SIGNIFOR Rx

Monitor for hypocortisolism; consider temporary dose reduction, interruption or steroid replacement therapy if occurs. Risk of hyperglycemia; initiate or adjust antidiabetic treatment if occurs; reduce dose or discontinue if remains uncontrolled. Monitor HbA1c or FPG prior to initiation, every week for the first 2–3 months, for 2–4 weeks after dose increase, and thereafter as indicated. Congenital long QT prolongation. Cardiac disease (eg, recent MI, CHF, unstable angina, significant bradycardia). High-grade heart block. Hypokalemia and/or hypomagnesemia; correct and monitor electrolytes prior to starting and during therapy. Monitor liver tests prior to initiation, 1–2 weeks after, monthly for 3 months, then every 6 months thereafter; measure liver enzymes weekly or more frequently as indicated. Discontinue and treat if cholelithiasis complications are suspected. Transsphenoidal surgery. Pituitary irradiation. Monitor baseline ECG, gallbladder ultrasound, pituitary function prior to initiation and periodically during treatment. Premenopausal women: potential for unintended pregnancy due to improved fertility. Pregnancy. Nursing mothers.