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4Because of the advantages of ADTit may be desirable to try patients on this form of therapy who have been on daily corticoids for long periods of timeegpatients with rheumatoid arthritisSince these patients may already have a suppressed HPA axisestablishing them on ADT may be difficult and not always successfulHoweverit is recommended that regular attempts be made to change them overIt may be helpful to triple or even quadruple the daily maintenance dose and administer this every other day rather than just doubling the daily dose if difficulty is encounteredOnce the patient is again controlledan attempt should be made to reduce this dose to a minimum.

Once control has been establishedtwo courses are availableachange to ADT and then gradually reduce the amount of corticoid given every other day orbfollowing control of the disease process reduce the daily dose of corticoid to the lowest effective level as rapidly as possible and then change over to an alternate day scheduleTheoreticallycourseamay be preferable.

Using corticosteroid medications for a long time can make it more difficult for your body to respond to physical stressThereforebefore having surgery or emergency treatmentor if you get a serious illness/injurytell your doctor or dentist that you are using Cheap trimox this medication or have used this medication within the past 12 monthsTell your doctor right away if you develop unusual/extreme tiredness or weight lossIf you will be using this medication for a long timecarry a warning card or medical ID bracelet that identifies your use of this medication.

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