, right knee |
| M17.32 | Unilateral post-traumatic osteoarthritis, left knee |
| M18.2 | Bilateral post-traumatic osteoarthritis of first carpometacarpal joints |
| M18.3 | Unilateral post-traumatic osteoarthritis of first carpometacarpal joint |
| M18.30 | Unilateral post-traumatic osteoarthritis of first carpometacarpal joint, unspecified hand |
| M18.31 | Unilateral post-traumatic osteoarthritis of first carpometacarpal joint, right hand |
| M18.32 | Unilateral post-traumatic osteoarthritis of first carpometacarpal joint, left hand |
| M19.1 | Post-traumatic osteoarthritis of other joints |
| M19.11 | Post-traumatic osteoarthritis, shoulder |
| M19.111 | Post-traumatic osteoarthritis, right shoulder |
| M19.112 | Post-traumatic osteoarthritis, left shoulder |
| M19.119 | Post-traumatic osteoarthritis, unspecified shoulder |
| M19.12 | Post-traumatic osteoarthritis, elbow |
| M19.121 | Post-traumatic osteoarthritis, right elbow |
| M19.122 | Post-traumatic osteoarthritis, left elbow |
| M19.129 | Post-traumatic osteoarthritis, unspecified elbow |
| M19.13 | Post-traumatic osteoarthritis, wrist |
| M19.131 | Post-traumatic osteoarthritis, right wrist |
| M19.132 | Post-traumatic osteoarthritis, left wrist |
| M19.139 | Post-traumatic osteoarthritis, unspecified wrist |
| M19.14 | Post-traumatic osteoarthritis, hand |
| M19.141 | Post-traumatic osteoarthritis, right hand |
| M19.142 | Post-traumatic osteoarthritis, left hand |
| M19.149 | Post-traumatic osteoarthritis, unspecified hand |
| M19.17 | Post-traumatic osteoarthritis, ankle and foot |
| M19.171 | Post-traumatic osteoarthritis, right ankle and foot |
| M19.172 | Post-traumatic osteoarthritis, left ankle and foot |
| M19.179 | Post-traumatic osteoarthritis, unspecified ankle and foot |
| M19.19 | Post-traumatic osteoarthritis, other specified site |
| M19.92 | Post-traumatic osteoarthritis, unspecified site |
| Primary adrenocortical insufficiency | |
| E27.1 | Primary adrenocortical insufficiency |
| Psoriasis | |
| L40 | Psoriasis |
| L40.0 | Psoriasis vulgaris |
| L40.1 | Generalized pustular psoriasis |
| L40.2 | Acrodermatitis continua |
| L40.3 | Pustulosis palmaris et plantaris |
| L40.4 | Guttate psoriasis |
| L40.5 | Arthropathic psoriasis |
| L40.50 | Arthropathic psoriasis, unspecified |
| L40.51 | Distal interphalangeal psoriatic arthropathy |
| L40.52 | Psoriatic arthritis mutilans |
| L40.53 | Psoriatic spondylitis |
| L40.54 | Psoriatic juvenile arthropathy |
| L40.59 | Other psoriatic arthropathy |
| L40.8 | Other psoriasis |
| L40.9 | Psoriasis, unspecified |
| Psoriatic arthritis | |
| L40.5 | Arthropathic psoriasis |
| L40.50 | Arthropathic psoriasis, unspecified |
| L40.51 | Distal interphalangeal psoriatic arthropathy |
| L40.52 | Psoriatic arthritis mutilans |
| L40.53 | Psoriatic spondylitis |
| L40.54 | Psoriatic juvenile arthropathy |
| L40.59 | Other psoriatic arthropathy |
| Rheumatoid arthritis | |
| M05 | Rheumatoid arthritis with rheumatoid factor |
| M05.0 | Felty's syndrome |
| M05.00 | Felty's syndrome, unspecified site |
| M05.01 | Felty's syndrome, shoulder |
| M05.011 | Felty's syndrome, right shoulder |
| M05.012 | Felty's syndrome, left shoulder |
| M05.019 | Felty's syndrome, unspecified shoulder |
| M05.02 | Felty's syndrome, elbow |
| M05.021 | Felty's syndrome, right elbow |
| M05.022 | Felty's syndrome, left elbow |
| M05.029 | Felty's syndrome, unspecified elbow |
| M05.03 | Felty's syndrome, wrist |
| M05.031 | Felty's syndrome, right wrist |
| M05.032 | Felty's syndrome, left wrist |
| M05.039 | Felty's syndrome, unspecified wrist |
| M05.04 | Felty's syndrome, hand |
| M05.041 | Felty's syndrome, right hand |
| M05.042 | Felty's syndrome, left hand |
| M05.049 | Felty's syndrome, unspecified hand |
| M05.05 | Felty's syndrome, hip |
| M05.051 | Felty's syndrome, right hip |
| M05.052 | Felty's syndrome, left hip |
| M05.059 | Felty's syndrome, unspecified hip |
| M05.06 | Felty's syndrome, knee |
| M05.061 | Felty's syndrome, right knee |
| M05.062 | Felty's syndrome, left knee |
| M05.069 | Felty's syndrome, unspecified knee |
| M05.07 | Felty's syndrome, ankle and foot |
| M05.071 | Felty's syndrome, right ankle and foot |
| M05.072 | Felty's syndrome, left ankle and foot |
| M05.079 | Felty's syndrome, unspecified ankle and foot |
| M05.09 | Felty's syndrome, multiple sites |
| M05.1 | Rheumatoid lung disease with rheumatoid arthritis |
| M05.10 | Rheumatoid lung disease with rheumatoid arthritis of unspecified site |
| M05.11 | Rheumatoid lung disease with rheumatoid arthritis of shoulder |
| M05.111 | Rheumatoid lung disease with rheumatoid arthritis of right shoulder |
| M05.112 | Rheumatoid lung disease with rheumatoid arthritis of left shoulder |
| M05.119 | Rheumatoid lung disease with rheumatoid arthritis of unspecified shoulder |
| M05.12 | Rheumatoid lung disease with rheumatoid arthritis of elbow |
| M05.121 | Rheumatoid lung disease with rheumatoid arthritis of right elbow |
| M05.122 | Rheumatoid lung disease with rheumatoid arthritis of left elbow |
| M05.129 | Rheumatoid lung disease with rheumatoid arthritis of unspecified elbow |
| M05.13 | Rheumatoid lung disease with rheumatoid arthritis of wrist |
| M05.131 | Rheumatoid lung disease with rheumatoid arthritis of right wrist |
| M05.132 | Rheumatoid lung disease with rheumatoid arthritis of left wrist |
| M05.139 | Rheumatoid lung disease with rheumatoid arthritis of unspecified wrist |
| M05.14 | Rheumatoid lung disease with rheumatoid arthritis of hand |
| M05.141 | Rheumatoid lung disease with rheumatoid arthritis of right hand |
| M05.142 | Rheumatoid lung disease with rheumatoid arthritis of left hand |
| M05.149 | Rheumatoid lung disease with rheumatoid arthritis of unspecified hand |
| M05.15 | Rheumatoid lung disease with rheumatoid arthritis of hip |
| M05.151 | Rheumatoid lung disease with rheumatoid arthritis of right hip |
| M05.152 | Rheumatoid lung disease with rheumatoid arthritis of left hip |
| M05.159 | Rheumatoid lung disease with rheumatoid arthritis of unspecified hip |
| M05.16 | Rheumatoid lung disease with rheumatoid arthritis of knee |
| M05.161 | Rheumatoid lung disease with rheumatoid arthritis of right knee |
| M05.162 | Rheumatoid lung disease with rheumatoid arthritis of left knee |
| M05.169 | Rheumatoid lung disease with rheumatoid arthritis of unspecified knee |
| M05.17 | Rheumatoid lung disease with rheumatoid arthritis of ankle and foot |
| M05.171 | Rheumatoid lung disease with rheumatoid arthritis of right ankle and foot |
| M05.172 | Rheumatoid lung disease with rheumatoid arthritis of left ankle and foot |
| M05.179 | Rheumatoid lung disease with rheumatoid arthritis of unspecified ankle and foot |
| M05.19 | Rheumatoid lung disease with rheumatoid arthritis of multiple sites |
| M05.2 | Rheumatoid vasculitis with rheumatoid arthritis |
| M05.20 | Rheumatoid vasculitis with rheumatoid arthritis of unspecified site |
| M05.21 | Rheumatoid vasculitis with rheumatoid arthritis of shoulder |
| M05.211 | Rheumatoid vasculitis with rheumatoid arthritis of right shoulder |
| M05.212 | Rheumatoid vasculitis with rheumatoid arthritis of left shoulder |
| M05.219 | Rheumatoid vasculitis with rheumatoid arthritis of unspecified shoulder |
| M05.22 | Rheumatoid vasculitis with rheumatoid arthritis of elbow |
| M05.221 | Rheumatoid vasculitis with rheumatoid arthritis of right elbow |
| M05.222 | Rheumatoid vasculitis with rheumatoid arthritis of left elbow |
| M05.229 | Rheumatoid vasculitis with rheumatoid arthritis of unspecified elbow |
| M05.23 | Rheumatoid vasculitis with rheumatoid arthritis of wrist |
| M05.231 | Rheumatoid vasculitis with rheumatoid arthritis of right wrist |
| M05.232 | Rheumatoid vasculitis with rheumatoid arthritis of left wrist |
| M05.239 | Rheumatoid vasculitis with rheumatoid arthritis of unspecified wrist |
| M05.24 | Rheumatoid vasculitis with rheumatoid arthritis of hand |
| M05.241 | Rheumatoid vasculitis with rheumatoid arthritis of right hand |
| M05.242 | Rheumatoid vasculitis with rheumatoid arthritis of left hand |
| M05.249 | Rheumatoid vasculitis with rheumatoid arthritis of unspecified hand |
| M05.25 | Rheumatoid vasculitis with rheumatoid arthritis of hip |
| M05.251 | Rheumatoid vasculitis with rheumatoid arthritis of right hip |
| M05.252 | Rheumatoid vasculitis with rheumatoid arthritis of left hip |
| M05.259 | Rheumatoid vasculitis with rheumatoid arthritis of unspecified hip |
| M05.26 | Rheumatoid vasculitis with rheumatoid arthritis of knee |
| M05.261 | Rheumatoid vasculitis with rheumatoid arthritis of right knee |
| M05.262 | Rheumatoid vasculitis with rheumatoid arthritis of left knee |
| M05.269 | Rheumatoid vasculitis with rheumatoid arthritis of unspecified knee |
| M05.27 | Rheumatoid vasculitis with rheumatoid arthritis of ankle and foot |
| M05.271 | Rheumatoid vasculitis with rheumatoid arthritis of right ankle and foot |
| M05.272 | Rheumatoid vasculitis with rheumatoid arthritis of left ankle and foot |
| M05.279 | Rheumatoid vasculitis with rheumatoid arthritis of unspecified ankle and foot |
| M05.29 | Rheumatoid vasculitis with rheumatoid arthritis of multiple sites |
| M05.3 | Rheumatoid heart disease with rheumatoid arthritis |
| M05.30 | Rheumatoid heart disease with rheumatoid arthritis of unspecified site |
| M05.31 | Rheumatoid heart disease with rheumatoid arthritis of shoulder |
| M05.311 | Rheumatoid heart disease with rheumatoid arthritis of right shoulder |
| M05.312 | Rheumatoid heart disease with rheumatoid arthritis of left shoulder |
| M05.319 | Rheumatoid heart disease with rheumatoid arthritis of unspecified shoulder |
| M05.32 | Rheumatoid heart disease with rheumatoid arthritis of elbow |
| M05.321 | Rheumatoid heart disease with rheumatoid arthritis of right elbow |
| M05.322 | Rheumatoid heart disease with rheumatoid arthritis of left elbow |
| M05.329 | Rheumatoid heart disease with rheumatoid arthritis of unspecified elbow |
| M05.33 | Rheumatoid heart disease with rheumatoid arthritis of wrist |
| M05.331 | Rheumatoid heart disease with rheumatoid arthritis of right wrist |
| M05.332 | Rheumatoid heart disease with rheumatoid arthritis of left wrist |
| M05.339 | Rheumatoid heart disease with rheumatoid arthritis of unspecified wrist |
| M05.34 | Rheumatoid heart disease with rheumatoid arthritis of hand |
| M05.341 | Rheumatoid heart disease with rheumatoid arthritis of right hand |
| M05.342 | Rheumatoid heart disease with rheumatoid arthritis of left hand |
| M05.349 | Rheumatoid heart disease with rheumatoid arthritis of unspecified hand |
| M05.35 | Rheumatoid heart disease with rheumatoid arthritis of hip |
| M05.351 | Rheumatoid heart disease with rheumatoid arthritis of right hip |
| M05.352 | Rheumatoid heart disease with rheumatoid arthritis of left hip |
| M05.359 | Rheumatoid heart disease with rheumatoid arthritis of unspecified hip |
| M05.36 | Rheumatoid heart disease with rheumatoid arthritis of knee |
| M05.361 | Rheumatoid heart disease with rheumatoid arthritis of right knee |
| M05.362 | Rheumatoid heart disease with rheumatoid arthritis of left knee |
| M05.369 | Rheumatoid heart disease with rheumatoid arthritis of unspecified knee |
| M05.37 | Rheumatoid heart disease with rheumatoid arthritis of ankle and foot |
| M05.371 | Rheumatoid heart disease with rheumatoid arthritis of right ankle and foot |
| M05.372 | Rheumatoid heart disease with rheumatoid arthritis of left ankle and foot |
| M05.379 | Rheumatoid heart disease with rheumatoid arthritis of unspecified ankle and foot |
| M05.39 | Rheumatoid heart disease with rheumatoid arthritis of multiple sites |
| M05.4 | Rheumatoid myopathy with rheumatoid arthritis |
| M05.40 | Rheumatoid myopathy with rheumatoid arthritis of unspecified site |
| M05.41 | Rheumatoid myopathy with rheumatoid arthritis of shoulder |
| M05.411 | Rheumatoid myopathy with rheumatoid arthritis of right shoulder |
| M05.412 | Rheumatoid myopathy with rheumatoid arthritis of left shoulder |
| M05.419 | Rheumatoid myopathy with rheumatoid arthritis of unspecified shoulder |
| M05.42 | Rheumatoid myopathy with rheumatoid arthritis of elbow |
| M05.421 | Rheumatoid myopathy with rheumatoid arthritis of right elbow |
| M05.422 | Rheumatoid myopathy with rheumatoid arthritis of left elbow |
| M05.429 | Rheumatoid myopathy with rheumatoid arthritis of unspecified elbow |
| M05.43 | Rheumatoid myopathy with rheumatoid arthritis of wrist |
| M05.431 | Rheumatoid myopathy with rheumatoid arthritis of right wrist |
| M05.432 | Rheumatoid myopathy with rheumatoid arthritis of left wrist |
| M05.439 | Rheumatoid myopathy with rheumatoid arthritis of unspecified wrist |
| M05.44 | Rheumatoid myopathy with rheumatoid arthritis of hand |
| M05.441 | Rheumatoid myopathy with rheumatoid arthritis of right hand |
| M05.442 | Rheumatoid myopathy with rheumatoid arthritis of left hand |
| M05.449 | Rheumatoid myopathy with rheumatoid arthritis of unspecified hand |
| M05.45 | Rheumatoid myopathy with rheumatoid arthritis of hip |
| M05.451 | Rheumatoid myopathy with rheumatoid arthritis of right hip |
| M05.452 | Rheumatoid myopathy with rheumatoid arthritis of left hip |
| M05.459 | Rheumatoid myopathy with rheumatoid arthritis of unspecified hip |
| M05.46 | Rheumatoid myopathy with rheumatoid arthritis of knee |
| M05.461 | Rheumatoid myopathy with rheumatoid arthritis of right knee |
| M05.462 | Rheumatoid myopathy with rheumatoid arthritis of left knee |
| M05.469 | Rheumatoid myopathy with rheumatoid arthritis of unspecified knee |
| M05.47 | Rheumatoid myopathy with rheumatoid arthritis of ankle and foot |
| M05.471 | Rheumatoid myopathy with rheumatoid arthritis of right ankle and foot |
| M05.472 | Rheumatoid myopathy with rheumatoid arthritis of left ankle and foot |
| M05.479 | Rheumatoid myopathy with rheumatoid arthritis of unspecified ankle and foot |
| M05.49 | Rheumatoid myopathy with rheumatoid arthritis of multiple sites |
| M05.5 | Rheumatoid polyneuropathy with rheumatoid arthritis |
| M05.50 | Rheumatoid polyneuropathy with rheumatoid arthritis of unspecified site |
| M05.51 | Rheumatoid polyneuropathy with rheumatoid arthritis of shoulder |
| M05.511 | Rheumatoid polyneuropathy with rheumatoid arthritis of right shoulder |
| M05.512 | Rheumatoid polyneuropathy with rheumatoid arthritis of left shoulder |
| M05.519 | Rheumatoid polyneuropathy with rheumatoid arthritis of unspecified shoulder |
| M05.52 | Rheumatoid polyneuropathy with rheumatoid arthritis of elbow |
| M05.521 | Rheumatoid polyneuropathy with rheumatoid arthritis of right elbow |
| M05.522 | Rheumatoid polyneuropathy with rheumatoid arthritis of left elbow |
| M05.529 | Rheumatoid polyneuropathy with rheumatoid arthritis of unspecified elbow |
| M05.53 | Rheumatoid polyneuropathy with rheumatoid arthritis of wrist |
| M05.531 | Rheumatoid polyneuropathy with rheumatoid arthritis of right wrist |
| M05.532 | Rheumatoid polyneuropathy with rheumatoid arthritis of left wrist |
| M05.539 | Rheumatoid polyneuropathy with rheumatoid arthritis of unspecified wrist |
| M05.54 | Rheumatoid polyneuropathy with rheumatoid arthritis of hand |
| M05.541 | Rheumatoid polyneuropathy with rheumatoid arthritis of right hand |
| M05.542 | Rheumatoid polyneuropathy with rheumatoid arthritis of left hand |
| M05.549 | Rheumatoid polyneuropathy with rheumatoid arthritis of unspecified hand |
| M05.55 | Rheumatoid polyneuropathy with rheumatoid arthritis of hip |
| M05.551 | Rheumatoid polyneuropathy with rheumatoid arthritis of right hip |
| M05.552 | Rheumatoid polyneuropathy with rheumatoid arthritis of left hip |
| M05.559 | Rheumatoid polyneuropathy with rheumatoid arthritis of unspecified hip |
| M05.56 | Rheumatoid polyneuropathy with rheumatoid arthritis of knee |
| M05.561 | Rheumatoid polyneuropathy with rheumatoid arthritis of right knee |
| M05.562 | Rheumatoid polyneuropathy with rheumatoid arthritis of left knee |
| M05.569 | Rheumatoid polyneuropathy with rheumatoid arthritis of unspecified knee |
| M05.57 | Rheumatoid polyneuropathy with rheumatoid arthritis of ankle and foot |
| M05.571 | Rheumatoid polyneuropathy with rheumatoid arthritis of right ankle and foot |
| M05.572 | Rheumatoid polyneuropathy with rheumatoid arthritis of left ankle and foot |
| M05.579 | Rheumatoid polyneuropathy with rheumatoid arthritis of unspecified ankle and foot |
| M05.59 | Rheumatoid polyneuropathy with rheumatoid arthritis of multiple sites |
| M05.6 | Rheumatoid arthritis with involvement of other organs and systems |
| M05.60 | Rheumatoid arthritis of unspecified site with involvement of other organs and systems |
| M05.61 | Rheumatoid arthritis of shoulder with involvement of other organs and systems |
| M05.611 | Rheumatoid arthritis of right shoulder with involvement of other organs and systems |
| M05.612 | Rheumatoid arthritis of left shoulder with involvement of other organs and systems |
| M05.619 | Rheumatoid arthritis of unspecified shoulder with involvement of other organs and systems |
| M05.62 | Rheumatoid arthritis of elbow with involvement of other organs and systems |
| M05.621 | Rheumatoid arthritis of right elbow with involvement of other organs and systems |
| M05.622 | Rheumatoid arthritis of left elbow with involvement of other organs and systems |
| M05.629 | Rheumatoid arthritis of unspecified elbow with involvement of other organs and systems |
| M05.63 | Rheumatoid arthritis of wrist with involvement of other organs and systems |
| M05.631 | Rheumatoid arthritis of right wrist with involvement of other organs and systems |
| M05.632 | Rheumatoid arthritis of left wrist with involvement of other organs and systems |
| M05.639 | Rheumatoid arthritis of unspecified wrist with involvement of other organs and systems |
| M05.64 | Rheumatoid arthritis of hand with involvement of other organs and systems |
| M05.641 | Rheumatoid arthritis of right hand with involvement of other organs and systems |
| M05.642 | Rheumatoid arthritis of left hand with involvement of other organs and systems |
| M05.649 | Rheumatoid arthritis of unspecified hand with involvement of other organs and systems |
| M05.65 | Rheumatoid arthritis of hip with involvement of other organs and systems |
| M05.651 | Rheumatoid arthritis of right hip with involvement of other organs and systems |
| M05.652 | Rheumatoid arthritis of left hip with involvement of other organs and systems |
| M05.659 | Rheumatoid arthritis of unspecified hip with involvement of other organs and systems |
| M05.66 | Rheumatoid arthritis of knee with involvement of other organs and systems |
| M05.661 | Rheumatoid arthritis of right knee with involvement of other organs and systems |
| M05.662 | Rheumatoid arthritis of left knee with involvement of other organs and systems |
| M05.669 | Rheumatoid arthritis of unspecified knee with involvement of other organs and systems |
| M05.67 | Rheumatoid arthritis of ankle and foot with involvement of other organs and systems |
| M05.671 | Rheumatoid arthritis of right ankle and foot with involvement of other organs and systems |
| M05.672 | Rheumatoid arthritis of left ankle and foot with involvement of other organs and systems |
| M05.679 | Rheumatoid arthritis of unspecified ankle and foot with involvement of other organs and systems |
| M05.69 | Rheumatoid arthritis of multiple sites with involvement of other organs and systems |
| M05.7 | Rheumatoid arthritis with rheumatoid factor without organ or systems involvement |
| M05.70 | Rheumatoid arthritis with rheumatoid factor of unspecified site without organ or systems involvement |
| M05.71 | Rheumatoid arthritis with rheumatoid factor of shoulder without organ or systems involvement |
| M05.711 | Rheumatoid arthritis with rheumatoid factor of right shoulder without organ or systems involvement |
| M05.712 | Rheumatoid arthritis with rheumatoid factor of left shoulder without organ or systems involvement |
| M05.719 | Rheumatoid arthritis with rheumatoid factor of unspecified shoulder without organ or systems involvement |
| M05.72 | Rheumatoid arthritis with rheumatoid factor of elbow without organ or systems involvement |
| M05.721 | Rheumatoid arthritis with rheumatoid factor of right elbow without organ or systems involvement |
| M05.722 | Rheumatoid arthritis with rheumatoid factor of left elbow without organ or systems involvement |
| M05.729 | Rheumatoid arthritis with rheumatoid factor of unspecified elbow without organ or systems involvement |
| M05.73 | Rheumatoid arthritis with rheumatoid factor of wrist without organ or systems involvement |
| M05.731 | Rheumatoid arthritis with rheumatoid factor of right wrist without organ or systems involvement |
| M05.732 | Rheumatoid arthritis with rheumatoid factor of left wrist without organ or systems involvement |
| M05.739 | Rheumatoid arthritis with rheumatoid factor of unspecified wrist without organ or systems involvement |
| M05.74 | Rheumatoid arthritis with rheumatoid factor of hand without organ or systems involvement |
| M05.741 | Rheumatoid arthritis with rheumatoid factor of right hand without organ or systems involvement |
| M05.742 | Rheumatoid arthritis with rheumatoid factor of left hand without organ or systems involvement |
| M05.749 | Rheumatoid arthritis with rheumatoid factor of unspecified hand without organ or systems involvement |
| M05.75 | Rheumatoid arthritis with rheumatoid factor of hip without organ or systems involvement |
| M05.751 | Rheumatoid arthritis with rheumatoid factor of right hip without organ or systems involvement |
| M05.752 | Rheumatoid arthritis with rheumatoid factor of left hip without organ or systems involvement |
| M05.759 | Rheumatoid arthritis with rheumatoid factor of unspecified hip without organ or systems involvement |
| M05.76 | Rheumatoid arthritis with rheumatoid factor of knee without organ or systems involvement |
| M05.761 | Rheumatoid arthritis with rheumatoid factor of right knee without organ or systems involvement |
| M05.762 | Rheumatoid arthritis with rheumatoid factor of left knee without organ or systems involvement |
| M05.769 | Rheumatoid arthritis with rheumatoid factor of unspecified knee without organ or systems involvement |
| M05.77 | Rheumatoid arthritis with rheumatoid factor of ankle and foot without organ or systems involvement |
| M05.771 | Rheumatoid arthritis with rheumatoid factor of right ankle and foot without organ or systems involvement |
| M05.772 | Rheumatoid arthritis with rheumatoid factor of left ankle and foot without organ or systems involvement |
| M05.779 | Rheumatoid arthritis with rheumatoid factor of unspecified ankle and foot without organ or systems involvement |
| M05.79 | Rheumatoid arthritis with rheumatoid factor of multiple sites without organ or systems involvement |
| M05.7A | Rheumatoid arthritis with rheumatoid factor of other specified site without organ or systems involvement |
| M05.8 | Other rheumatoid arthritis with rheumatoid factor |
| M05.80 | Other rheumatoid arthritis with rheumatoid factor of unspecified site |
| M05.81 | Other rheumatoid arthritis with rheumatoid factor of shoulder |
| M05.811 | Other rheumatoid arthritis with rheumatoid factor of right shoulder |
| M05.812 | Other rheumatoid arthritis with rheumatoid factor of left shoulder |
| M05.819 | Other rheumatoid arthritis with rheumatoid factor of unspecified shoulder |
| M05.82 | Other rheumatoid arthritis with rheumatoid factor of elbow |
| M05.821 | Other rheumatoid arthritis with rheumatoid factor of right elbow |
| M05.822 | Other rheumatoid arthritis with rheumatoid factor of left elbow |
| M05.829 | Other rheumatoid arthritis with rheumatoid factor of unspecified elbow |
| M05.83 | Other rheumatoid arthritis with rheumatoid factor of wrist |
| M05.831 | Other rheumatoid arthritis with rheumatoid factor of right wrist |
| M05.832 | Other rheumatoid arthritis with rheumatoid factor of left wrist |
| M05.839 | Other rheumatoid arthritis with rheumatoid factor of unspecified wrist |
| M05.84 | Other rheumatoid arthritis with rheumatoid factor of hand |
| M05.841 | Other rheumatoid arthritis with rheumatoid factor of right hand |
| M05.842 | Other rheumatoid arthritis with rheumatoid factor of left hand |
| M05.849 | Other rheumatoid arthritis with rheumatoid factor of unspecified hand |
| M05.85 | Other rheumatoid arthritis with rheumatoid factor of hip |
| M05.851 | Other rheumatoid arthritis with rheumatoid factor of right hip |
| M05.852 | Other rheumatoid arthritis with rheumatoid factor of left hip |
| M05.859 | Other rheumatoid arthritis with rheumatoid factor of unspecified hip |
| M05.86 | Other rheumatoid arthritis with rheumatoid factor of knee |
| M05.861 | Other rheumatoid arthritis with rheumatoid factor of right knee |
| M05.862 | Other rheumatoid arthritis with rheumatoid factor of left knee |
| M05.869 | Other rheumatoid arthritis with rheumatoid factor of unspecified knee |
| M05.87 | Other rheumatoid arthritis with rheumatoid factor of ankle and foot |
| M05.871 | Other rheumatoid arthritis with rheumatoid factor of right ankle and foot |
| M05.872 | Other rheumatoid arthritis with rheumatoid factor of left ankle and foot |
| M05.879 | Other rheumatoid arthritis with rheumatoid factor of unspecified ankle and foot |
| M05.89 | Other rheumatoid arthritis with rheumatoid factor of multiple sites |
| M05.8A | Other rheumatoid arthritis with rheumatoid factor of other specified site |
| M05.9 | Rheumatoid arthritis with rheumatoid factor, unspecified |
| M06 | Other rheumatoid arthritis |
| M06.0 | Rheumatoid arthritis without rheumatoid factor |
| M06.00 | Rheumatoid arthritis without rheumatoid factor, unspecified site |
| M06.01 | Rheumatoid arthritis without rheumatoid factor, shoulder |
| M06.011 | Rheumatoid arthritis without rheumatoid factor, right shoulder |
| M06.012 | Rheumatoid arthritis without rheumatoid factor, left shoulder |
| M06.019 | Rheumatoid arthritis without rheumatoid factor, unspecified shoulder |
| M06.02 | Rheumatoid arthritis without rheumatoid factor, elbow |
| M06.021 | Rheumatoid arthritis without rheumatoid factor, right elbow |
| M06.022 | Rheumatoid arthritis without rheumatoid factor, left elbow |
| M06.029 | Rheumatoid arthritis without rheumatoid factor, unspecified elbow |
| M06.03 | Rheumatoid arthritis without rheumatoid factor, wrist |
| M06.031 | Rheumatoid arthritis without rheumatoid factor, right wrist |
| M06.032 | Rheumatoid arthritis without rheumatoid factor, left wrist |
| M06.039 | Rheumatoid arthritis without rheumatoid factor, unspecified wrist |
| M06.04 | Rheumatoid arthritis without rheumatoid factor, hand |
| M06.041 | Rheumatoid arthritis without rheumatoid factor, right hand |
| M06.042 | Rheumatoid arthritis without rheumatoid factor, left hand |
| M06.049 | Rheumatoid arthritis without rheumatoid factor, unspecified hand |
| M06.05 | Rheumatoid arthritis without rheumatoid factor, hip |
| M06.051 | Rheumatoid arthritis without rheumatoid factor, right hip |
| M06.052 | Rheumatoid arthritis without rheumatoid factor, left hip |
| M06.059 | Rheumatoid arthritis without rheumatoid factor, unspecified hip |
| M06.06 | Rheumatoid arthritis without rheumatoid factor, knee |
| M06.061 | Rheumatoid arthritis without rheumatoid factor, right knee |
| M06.062 | Rheumatoid arthritis without rheumatoid factor, left knee |
| M06.069 | Rheumatoid arthritis without rheumatoid factor, unspecified knee |
| M06.07 | Rheumatoid arthritis without rheumatoid factor, ankle and foot |
| M06.071 | Rheumatoid arthritis without rheumatoid factor, right ankle and foot |
| M06.072 | Rheumatoid arthritis without rheumatoid factor, left ankle and foot |
| M06.079 | Rheumatoid arthritis without rheumatoid factor, unspecified ankle and foot |
| M06.08 | Rheumatoid arthritis without rheumatoid factor, vertebrae |
| M06.09 | Rheumatoid arthritis without rheumatoid factor, multiple sites |
| M06.0A | Rheumatoid arthritis without rheumatoid factor, other specified site |
| M06.8 | Other specified rheumatoid arthritis |
| M06.80 | Other specified rheumatoid arthritis, unspecified site |
| M06.81 | Other specified rheumatoid arthritis, shoulder |
| M06.811 | Other specified rheumatoid arthritis, right shoulder |
| M06.812 | Other specified rheumatoid arthritis, left shoulder |
| M06.819 | Other specified rheumatoid arthritis, unspecified shoulder |
| M06.82 | Other specified rheumatoid arthritis, elbow |
| M06.821 | Other specified rheumatoid arthritis, right elbow |
| M06.822 | Other specified rheumatoid arthritis, left elbow |
| M06.829 | Other specified rheumatoid arthritis, unspecified elbow |
| M06.83 | Other specified rheumatoid arthritis, wrist |
| M06.831 | Other specified rheumatoid arthritis, right wrist |
| M06.832 | Other specified rheumatoid arthritis, left wrist |
| M06.839 | Other specified rheumatoid arthritis, unspecified wrist |
| M06.84 | Other specified rheumatoid arthritis, hand |
| M06.841 | Other specified rheumatoid arthritis, right hand |
| M06.842 | Other specified rheumatoid arthritis, left hand |
| M06.849 | Other specified rheumatoid arthritis, unspecified hand |
| M06.85 | Other specified rheumatoid arthritis, hip |
| M06.851 | Other specified rheumatoid arthritis, right hip |
| M06.852 | Other specified rheumatoid arthritis, left hip |
| M06.859 | Other specified rheumatoid arthritis, unspecified hip |
| M06.86 | Other specified rheumatoid arthritis, knee |
| M06.861 | Other specified rheumatoid arthritis, right knee |
| M06.862 | Other specified rheumatoid arthritis, left knee |
| M06.869 | Other specified rheumatoid arthritis, unspecified knee |
| M06.87 | Other specified rheumatoid arthritis, ankle and foot |
| M06.871 | Other specified rheumatoid arthritis, right ankle and foot |
| M06.872 | Other specified rheumatoid arthritis, left ankle and foot |
| M06.879 | Other specified rheumatoid arthritis, unspecified ankle and foot |
| M06.88 | Other specified rheumatoid arthritis, vertebrae |
| M06.89 | Other specified rheumatoid arthritis, multiple sites |
| M06.8A | Other specified rheumatoid arthritis, other specified site |
| M06.9 | Rheumatoid arthritis, unspecified |
| Sarcoidosis | |
| D86 | Sarcoidosis |
| D86.0 | Sarcoidosis of lung |
| D86.1 | Sarcoidosis of lymph nodes |
| D86.2 | Sarcoidosis of lung with sarcoidosis of lymph nodes |
| D86.3 | Sarcoidosis of skin |
| D86.8 | Sarcoidosis of other sites |
| D86.81 | Sarcoid meningitis |
| D86.82 | Multiple cranial nerve palsies in sarcoidosis |
| D86.83 | Sarcoid iridocyclitis |
| D86.84 | Sarcoid pyelonephritis |
| D86.85 | Sarcoid myocarditis |
| D86.86 | Sarcoid arthropathy |
| D86.87 | Sarcoid myositis |
| D86.89 | Sarcoidosis of other sites |
| D86.9 | Sarcoidosis, unspecified |
| Serum sickness | |
| T80.6 | Other serum reactions |
| Severe persistent asthma | |
| J45.50 | Severe persistent asthma, uncomplicated |
| Synovitis | |
| M65.4 | Radial styloid tenosynovitis [de quervain] |
| M65.8 | Other synovitis and tenosynovitis |
| M65.80 | Other synovitis and tenosynovitis, unspecified site |
| M65.81 | Other synovitis and tenosynovitis, shoulder |
| M65.811 | Other synovitis and tenosynovitis, right shoulder |
| M65.812 | Other synovitis and tenosynovitis, left shoulder |
| M65.819 | Other synovitis and tenosynovitis, unspecified shoulder |
| M65.82 | Other synovitis and tenosynovitis, upper arm |
| M65.821 | Other synovitis and tenosynovitis, right upper arm |
| M65.822 | Other synovitis and tenosynovitis, left upper arm |
| M65.829 | Other synovitis and tenosynovitis, unspecified upper arm |
| M65.83 | Other synovitis and tenosynovitis, forearm |
| M65.831 | Other synovitis and tenosynovitis, right forearm |
| M65.832 | Other synovitis and tenosynovitis, left forearm |
| M65.839 | Other synovitis and tenosynovitis, unspecified forearm |
| M65.84 | Other synovitis and tenosynovitis, hand |
| M65.841 | Other synovitis and tenosynovitis, right hand |
| M65.842 | Other synovitis and tenosynovitis, left hand |
| M65.849 | Other synovitis and tenosynovitis, unspecified hand |
| M65.85 | Other synovitis and tenosynovitis, thigh |
| M65.851 | Other synovitis and tenosynovitis, right thigh |
| M65.852 | Other synovitis and tenosynovitis, left thigh |
| M65.859 | Other synovitis and tenosynovitis, unspecified thigh |
| M65.86 | Other synovitis and tenosynovitis, lower leg |
| M65.861 | Other synovitis and tenosynovitis, right lower leg |
| M65.862 | Other synovitis and tenosynovitis, left lower leg |
| M65.869 | Other synovitis and tenosynovitis, unspecified lower leg |
| M65.87 | Other synovitis and tenosynovitis, ankle and foot |
| M65.871 | Other synovitis and tenosynovitis, right ankle and foot |
| M65.872 | Other synovitis and tenosynovitis, left ankle and foot |
| M65.879 | Other synovitis and tenosynovitis, unspecified ankle and foot |
| M65.88 | Other synovitis and tenosynovitis, other site |
| M65.89 | Other synovitis and tenosynovitis, multiple sites |
| M65.9 | Synovitis and tenosynovitis, unspecified |
| M65.90 | Unspecified synovitis and tenosynovitis, unspecified site |
| M65.91 | Unspecified synovitis and tenosynovitis, shoulder |
| M65.911 | Unspecified synovitis and tenosynovitis, right shoulder |
| M65.912 | Unspecified synovitis and tenosynovitis, left shoulder |
| M65.919 | Unspecified synovitis and tenosynovitis, unspecified shoulder |
| M65.92 | Unspecified synovitis and tenosynovitis, upper arm |
| M65.921 | Unspecified synovitis and tenosynovitis, right upper arm |
| M65.922 | Unspecified synovitis and tenosynovitis, left upper arm |
| M65.929 | Unspecified synovitis and tenosynovitis, unspecified upper arm |
| M65.93 | Unspecified synovitis and tenosynovitis, forearm |
| M65.931 | Unspecified synovitis and tenosynovitis, right forearm |
| M65.932 | Unspecified synovitis and tenosynovitis, left forearm |
| M65.939 | Unspecified synovitis and tenosynovitis, unspecified forearm |
| M65.94 | Unspecified synovitis and tenosynovitis, hand |
| M65.941 | Unspecified synovitis and tenosynovitis, right hand |
| M65.942 | Unspecified synovitis and tenosynovitis, left hand |
| M65.949 | Unspecified synovitis and tenosynovitis, unspecified hand |
| M65.95 | Unspecified synovitis and tenosynovitis, thigh |
| M65.951 | Unspecified synovitis and tenosynovitis, right thigh |
| M65.952 | Unspecified synovitis and tenosynovitis, left thigh |
| M65.959 | Unspecified synovitis and tenosynovitis, unspecified thigh |
| M65.96 | Unspecified synovitis and tenosynovitis, lower leg |
| M65.961 | Unspecified synovitis and tenosynovitis, right lower leg |
| M65.962 | Unspecified synovitis and tenosynovitis, left lower leg |
| M65.969 | Unspecified synovitis and tenosynovitis, unspecified lower leg |
| M65.97 | Unspecified synovitis and tenosynovitis, ankle and foot |
| M65.971 | Unspecified synovitis and tenosynovitis, right ankle and foot |
| M65.972 | Unspecified synovitis and tenosynovitis, left ankle and foot |
| M65.979 | Unspecified synovitis and tenosynovitis, unspecified ankle and foot |
| M65.98 | Unspecified synovitis and tenosynovitis, other site |
| M65.99 | Unspecified synovitis and tenosynovitis, multiple sites |
| Synovitis due to osteoarthritis | |
| M65.8 | Other synovitis and tenosynovitis |
| M65.80 | Other synovitis and tenosynovitis, unspecified site |
| M65.81 | Other synovitis and tenosynovitis, shoulder |
| M65.811 | Other synovitis and tenosynovitis, right shoulder |
| M65.812 | Other synovitis and tenosynovitis, left shoulder |
| M65.819 | Other synovitis and tenosynovitis, unspecified shoulder |
| M65.82 | Other synovitis and tenosynovitis, upper arm |
| M65.821 | Other synovitis and tenosynovitis, right upper arm |
| M65.822 | Other synovitis and tenosynovitis, left upper arm |
| M65.829 | Other synovitis and tenosynovitis, unspecified upper arm |
| M65.83 | Other synovitis and tenosynovitis, forearm |
| M65.831 | Other synovitis and tenosynovitis, right forearm |
| M65.832 | Other synovitis and tenosynovitis, left forearm |
| M65.839 | Other synovitis and tenosynovitis, unspecified forearm |
| M65.84 | Other synovitis and tenosynovitis, hand |
| M65.841 | Other synovitis and tenosynovitis, right hand |
| M65.842 | Other synovitis and tenosynovitis, left hand |
| M65.849 | Other synovitis and tenosynovitis, unspecified hand |
| M65.85 | Other synovitis and tenosynovitis, thigh |
| M65.851 | Other synovitis and tenosynovitis, right thigh |
| M65.852 | Other synovitis and tenosynovitis, left thigh |
| M65.859 | Other synovitis and tenosynovitis, unspecified thigh |
| M65.86 | Other synovitis and tenosynovitis, lower leg |
| M65.861 | Other synovitis and tenosynovitis, right lower leg |
| M65.862 | Other synovitis and tenosynovitis, left lower leg |
| M65.869 | Other synovitis and tenosynovitis, unspecified lower leg |
| M65.87 | Other synovitis and tenosynovitis, ankle and foot |
| M65.871 | Other synovitis and tenosynovitis, right ankle and foot |
| M65.872 | Other synovitis and tenosynovitis, left ankle and foot |
| M65.879 | Other synovitis and tenosynovitis, unspecified ankle and foot |
| M65.88 | Other synovitis and tenosynovitis, other site |
| M65.89 | Other synovitis and tenosynovitis, multiple sites |
| M65.9 | Synovitis and tenosynovitis, unspecified |
| M65.951 | Unspecified synovitis and tenosynovitis, right thigh |
| M65.952 | Unspecified synovitis and tenosynovitis, left thigh |
| M65.959 | Unspecified synovitis and tenosynovitis, unspecified thigh |
| M65.96 | Unspecified synovitis and tenosynovitis, lower leg |
| M65.961 | Unspecified synovitis and tenosynovitis, right lower leg |
| M65.962 | Unspecified synovitis and tenosynovitis, left lower leg |
| M65.969 | Unspecified synovitis and tenosynovitis, unspecified lower leg |
| M65.97 | Unspecified synovitis and tenosynovitis, ankle and foot |
| M65.971 | Unspecified synovitis and tenosynovitis, right ankle and foot |
| M65.972 | Unspecified synovitis and tenosynovitis, left ankle and foot |
| M65.979 | Unspecified synovitis and tenosynovitis, unspecified ankle and foot |
| M65.98 | Unspecified synovitis and tenosynovitis, other site |
| M65.99 | Unspecified synovitis and tenosynovitis, multiple sites |
| Systemic dermatomyositis | |
| M33 | Dermatopolymyositis |
| M33.0 | Juvenile dermatomyositis |
| M33.00 | Juvenile dermatomyositis, organ involvement unspecified |
| M33.01 | Juvenile dermatomyositis with respiratory involvement |
| M33.02 | Juvenile dermatomyositis with myopathy |
| M33.03 | Juvenile dermatomyositis without myopathy |
| M33.09 | Juvenile dermatomyositis with other organ involvement |
| M33.1 | Other dermatomyositis |
| M33.10 | Other dermatomyositis, organ involvement unspecified |
| M33.11 | Other dermatomyositis with respiratory involvement |
| M33.12 | Other dermatomyositis with myopathy |
| M33.13 | Other dermatomyositis without myopathy |
| M33.19 | Other dermatomyositis with other organ involvement |
| M33.9 | Dermatopolymyositis, unspecified |
| M33.90 | Dermatopolymyositis, unspecified, organ involvement unspecified |
| M33.91 | Dermatopolymyositis, unspecified with respiratory involvement |
| M33.92 | Dermatopolymyositis, unspecified with myopathy |
| M33.93 | Dermatopolymyositis, unspecified without myopathy |
| M33.99 | Dermatopolymyositis, unspecified with other organ involvement |
| M36.0 | Dermato(poly)myositis in neoplastic disease |
| Systemic lupus erythematosus | |
| M32 | Systemic lupus erythematosus (SLe) |
| M32.0 | Drug-induced systemic lupus erythematosus |
| M32.1 | Systemic lupus erythematosus with organ or system involvement |
| M32.10 | Systemic lupus erythematosus, organ or system involvement unspecified |
| M32.11 | Endocarditis in systemic lupus erythematosus |
| M32.12 | Pericarditis in systemic lupus erythematosus |
| M32.13 | Lung involvement in systemic lupus erythematosus |
| M32.14 | Glomerular disease in systemic lupus erythematosus |
| M32.15 | Tubulo-interstitial nephropathy in systemic lupus erythematosus |
| M32.19 | Other organ or system involvement in systemic lupus erythematosus |
| M32.8 | Other forms of systemic lupus erythematosus |
| M32.9 | Systemic lupus erythematosus, unspecified |
| Tendonitis | |
| M75.2 | Bicipital tendinitis |
| M75.20 | Bicipital tendinitis, unspecified shoulder |
| M75.21 | Bicipital tendinitis, right shoulder |
| M75.22 | Bicipital tendinitis, left shoulder |
| M76.0 | Gluteal tendinitis |
| M76.00 | Gluteal tendinitis, unspecified hip |
| M76.01 | Gluteal tendinitis, right hip |
| M76.02 | Gluteal tendinitis, left hip |
| M76.1 | Psoas tendinitis |
| M76.10 | Psoas tendinitis, unspecified hip |
| M76.11 | Psoas tendinitis, right hip |
| M76.12 | Psoas tendinitis, left hip |
| M76.5 | Patellar tendinitis |
| M76.50 | Patellar tendinitis, unspecified knee |
| M76.51 | Patellar tendinitis, right knee |
| M76.52 | Patellar tendinitis, left knee |
| M76.6 | Achilles tendinitis |
| M76.60 | Achilles tendinitis, unspecified leg |
| M76.61 | Achilles tendinitis, right leg |
| M76.62 | Achilles tendinitis, left leg |
| M76.7 | Peroneal tendinitis |
| M76.70 | Peroneal tendinitis, unspecified leg |
| M76.71 | Peroneal tendinitis, right leg |
| M76.72 | Peroneal tendinitis, left leg |
| M76.82 | Posterior tibial tendinitis |
| M76.821 | Posterior tibial tendinitis, right leg |
| M76.822 | Posterior tibial tendinitis, left leg |
| M76.829 | Posterior tibial tendinitis, unspecified leg |
| Tenosynovitis | |
| M65.4 | Radial styloid tenosynovitis [de quervain] |
| M65.8 | Other synovitis and tenosynovitis |
| M65.80 | Other synovitis and tenosynovitis, unspecified site |
| M65.81 | Other synovitis and tenosynovitis, shoulder |
| M65.811 | Other synovitis and tenosynovitis, right shoulder |
| M65.812 | Other synovitis and tenosynovitis, left shoulder |
| M65.819 | Other synovitis and tenosynovitis, unspecified shoulder |
| M65.82 | Other synovitis and tenosynovitis, upper arm |
| M65.821 | Other synovitis and tenosynovitis, right upper arm |
| M65.822 | Other synovitis and tenosynovitis, left upper arm |
| M65.829 | Other synovitis and tenosynovitis, unspecified upper arm |
| M65.83 | Other synovitis and tenosynovitis, forearm |
| M65.831 | Other synovitis and tenosynovitis, right forearm |
| M65.832 | Other synovitis and tenosynovitis, left forearm |
| M65.839 | Other synovitis and tenosynovitis, unspecified forearm |
| M65.84 | Other synovitis and tenosynovitis, hand |
| M65.841 | Other synovitis and tenosynovitis, right hand |
| M65.842 | Other synovitis and tenosynovitis, left hand |
| M65.849 | Other synovitis and tenosynovitis, unspecified hand |
| M65.85 | Other synovitis and tenosynovitis, thigh |
| M65.851 | Other synovitis and tenosynovitis, right thigh |
| M65.852 | Other synovitis and tenosynovitis, left thigh |
| M65.859 | Other synovitis and tenosynovitis, unspecified thigh |
| M65.86 | Other synovitis and tenosynovitis, lower leg |
| M65.861 | Other synovitis and tenosynovitis, right lower leg |
| M65.862 | Other synovitis and tenosynovitis, left lower leg |
| M65.869 | Other synovitis and tenosynovitis, unspecified lower leg |
| M65.87 | Other synovitis and tenosynovitis, ankle and foot |
| M65.871 | Other synovitis and tenosynovitis, right ankle and foot |
| M65.872 | Other synovitis and tenosynovitis, left ankle and foot |
| M65.879 | Other synovitis and tenosynovitis, unspecified ankle and foot |
| M65.88 | Other synovitis and tenosynovitis, other site |
| M65.89 | Other synovitis and tenosynovitis, multiple sites |
| M65.9 | Synovitis and tenosynovitis, unspecified |
| M65.90 | Unspecified synovitis and tenosynovitis, unspecified site |
| M65.91 | Unspecified synovitis and tenosynovitis, shoulder |
| M65.911 | Unspecified synovitis and tenosynovitis, right shoulder |
| M65.912 | Unspecified synovitis and tenosynovitis, left shoulder |
| M65.919 | Unspecified synovitis and tenosynovitis, unspecified shoulder |
| M65.92 | Unspecified synovitis and tenosynovitis, upper arm |
| M65.921 | Unspecified synovitis and tenosynovitis, right upper arm |
| M65.922 | Unspecified synovitis and tenosynovitis, left upper arm |
| M65.929 | Unspecified synovitis and tenosynovitis, unspecified upper arm |
| M65.93 | Unspecified synovitis and tenosynovitis, forearm |
| M65.931 | Unspecified synovitis and tenosynovitis, right forearm |
| M65.932 | Unspecified synovitis and tenosynovitis, left forearm |
| M65.939 | Unspecified synovitis and tenosynovitis, unspecified forearm |
| M65.94 | Unspecified synovitis and tenosynovitis, hand |
| M65.941 | Unspecified synovitis and tenosynovitis, right hand |
| M65.942 | Unspecified synovitis and tenosynovitis, left hand |
| M65.949 | Unspecified synovitis and tenosynovitis, unspecified hand |
| M65.95 | Unspecified synovitis and tenosynovitis, thigh |
| M65.951 | Unspecified synovitis and tenosynovitis, right thigh |
| M65.952 | Unspecified synovitis and tenosynovitis, left thigh |
| M65.959 | Unspecified synovitis and tenosynovitis, unspecified thigh |
| M65.96 | Unspecified synovitis and tenosynovitis, lower leg |
| M65.961 | Unspecified synovitis and tenosynovitis, right lower leg |
| M65.962 | Unspecified synovitis and tenosynovitis, left lower leg |
| M65.969 | Unspecified synovitis and tenosynovitis, unspecified lower leg |
| M65.97 | Unspecified synovitis and tenosynovitis, ankle and foot |
| M65.971 | Unspecified synovitis and tenosynovitis, right ankle and foot |
| M65.972 | Unspecified synovitis and tenosynovitis, left ankle and foot |
| M65.979 | Unspecified synovitis and tenosynovitis, unspecified ankle and foot |
| M65.98 | Unspecified synovitis and tenosynovitis, other site |
| M65.99 | Unspecified synovitis and tenosynovitis, multiple sites |
| Thyroiditis | |
| E06 | Thyroiditis |
| E06.0 | Acute thyroiditis |
| E06.1 | Subacute thyroiditis |
| E06.2 | Chronic thyroiditis with transient thyrotoxicosis |
| E06.3 | Autoimmune thyroiditis |
| E06.4 | Drug-induced thyroiditis |
| E06.5 | Other chronic thyroiditis |
| E06.9 | Thyroiditis, unspecified |
| Trichinosis | |
| B75 | Trichinellosis |
Formulary Reference Tool