Patient education: Oral steroid medicines (The Basics)

What are oral steroids? — Oral steroids, also known as "glucocorticoids," are pills you take by mouth to treat a wide range of medical conditions. These include autoimmune conditions (such as rheumatoid arthritis), allergic reactions, and flares of asthma or chronic obstructive pulmonary disease (also called "COPD"). Steroid medicines can also be given through an "IV" if you cannot swallow pills or you are in the hospital. An IV is a thin tube that goes into a vein.

This article is for people who need to take oral steroids for a short time. Some people need to take oral steroids for their whole life for a condition called "Addison's disease." In this condition, the body does not make enough of the hormone "cortisol."

Other steroid medicines come as inhalers, nose sprays, or creams or ointments that go on the skin. These are sometimes called "corticosteroids." This article is only about oral steroids.

Oral steroid medicines are not the same as the steroids some athletes take illegally to build muscle.

What are the names of common oral steroids? — Commonly used oral steroids include prednisone (sample brand name: Deltasone), prednisolone (sample brand name: Orapred), dexamethasone (sample brand name: Decadron), and methylprednisolone (sample brand name: Medrol). These medicines come as pills and liquids.

What are oral steroids used for? — Oral steroids treat a wide variety of medical conditions. They include:

●Autoimmune conditions, such as rheumatoid arthritis, Crohn disease, or lupus – Some medical conditions happen when the body's infection-fighting system, called the "immune system," attacks healthy tissues and organs. This is called an "autoimmune response." Oral steroid medicines can help reduce or prevent this attack.

●Asthma, COPD, or gout flare – Oral steroids are used to reduce swelling and improve breathing for people who are having a severe flare or "attack" of asthma or COPD. (COPD is short for "chronic obstructive pulmonary disease," a lung disease that makes it hard to breathe.) Oral steroids can also reduce pain and swelling in people with attacks of gout.

●Nausea and vomiting – Oral steroids are sometimes used with other medicines to prevent nausea and vomiting due to chemotherapy.

●Prevent organ rejection – Oral steroids are also used with other medicines to keep your immune system from attacking a transplanted kidney or other transplanted organ.

●Severe allergic reaction – Oral steroids can be used for a short time to help with a severe allergic reaction, for example due to poison ivy. You might take a smaller dose each day for several days, and then stop.

There are separate patient education articles in UpToDate that discuss the range of medical conditions treated with oral steroids. Several are listed at the end of this article. Ask your doctor or nurse for the UpToDate patient education article about your disease or condition.

How do I take oral steroids? — Follow the instructions your doctor gives you. People usually take oral steroids with breakfast or another meal so the medicine does not cause an upset stomach.

What are the side effects of oral steroids? — Taking oral steroids for less than 3 weeks is not likely to cause any serious side effects. Mild side effects that can happen with short-term use include upset stomach, increased appetite, and trouble sleeping. Talk to your doctor if you have any of these side effects and they bother you.

More serious effects can occur if your condition requires you to take oral steroids for a long time or at high doses. These can include:

●Thin skin

●Eye problems (such as glaucoma or cataracts)

●High blood pressure

●Heart problems

●Osteoporosis and other bone problems

●Growth problems in children and adolescents

●High blood sugar or diabetes

●Higher chance of getting infections

Your doctor will give you the lowest dose for the shortest possible time. This lowers the risk of side effects. If you take steroid medicines for a long time, you will need regular exams and tests.

What else should I know about oral steroids? — Always take your steroid medicine exactly the way your doctor tells you to.

If you need to take oral steroids for more than 3 weeks, carry a card that lists the name and dose of the steroid you take. Show this card to anyone who treats you. You should also talk to your doctor or nurse to make sure you get all the vaccines you need. That's because taking steroid medicines for a long time can increase your chance of getting certain infections.

If your condition changes, or you get sick or need surgery when you have been taking oral steroids for more than 3 weeks, your doctor might adjust your dose. If you need to stop taking your steroid medicine, they will explain how to gradually decrease the dose. This is called "tapering."

For more detailed information about your medicines, ask your doctor or nurse for information from Lexicomp available through UpToDate. The Lexicomp handouts explain how to use and store your medicines. They also list possible side effects and warn you if your medicines should not be taken with certain other medicines or foods.

More on this topic

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Patient education: Liver transplant (The Basics)
Patient education: Multiple sclerosis in adults (The Basics)
Patient education: Nausea and vomiting with cancer treatment (The Basics)
Patient education: Psoriatic arthritis in adults (The Basics)
Patient education: Rheumatoid arthritis (The Basics)
Patient education: Inhaled corticosteroid medicines (The Basics)
Patient education: Topical corticosteroid medicines (The Basics)

Patient education: Coping with high prescription drug prices in the United States (Beyond the Basics)
Patient education: Adrenal insufficiency (Addison's disease) (Beyond the Basics)
Patient education: Rheumatoid arthritis treatment (Beyond the Basics)