Corticosteroids reduce inflammation throughout the body. This class of drugs also helps normalize your immune system. Corticosteroids can carry major side effects in some people, including weight gain and mood changes. Some people may see a rise in blood sugar while taking corticosteroid medications.
Corticosteroids are used in several forms, to treat many different conditions. Examples include inhalant corticosteroids that are used to prevent asthma attacks, and corticosteroid ointments, creams and gels that are used to treat skin problems. Common varieties include beclomethasone (Beconase, Vancenase, Vanceril), betamethasone (Diprolene, Lotrisone), hydrocortisone, mometasone (Elocon), prednisone (Deltasone, Orasone), and triamcinolone (Azmacort, Nasacort).
Due to their widespread effects, these drugs are useful in treating many medical conditions, but they can also have serious side-effects.
Because they reduce itching, swelling, redness, and allergic reactions, they are often used in treating skin problems, severe allergies, asthma, and arthritis. These drugs also suppress the body's immune response, so they are used in patients who have received organ transplants, to reduce the chance of rejection. In people whose bodies do not produce enough natural corticosteroids, the drugs can raise the levels of those hormones. Corticosteroids also are used to treat certain cancers (along with other drugs), and to reduce inflammation in other medical conditions.
Gargling and rinsing the mouth with water after using inhalant corticosteroids helps prevent hoarseness and throat irritation.
Patients who take corticosteroids regularly should not stop taking them suddenly, even if their symptoms improve. Gradually tapering the dose before stopping the drug completely can allow the body time to adjust. If directed by a physician to reduce the dose, follow directions exactly and see the physician as often as directed.
Corticosteroid ointments, creams and gels can be absorbed through the skin and travel into the bloodstream. This is not a problem unless large amounts are absorbed. When this occurs, unwanted side-effects in other parts of the body are possible. To reduce the chance of that happening, do not spread the medicine over too large an area and do not cover it with plastic wrap, adhesive bandage, or any other type of airtight covering unless told to by your physician.
Side-effects are generally rare when corticosteroids are used for a short time. However, with prolonged use and/or in high doses, corticosteroids have many predictable – and unpredictable – side-effects. Common side-effects include:
These problems often go away as the body adjusts to the drug and do not require medical treatment.
Less common side-effects may occur with some forms of corticosteroids. Inhalants may cause dry throat, headache, nausea, skin bruising or thinning, and an unpleasant taste. Nasal spray forms may irritate the nose or throat, and ointments, gels, or creams may irritate the skin. Again, these side-effects do not need medical attention unless they don't go away or they interfere with normal activities.
More serious side-effects are not common but may occur, especially at higher doses. If breathing problems, wheezing, or tightness in the chest occur, call a physician immediately. Additional side-effects do not need emergency care, but should have prompt medical attention. Anyone who is taking corticosteroids and has any of the symptoms listed below should check with the physician who prescribed the medicine as soon as possible:
A rare complication of cortisone medications is severe bone damage (avascular necrosis) which can destroy large joints, such as the hips and shoulders. In addition, abruptly stopping corticosteroids can cause flares of the disease and result in other side-effects including nausea, vomiting and decreased blood pressure.
In children and teenagers, these medicines can stop or slow growth and affect the function of the adrenal glands (small glands located above each kidney, which secrete natural corticosteroids). Another possible problem for children is that corticosteroids may make infections such as chickenpox and measles more serious.
Corticosteroids may interact with a variety of other medicines. When this happens, the effects of one or both of the drugs may change, or the risk of side-effects may be greater. Anyone who takes corticosteroids should let the physician know all other medicines he or she is taking. Among the drugs that may interact with corticosteroids are: Insulin and diabetes medicines; Heart medicine such as digitalis; Diuretics (water pills); Medicine containing potassium or sodium; Immunizations (vaccinations); Cyclosporine (Sandimmune); Blood thinners, such as warfarin (Coumadin); Estrogen drugs, such as conjugated estrogens (Premarin) or oral contraceptives; Antacids (if taken frequently).
People with certain medical conditions or who are taking certain other medicines can have problems if they take corticosteroids. Corticosteroids can also cover up the symptoms of some medical problems: if the condition gets worse, the patient has no way of knowing it. Before taking these drugs, be sure to let the physician know about any of these conditions:
Polymyositis is generally treated with high doses of corticosteroids initially, administered orally or intravenously. They are very good at decreasing muscle inflammation but are usually are required for years. Their continued use will be based on what a doctor finds in terms of symptoms and muscle enzyme blood test results.
Inhalant forms of corticosteroid drugs will reduce the frequency and severity of asthma attacks when taken every day, but will not relieve an asthma attack once it has started. To relieve asthma symptoms, patients must use airway-opening medications (bronchodilators). When using inhalant forms of both a bronchodilator and a corticosteroid, use the bronchodilator first and then wait several minutes before using the corticosteroid.