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Corticosteroids: (Average) Estrogens have been related to elevated serum concentrations of corticosteroid binding globulin (CBG), resulting in elevated total circulating corticosteroids, though the free concentrations of these hormones may be decrease; the medical significance is not recognized. Estrogens are CYP3A4 substrates and dexamethasone is a CYP3A4 inducer; concomitant use could lower the scientific efficacy of estrogens. Patients ought to be monitored for signs of decreased scientific effects of estrogens (e.g., breakthrough bleeding), oral contraceptives, or non-oral combination contraceptives if these drugs are used together.
As Large Pharma, PBMs and insurers are seeing their annual profits rise into the billions, Individuals continue to pay extra for prescription drugs than any other nation, and drug prices continue to rise comparatively unchecked. Until the pharmacy benefit supervisor business model is extra transparent and carefully aligned with the interests of patients, customers shall be at the mercy of this hidden hand.