Please read this leaflet carefully before you start to take this medicine. If you do not understand it or you want to know more, ask your doctor or pharmacist. Keep the leaflet, you may want to read it again.

The name of your medicine is Cortisyl tablets. Each tablet contains 25mg of the active ingredient, Cortisone Acetate BR

The tablets also contain lactose, maize starch, povidone, soluble starch, colloidal silicon dioxide, magnesium stearate and purified talc.

Cortisyl tablets are available in a pack of 56 tablets.

Cortisone, the active ingredient is a glucocorticoid. This means that it is a type of steroid. This is used as a hormone replacement therapy.

Cortisyl tablets are used to replace the hormone cortisone in your body which will be at a low level if you suffer from Addison’s disease, have had your adrenal glands removed during an operation or if they are damaged.

The Marketing Authorisation for Cortisyl tablets is held by Roussel Laboratories Ltd, 8roadwater Park, North Orbital Road, Denham, Uxbridge, Middlesex, UB9 5HR

It is manufactured by Roussel Laboratories Ltd, Covingham, Swindon, Wiltshire, SN3 58Z.

Your medicine can be used to treat many different conditions, as described above.

Before you take Cortisyl tablets, please read the following questions. If the answer is YES to ANY of these questions, you MUST tell your doctor before taking your medicine.

• Are you pregnant or trying to become pregnant?
• Are you breastfeeding?
• Have you ever had a bad reaction to or are allergic to any of the ingredients in this product?

• Have you ever been, or are you, being treated for tuberculosis?
• Are you epileptic?
• Do you, or does anyone in your family, have diabetes?
• Do you have high blood pressure?
• Do you suffer from kidney, liver or heart problems?
• Do you have osteoporosis (brittle/weak bones)?
• Do you, or does anyone in your family, have glaucoma?
• Do you have, or have had, a stomach ulcer?
• Have you ever had a bad reaction to any steroid before, such as muscle weakness or did your moods change in any way?

Your medicine may interfere with other medicines that you may be taking, such as barbiturates, rifampicin, phenytoin, amphotericin, methotrexate, salicylates (such as aspirin), hypoglycaemic agents (for diabetics and any medicine used to stop your blood cloning easily, for example warfarin. Your doctor will know about these and may change your dose of medication to deal with this.

If you have just had, or are due to have any injections or vaccinations such as those needed for a foreign holiday, you should mention to the nurse or doctor that you are taking Cortisyl tablets.

NOTE: Your doctor may advise you to take this medicine in a different way for example taking a different dose of Cortisyl tablets every other day. Sometimes when you have been taking this medicine for a long time, your dose may need to be changed if you become ill or are to have a surgical operation. Because of this, you should always follow your doctor s advice about how and when to take your medicine and always read the label. Your pharmacist may also help you if you are not sure.

You may be given a blue "steroid card" from either your doctor or pharmacist when you are given your medicine. It is in your best interest to carry the card with you at all times because it contains. as well as your dosage instructions, information which would be very important if you were, for example, to fall ill or be involved in an accident.

If you do forget to take a dose at the correct time, take your Cortisyl tablets as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and carry on as normal. Do not take any extra tablets to make up.

If you accidentally take too many tablets, contact your doctor or the hospital casualty department immediately.

Keep taking your medicine until your doctor tells you to stop.

Have you got a repeat prescription from your doctor? It is very important that you do not stop taking this medicine abruptly. Keep a supply in reserve so that you will not accidentally run out of tablets.

If your doctor tells you that you no longer need to take Cortisyl tablets, follow your doctors advice carefully about how to finish off your course of treatment. Sometimes problems can occur, for example fever, sickness, aching muscles and joints, if you stop them too quickly/abruptly.

Your doctor may put you on a "reducing dose"; this means that the number of tablets that you take is gradually lowered over a period of either days or weeks so that you eventually end up having no tablets to take.

Like all medicines, Cortisyl tablets may occasionally cause you some problems. It affects different people in different ways.

Your medicine may cause you to suffer from stomach, pancreatic or bowel trouble such as a feeling of fullness/being bloated or maybe some pain. If you notice any blood in your stools or vomit you should see your doctor. Sometimes the throat may become very sore. You may find that the inside of your mouth develops white areas on its surface, if this happens, you should see your doctor.

You may find that your appetite increases and that you gain some weight, perhaps around your face. Alternatively, you may find that you lose weight and feel weak. Osteoporosis may occur and sometimes it can become easier to fracture your bones and for your tendons to tear. Sometimes. patients find that their muscles become weaker and smaller so they do not feel as strong as usual.

Women taking this medicine may find that their periods become irregular or stop altogether.

Your hair may grow faster and thicker than before you started this medicine. It has also been noted that some people develop signs of diabetes, for example increased thirst and frequency of going to the toilet. If you are already diabetic, you may find that you need to take more medication to balance the effect of Cortisyl tablets. You should discuss this with your doctor. Children who take this medicine may not grow as quickly as others of their age.

You may find that your blood pressure goes up and that you retain water. It could also be more likely that clots will form in your blood.

If you suffer from epilepsy, your doctor may wish to alter your dose of medication whilst you are taking Cortisyl tablets. This is because the symptoms of your epilepsy may become more prominent.

You may develop skin problems such as acne or find that any wounds or cuts do not heal as quickly as they did before you started this medicine. You may also find that your skin becomes flushed red and thinner than before and that stretch marks may appear.

You may notice that your moods change so that you feel either very happy or very depressed. You could also find it more difficult to fall asleep at night. These tablets affect people in many different ways.

If you find that your eyes are hurting, have any change in vision or that you have a bad headache, especially behind your eyes, you should check with your doctor. This may continue, or start to happen after you have been told to stop taking this medicine.

Cortisyl tablets can lower your resistance to infections. This means that patients sometimes find that they catch a cold or symptoms of a previous infection such as tuberculosis (TB), occur more easily than they did before they started to take this medicine.

If you have any other problems and think that your medicine may be causing them, tell your doctor or pharmacist.

Do not use your medicine after the date shown on the label, (expiry date).

Keep this medicine at normal room temperature (25°C/77°F), in a dry place and protect it from light. Keep it in the pack in which it was given to you. Do not transfer your medicine to another container.

Keep this medicine in a safe place where children can not get at it. Your medicines could harm them.

If your doctor decides that you no longer need to take Cortisyl tablets and that your treatment is complete, return any left over medicine to a pharmacist. Only keep it if the doctor tells you to.

This leaflet was revised September 1995.