What to know about corticosteroids

Corticosteroids such as prednisone and cortisone are a class of drugs which can reduce inflammation effectively. These often trigger a number of side effects, however, which limit their use.

Corticosteroids are different from the performance-enhancing drugs used by certain athletes and bodybuilders. Those steroids are anabolic.

In this article we look at the corticosteroid forms and their uses. We are also looking at how those drugs work and the potential risks of using them.

Uses

Corticosteroids have many different body effects, meaning they can treat a variety of medical conditions. It can reduce inflammation, suppress overactive responses to the immune system, and assist with hormonal imbalances.

Corticosteroids act quickly in the body making them useful for the treatment of sudden , severe symptoms. They can handle allergic reactions effectively , for example.

These medicines can also suppress the immune system , making them useful in treating autoimmune diseases.

Some conditions that may help treat the corticosteroids include:

• asthma
• allergies
• eczema
• hives
• psoriasis
• chronic obstructive pulmonary disease (COPD)
• inflammatory bowel disease, which includes Crohn’s disease and ulcerative colitis
• multiple sclerosis (MS)
• lupus
• Addison’s disease
• rheumatoid arthritis

Doctors can also use these to treat people who recover from organ transplant.

Types and drug list

In the United States corticosteroids have a long history of usage. Most are now in generic forms, including:

• cortisone
• prednisone
• prednisolone
• methylprednisolone
• dexamethasone
• betamethasone
• hydrocortisone

Corticosteroids can come in the form of:

• tablets
• capsules
• eye drops
• lotions, creams, ointments, or gels
• nasal or mouth sprays
• injections

Depending on the problem a doctor will prescribe various forms of corticosteroids. For example, when treating skin conditions, they can prescribe a cream, lotion, ointment, or gel.

Side effects

Long-term use of corticosteroids can have side effects that include:

• acne
• weight gain
• bruising
• mood disorders, including depression
• high blood pressure
• diabetes
• osteoporosis
• cataracts
• glaucoma
• liver damage

Long-term use of corticosteroids can cause the adrenal glands to stop the hormone cortisol production. It can take some time for the body to start releasing cortisol at a normal rate after stopping the use of corticosteroids.

Short-term corticosteroid use is safer but risks remain. These drugs, for example , can cause changes in sleep , mood and appetite.

There are also signs that there could be more serious side effects from short-term use. A 2017 study involving 327,452 adults who received a corticosteroid prescription found that the risk of sepsis, blood clots and bone fractures increased within 30 days of using them.

How corticosteroids work

Corticosteroids imitate hormone effects, including cortisol, for example. A doctor will prescribe corticosteroids to either raise or reduce the activity of these hormones to a normal amount.

For example , a person with Addison’s disease will benefit from this treatment because their body does not produce enough cortisol.

The increase in hormonal activity suppresses the immune system, which activates inflammation within the body. Corticosteroids can reduce the inflammation by suppressing immune system function.

Risks

Corticosteroids can have substantial effects on the body through suppression of the immune system. Doctors typically use corticosteroids when other treatments don’t work, or require a quick response.

Taking corticosteroids can cause blood sugar spikes, which can be dangerous to people with diabetes.

Corticosteroids might be harmful in humans with:

• diabetes
• depression
• obesity
• substance use disorder
• glaucoma or cataracts
• ulcers
• a recent heart attack or heart failure
• high blood pressure
• liver problems
• epilepsy
• ongoing infections
• large wounds

Corticosteroid medicines may be used during pregnancy, but corticosteroid use always presents risks. Doctors can also stop prescribing these to women who are pregnant if possible.

Corticosteroids can reduce the efficacy of certain medications and make others more potent. Individuals will inform a doctor, before using corticosteroids, if they are taking some drug to treat the following:

• excessive blood clotting
• seizures
• diabetes
• HIV

Certain vaccines, like those for measles , mumps, and tuberculosis, may have hazardous corticosteroid interactions. Certain vaccines, such as flu or pneumonia vaccines, may not function as well if a person is also taking a high corticosteroid dose.

Use corticosteroids alongside non-steroidal anti-inflammatory drugs (NSAIDs), including ibuprofen ( Advil), can also be dangerous.

Depending on the specific type of corticosteroid the side effects can vary. For instance, a corticosteroid cream that a person applies to the face may have side effects different from a corticosteroid tablet or an injection.

Coping with side effects

Taking lower dosages over shorter periods will lower the risk of corticosteroid side effects. Doctors will always try to prescribe the lowest dosage yet to provide effective treatment.

Some tips to reducing the risk of Corticosteroid issues include:

• avoiding interactions by making sure that the doctor is aware of all other medications and supplements
• being careful to prevent infections where possible, such as by getting a flu vaccine and keeping open wounds clean and protected
• keeping the bones healthy through proper exercise, a healthful diet, and, for older adults, calcium and vitamin D supplements
• taking precautions to avoid becoming pregnant, if possible
• having regular eye exams
• watching out for signs of water retention, such as swollen ankles
• taking doses according to the doctor’s prescription
• applying a retinoid cream at the same time as corticosteroid creams, gels, or lotions to reduce the risk of thin skin
• avoiding sudden changes in dosage to reduce the risk of complications, such as withdrawal symptoms

Summary

Corticosteroids are effective in reducing inflammation and suppressing the immune system. These are useful for a variety of conditions , particularly when prompt treatment is required.

Long-term as well as short-term corticosteroid use can have side effects, some of which are serious. Only taking corticosteroids is important where there are no viable alternatives.

A person should take note of any side-effects or changes in symptoms when using corticosteroids. Also, they should make sure their doctor is aware of any other medications and supplements they take. The health care professional will help patients prevent harmful interactions.