Oral steroids (steroid medication taken by mouth) help in many diseases. However, some people who take oral steroids develop side-effects. This leaflet discusses the main possible side-effects, and gives other useful information if you take oral steroids. One vital point to remember is - if you have been taking a steroid medicine for more than three weeks then you should not stop taking it suddenly. If you think you are getting side-effects, don't just stop the your oral steroids: go and see your doctor.
Steroids (also known as cortisone or corticosteroids) are hormones that occur naturally in the body. Steroids decrease inflammation, suppress the body's immune system, block DNA from being made, as well as block a chemical called histamine (released during an allergic reaction). Steroid medicines are man-made but are similar to these natural hormones.
The type of steroids used to treat disease are called corticosteroids. They are different to the anabolic steroids which some athletes and bodybuilders use. Anabolic steroids have very different effects. Steroids are available as tablets, soluble tablets, and solutions, creams, ointments, inhalers, and injections.
Oral steroids are steroids that you can take by mouth - tablets, soluble tablets and liquids (solutions). Oral steroids available in the UK include: betamethasone, cortisone, deflazacort, dexamethasone, hydrocortisone, methylprednisolone, prednisolone and fludrocortisone acetate. They come in various different brand names. Prednisolone is the most commonly used oral steroid. This leaflet discusses the main possible side-effects of oral steroids as well as other important information if you take oral steroids.
Oral steroids are used to treat a large number of conditions. Some examples include: inflammatory bowel diseases (for example, Crohn's disease, ulcerative colitis), autoimmune diseases (for example, autoimmune hepatitis), joint and muscle diseases (for example, rheumatoid arthritis, polymyalgia rheumatica), allergies and asthma. They are also used to treat some cancers. In addition they can be prescribed as replacement treatment for people who have stopped making their own steroids - Addison's disease.
For many diseases, the benefits of taking steroids usually outweigh the side-effects. However, side-effects can sometimes be troublesome. You should read the information leaflet that comes with your medicine packet for a full list of possible side-effects. The main possible side-effects include the following:
The above are only the main possible side-effects which may affect some people who take steroids. There is often a balance between the risk of side-effects against the symptoms and damage that may result from some diseases if they are not treated. Some of the less common side-effects are not listed above but will be included on the leaflet that comes with your medicine.
It probably does no harm to forget the odd dose. However, you may get serious withdrawal effects once your body is used to the steroids. These may develop within a few days if you stop oral steroids suddenly. Any change in dose should be supervised by a doctor. Any reductions in dose are done slowly, over a number of weeks.
Your body normally makes steroid chemicals by itself which are necessary to be healthy. When you take oral steroids for a few weeks or more, your body may reduce or stop making its own steroid chemicals. If you then stop taking oral steroids suddenly, your body does not have any steroids. This can cause various withdrawal symptoms until your body resumes making natural steroids over a few weeks. The withdrawal symptoms can be serious, even life-threatening and include: weakness, tiredness, feeling sick, vomiting, diarrhoea, abdominal pain, low blood sugar, and low blood pressure which can cause dizziness, fainting or collapse.
If the dose is reduced gradually, the body gradually resumes its natural production of steroids and the withdrawal symptoms do not occur.
There are very few people who cannot take oral corticosteroids. Only people who have serious infections (and are not taking treatment for the infection) should not take oral steroids. This is because steroids suppress your immune system.
You cannot buy oral steroids. They are only available from a pharmacy, with a prescription.
A steroid treatment card should be given to you by the person who prescribes or supplies your medicine.
If you think you have had a side-effect to one of your medicines, you can report this on the Yellow Card Scheme. You can do this online at the following web address: www.mhra.gov.uk/yellowcard.
The Yellow Card Scheme is used to make pharmacists, doctors and nurses aware of any new side-effects that your medicines may have caused. If you wish to report a side-effect, you will need to provide basic information about:
It is helpful if you have your medication and/or the leaflet that came with it with you while you fill out the report.