Steroids (sometimes called cortisone or corticosteroids) are naturally occurring substances in the body. Steroids diminish inflammation, suppress the immune system, and prevent DNA replication, as well as a molecule called histamine from being produced (released during an allergic reaction).
Although steroid-usa medications are synthetic, they are similar to natural hormones.
Corticosteroids are steroid drugs that are used to treat disease. They are not the same as anabolic steroids, which are used by some sportsmen and bodybuilders. The effects of anabolic steroids vary greatly.
Steroids come in tablet form, soluble tablet form, liquid form (solutions), cream form, ointment form, inhaler form, and injectable form.
Oral steroid classifications
Glucocorticoids are the most regularly utilized group. Steroids in this category include:
Mineralocorticoids are the other group. The most frequent form is fludrocortisone, which is used to replace steroids that the body does not produce on its own.
They are often in the form of tablets, although some are also available as dispersible (dissolvable) tablets or solutions.
What are the most common uses for oral steroids?
Oral steroids are used for a variety of ailments. Here are a few examples:
- Crohn’s disease and ulcerative colitis are examples of inflammatory bowel illnesses.
- Systemic lupus erythematosus (SLE) and autoimmune hepatitis are examples of autoimmune disorders.
- Multiple MS relapses are a common occurrence.
- Muscle and joint disorders (for example, rheumatoid arthritis, polymyalgia rheumatica).
- COPD stands for chronic obstructive pulmonary disease (COPD).
Oral steroids are also used to treat cancer-related symptoms. They can also be recommended as a replacement medication for those who don’t have enough of their own natural hormones (as in Addison’s disease, congenital adrenal hyperplasia, and hypopituitarism).
What is the recommended dosage?
Individual steroids and the illness for which they are administered will have different effects. For short courses, a rather high dose is frequently administered every day for a few days or a week, and then abruptly terminated at the conclusion. If the dose is taken for more than three weeks, it must be gradually reduced.
For people who need to take oral steroids for a longer period of time, a frequent treatment strategy is to start with a high dose and gradually lower it to control symptoms. Symptoms are usually kept at bay by gradually reducing the dose to a lower daily amount.
Treatment duration varies depending on the ailment. If the situation improves, the steroid medication may be progressively discontinued. Some illnesses, however, necessitate the use of steroids for the rest of one’s life, as symptoms return if the steroids are stopped.
When am I going to take it?
Your pharmacist will provide you with specific directions. It depends on the type of steroid you’re taking and why you’re taking it. Steroids are usually taken with meals first thing in the morning.
Do steroids have any negative side effects?
In most cases, a short course of oral steroids has no negative effects. A one- to two-week regimen, for example, is frequently suggested to relieve a severe asthma attack. This is typically taken without issue.
If you take oral steroids for a long time (more than 2-3 months), or if you take short courses frequently, you are more prone to experience side effects.
The danger of side effects increases when the dose is increased. If you need steroids for a long time, the lowest possible dose that manages symptoms is the goal. To control symptoms, some disorders require a larger dose than others. Even when treating the same ailment, the dosage required varies greatly from person to person.
What are some of the potential adverse effects of using oral steroids?
The advantages of using oral steroids usually outweigh the disadvantages in many disorders. However, side effects can be bothersome at times. For a complete list of possible side effects, read the information sheet that comes with your medicine. The following are the most common side effects:
- Bones that have been ‘thinned’ (osteoporosis). If the danger is significant, however, there are several drugs that can help to protect you. To assist reduce bone loss, you can take a bisphosphonate medication, for example.
- Gaining weight. You may also notice puffiness around your eyes and face.
- Steroids may suppress the immune system, increasing the risk of infection.
- If you have never had chickenpox before, you are especially vulnerable to a severe version of the disease (and so are not immune). The majority of people have experienced chickenpox as a child and are hence immune. If you’re on corticosteroids and haven’t had chickenpox before, you should:
- Keep a safe distance from anyone who has chickenpox or shingles.
- If you come into contact with persons who have these illnesses, tell your doctor.
Additionally, if you have had tuberculosis (TB) in the past, even if it was many years ago, it may flare up again.
The blood pressure rises. As a result, have your blood pressure checked on a regular basis. If it reaches too high, it can be addressed.
If you have diabetes, high blood sugar (hyperglycemia) may necessitate additional treatment. Steroids have the potential to induce diabetes in some people. If you’re taking long-term steroids, your doctor could suggest a yearly blood sugar test to monitor for diabetes, especially if you have a family history of the disease.
Poor wound healing, thinner skin, and easy bruising are all skin issues. Stretchmarks can appear on the skin.
Muscle wasting. After the steroid is withdrawn, this improves, and physiotherapy may assist.
Changes in mood and behavior. Some people report that taking steroids makes them feel better about themselves. Steroids, on the other hand, can exacerbate depression and other mental health issues, as well as cause them. This side effect usually starts after a few weeks of starting treatment and is more common with greater doses.
Some people feel angry and disoriented, and they may even develop delusions and suicidal ideas. When steroid medication is stopped, these mental health problems can also occur. If you notice any concerning emotional or behavioral changes, seek medical help.
A higher chance of acquiring cataracts. If you notice any changes in your eyesight, such as blurred vision, contact your doctor. An eye specialist may be required to examine you.
Duodenal and stomach ulcers are more likely to occur. If you get indigestion or stomach (abdominal) symptoms, contact your doctor.
The above are only a few of the most common negative effects that some people who take steroids may experience. There is frequently a trade-off between the danger of side effects and the symptoms and damage that some diseases can cause if they are not treated.
Some of the less frequent adverse effects are not listed above, but they will be listed in the patient information booklet that comes with your medication.
Who can’t take corticosteroids by mouth?
Only a few people are unable to take oral corticosteroids. Oral steroids should only be avoided by those who have serious infections (who are not receiving therapy for the infection). This is due to the fact that steroids weaken your immune system, making you less likely to fight infection.
When used orally, oral steroids should be administered with caution in those who:
- Have a liver that isn’t functioning properly.
- Do you have a history of mental health issues?
- There are open wounds on your body that are mending. (Steroids
- may obstruct wound healing.)
- Have you ever had stomach or duodenal ulcers?
- Have the bones ‘thinned’ (osteoporosis).
- I’m suffering from cataracts.
- Have you recently had a heart attack, have heart failure, or have high blood pressure? (hypertension).
- I’m diabetic.
- I suffer from epilepsy.
Are you expecting a child? (If you take steroids during the first 12 weeks of pregnancy, there’s a chance your kid will be born with a cleft lip or palate.) The growth of your kid may be harmed if you use steroids for a long time.)
Are you a breastfeeding mother? (Breastfeeding should be avoided for at least four hours after using steroid medications.) If you’re taking high-dose steroids and breastfeeding, your infant may need to be monitored.)
How do I go off of oral steroids?
If you’ve taken an oral steroid for a short period of time (1-2 weeks), you can simply cease taking the tablets at the conclusion of the course.
When not to abruptly discontinue using oral steroids
If you’ve been taking oral steroids for more than three weeks, don’t quit abruptly. It’s unlikely that forgetting the occasional dose will cause any harm.
However, if your body has become accustomed to the steroids, you may experience severe withdrawal symptoms. If you abruptly cease taking oral steroids, these symptoms may appear within a few days. Any dose adjustment should be monitored by a physician. Any dose decreases are done gradually over a period of weeks.
Why is it necessary to progressively reduce the dose before discontinuing oral steroids?
Your body produces steroid compounds on its own, which are required for good health. When you take oral steroids for a few weeks or longer, your body’s natural steroid compounds may be reduced or stopped. If you suddenly stop taking oral steroids, your body will be depleted of steroids. This can result in a variety of withdrawal symptoms until your body begins to produce natural steroids again after a few weeks. Withdrawal symptoms can be dangerous, even deadly, and include:
- I’m not feeling well (nausea).
- I’m sick (vomiting).
- Pain in the stomach (abdomen).
- Blood sugar levels are low (hypoglycaemia).
- Hypotension (low blood pressure) can cause dizziness, fainting, or collapse.
When the dose is progressively reduced, the body’s natural steroid production resumes, and withdrawal symptoms are avoided.
There are a few more key considerations to remember about oral steroids.
When taking steroids, avoid taking anti-inflammatory pain relievers like ibuprofen (unless advised by a doctor). When you combine the two, you’re more likely to get a stomach or duodenal ulcer.
The majority of people who take regular steroids have a steroid card, which should be issued by the person who prescriptions or distributes your medicine, and/or wear a medical emergency identification bracelet or comparable.
In the event of an emergency, this provides information about your dose, your condition, and so on. If you were knocked unconscious in an accident, for example, it’s critical that the doctors know you’re on steroids and that you need to take them on a regular basis.
If you have other illnesses, your steroid dose may need to be increased for a short time. For instance, if you have a bad infection or are undergoing surgery. This is due to the fact that when you are physically stressed, you require more steroids.
If you have any concerns about your steroid treatment, see a doctor.
When I’m on steroids, may I take other medications?
Many additional drugs have the potential to ‘interact’ with oral steroids. This means that the steroid may have an effect on how they work, making the other medicine ineffective or causing greater side effects than usual. Alternatively, they may interact in the opposite direction, with the other medicine affecting the corticosteroid.
In order to take both medicines at the same time, doses may need to be changed.
Steroids can interact with a variety of medications, including:
- Warfarin is a blood thinner (a blood-thinning medicine to prevent blood clots).
Ibuprofen, diclofenac, and naproxen are examples of non-steroidal anti-inflammatory medicines (NSAIDs). Because both NSAIDs and steroids can cause stomach ulcers as a side effect, the risk is multiplied when they’re used simultaneously. To lower this risk, you may need to take a drug called a proton pump inhibitor (PPI).
Vaccines that are alive. The majority of vaccines do not contain the germ against which they are designed to protect, but a handful do.
Vaccines for measles, mumps, and rubella (MMR), rotavirus, yellow fever, and tuberculosis are among them (TB). After high-dose steroid treatment, live vaccinations are normally not given for three months.
Epilepsy medications, such as carbamazepine, phenytoin, and phenobarbital.
Diabetes medications. (After starting steroids, blood sugar levels should be checked more frequently, and the doses of diabetes medications adjusted as needed.)
Certain types of inhalers. When large doses of certain inhalers, such as salbutamol, are used with steroids, problems can occur.
‘Water tablets’ are a type of digoxin (diuretics).
Antiretroviral and antiretroviral therapies for HIV and AIDS.
What should I do if I’m taking a medication that has an interaction with oral steroids?
As long as your doctor is aware that you are taking medication, they will be able to provide you with appropriate advice. You can usually take both drugs, although the side effects may need to be monitored.
Blood tests, for example, may be required to ensure that the combination is not creating any issues. The doses can then be tweaked as needed.
If I’m pregnant or breastfeeding, may I take oral steroids?
Your doctor can help you balance the benefits and draw up a list of pros and downsides, but in general, steroids can be used safely by pregnant or breastfeeding women. The smallest dose possible would be utilized for the shortest amount of time. Steroids are known to marginally enhance the likelihood of your baby getting a cleft lip and/or palate if used early in pregnancy.
How to Make Use of the Yellow Card Program
If you believe you have had an adverse effect from one of your medications, you can use the Yellow Card Scheme to report it. You can apply for a yellow card online at www.mhra.gov.uk/yellowcard.
The Yellow Card Scheme is meant to alert pharmacists, doctors, and nurses to any new negative effects produced by drugs or other healthcare goods. If you want to report a side effect, you’ll need to know the following things:
- The unintended consequence.
- The name of the pharmaceutical you believe is to blame.
- The person who was affected by a side effect.
- As the side-effect reporter, please provide your contact information.