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Oral Steroids in Asthma
Oral steroids are steroid medicines such as prednisolone taken by mouth. This leaflet gives
useful information if you take oral steroids.
What are steroids?
Steroids are hormones that occur naturally in the body. Steroid medicines are man-made and
are similar to these natural hormones. They are usually given to decrease inflammation. The
types of steroids used to treat disease are called corticosteroids. They are different to the
anabolic steroids which some athletes and bodybuilders use.
Some general points about oral steroids
• A short course of steroids usually causes no problems. For example, a 1-2 week course is often prescribed to ease a severe attack of asthma. • Side effects are more likely to occur if more prolonged courses of steroids are needed
Side effects of prolonged courses of oral steroids
Side effects can include weight gain (often most obvious in facial appearance), increased risk
of infection and adrenal suppression. Much less commonly they can cause osteoporosis,
hypertension, cataracts and diabetes.
Adrenal suppression and stopping oral steroids
The body normally makes its own steroid chemicals which are necessary to be healthy. When
oral steroids are used for a few weeks or more, the body may reduce or stop making its own
steroid chemicals which can mean that there are no steroids available if the oral steroids are
stopped suddenly. Not enough steroids in the body can cause withdrawal symptoms
including: 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 of
oral steroids is reduced gradually, the body can resume its natural production of steroids and
the withdrawal symptoms do not occur. It usually takes a few weeks or sometimes a few
months for the body’s own production of steroids to re-start.
What happens during other illnesses?
• The body needs more steroids during times of physical stress such as serious infections or operations. Normally the body would make its own extra steroids; if there is adrenal suppression it will not be able to do so, so the dose of steroids taken will need to be increased. • Vomiting illness can make it impossible to keep the doses of oral steroids down, and in these circumstances, it may be necessary to contact an emergency doctor in case a steroid injection is needed.
Risk of infection and chickenpox
Long term oral steroids can increase the risk of serious infection, particularly chickenpox.
Children on long term steroids who have not had chickenpox in the past should make special
efforts to stay away from people with chickenpox or shingles and tell a doctor immediately if
you come into contact with people with these conditions. Under some circumstances an
injection of anti-chickenpox antibodies may be needed.
Most people who take regular steroids should carry a steroid card and/or a MedicAlert®
bracelet or similar. A steroid treatment cards are free and should supplied by your pharmacist.
MedicAlert® bracelets give details of the wearer’s dose of steroids and medical condition
both of which are important for doctors to know about in emergencies.
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