Criteria 2: Potentially inappropriate medication use in older adults due to drug–disease or drug–syndrome interactions that may exacerbate the disease or syndrome. (Table 3)
Comments
corticosteroids (oral and parenteral) Excludes inhaled and topical forms. Oral and parenteral corticosteroids may be required for conditions such as exacerbation of COPD but should be prescribed in the lowest effective dose and for the shortest possible duration.
Drug(s) ⇆ disease or syndrome
corticosteroids ⇄ Delirium
Rationale
Avoid in older adults with or at high risk of delirium because of the potential of inducing or worsening delirium. If needed, use the lowest possible dose for the shortest duration and monitor for delirium.
Recommendation
Avoid, except in situations listed under the rationale statement.
Quality of evidence: Moderate, Strength of Recommendation: Strong
Last updated: Sep. 19, 2025
Look-Alike/Sound-Alike methylPREDNISolone confused with medroxyPROGESTERone, methylTESTOSTERone
If needed, use the lowest possible dose for the shortest duration and monitor for delirium.