What oral steroids are there?
Steroids (also known as cortisone or corticosteroids) are chemicals (hormones) that occur naturally in the body. Steroids decrease inflammation, suppress the body's immune system, block DNA from being made, as well as blocking a chemical called histamine (released during an allergic reaction). Steroid medicines are man-made but are similar to these natural hormones.
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 liquids (solutions), creams, ointments, inhalers and injections.
Oral steroids are steroids that you can take by mouth - tablets, soluble tablets and solutions. Oral steroids include betamethasone, deflazacort, dexamethasone, hydrocortisone, methylprednisolone, prednisolone and fludrocortisone. They come in various different brand names. Prednisolone is the most commonly used oral steroid.
What are oral steroids usually prescribed for?
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, systemic lupus erythematosus (SLE), autoimmune hepatitis).
- Joint and muscle diseases (for example, rheumatoid arthritis, polymyalgia rheumatica).
- Chronic obstructive pulmonary disease (COPD).
They are also used to treat some cancers. In addition they can be prescribed as replacement treatment for people whose own natural steroids are lacking (for example, in Addison's disease and congenital adrenal hyperplasia).
What is the dose?
This will vary with individual steroids and with the condition for which they are prescribed. For short courses, usually a relatively high dose is prescribed each day, for a few days or a week or so, and then stopped abruptly at the end of the course. If taken for more than three weeks, the dose will need to be tailed off gradually.
For those who have to take steroids for a longer time, a common treatment plan is to start with a high dose to control symptoms. Often the dose is then slowly reduced to a lower daily dose that keeps symptoms away. The length of treatment can vary, depending on the disease. Sometimes the steroid treatment is gradually stopped if the condition improves. However, steroids are needed for life for some conditions, as symptoms return if the steroids are stopped.
When do I take it?
Your pharmacist will give you exact instructions. It will depend on which steroid you take, and what it is for. Mostly steroids are taken first thing in the morning, with food.
Further reading and references
British National Formulary; NICE Evidence Services (UK access only)
Corticosteroids - oral; NICE CKS, August 2015 (UK access only)
Gupta A, Gupta Y; Glucocorticoid-induced myopathy: Pathophysiology, diagnosis, and treatment. Indian J Endocrinol Metab. 2013 Sep17(5):913-6. doi: 10.4103/2230-8210.117215.
I've been interested to read other peoples experiences of Prednisolone on this site and, as a long term Pred user, thought I'd contribute.I was diagnosed with Sarcoidosis of the lungs about 15 years...Guest
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