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What are corticosteroids?

Corticosteroids are a class of medicines that are similar to hormones that the body makes in the adrenal glands. The body makes a number of different corticosteroids. These hormones have an anti-inflammatory effect. They help the body respond to infection, injury, surgery, and stress. Cortisol, for example, is one of these natural hormones.

Corticosteroids are also called steroids. They are different from the man-made anabolic steroids some athletes abuse.

When are they used?

Steroid medicine is used to reduce inflammation and help control your immune system. Some common steroids are:

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

Steroids are useful in the treatment of many common conditions, such as:

  • asthma
  • juvenile arthritis
  • inflammatory bowel disease
  • scleroderma
  • giant cell arteritis
  • polymyalgia rheumatica
  • ankylosing spondylitis
  • Behçet's disease
  • chronic lung disease
  • rheumatoid arthritis
  • lupus
  • ulcerative colitis
  • Crohn's disease)
  • psoriasis
  • eczema and other allergic conditions.

If you have a transplant, such as a kidney or heart, steroids may also be taken to keep your body from rejecting the transplanted organ.

How are they used?

Steroids can be taken or given in a variety of ways:

  • by mouth
  • with shots
  • on the skin
  • by inhaling through the nose or mouth
  • in the rectum
  • into the veins.

You don't need a prescription to buy mild forms of the medicine. Skin cream with a low amount of hydrocortisone is an example of a mild form of the medicine. However, you do need a prescription from your healthcare provider for most steroids.

Sometimes steroids are included in other medicines, such as eye medicine, inhalers, ear drops, nose drops, and nose sprays.

Steroids can be used for long-term or short-term treatment. When they are used for short-term treatment the medicine is used for several days for quick treatment of symptoms. When the treatment is long term, the medicine is taken for several months or years--for example, as treatment for severe rheumatoid arthritis or other chronic diseases.

This type of medicine is a strong medicine. To help avoid problems, always take it exactly as prescribed.

Is it OK to suddenly stop taking steroids?

Follow your healthcare provider's directions exactly when you are taking a steroid. Whether you can safely stop taking it quickly depends on the dose and how long you have been taking it. You should never stop taking the medicine earlier than recommended by your provider without checking with your provider first.

For some illnesses and conditions you may need treatment for just a few days. If your treatment lasts longer than this, you should not stop the treatment quickly. Follow your healthcare provider's instructions for slowly lowering the dosage. You will need to decrease it a little at a time. If you stop steroids too fast, serious problems can happen, such as:

  • Adrenal crisis. When this happens, your adrenal glands do not make enough natural cortisol, causing your body to not have enough cortisol. This can hurt your body's ability to respond to an emergency, such as injuries from an auto accident. You will be much more likely to go into shock.
  • Steroid withdrawal syndrome or rebound. This is another reaction to stopping the medicine too soon. It may cause fever, muscle pain, and joint pain.

What are the risks or side effects?

When steroids are used as prescribed as inhalers or creams for the skin, they usually have few, if any, side effects. However, taking them by mouth or getting shots on a regular basis can lead to side effects that include:

  • fat deposits in chest, face, upper back, and stomach
  • growth of hair on women's faces
  • thinning of the skin
  • stretch marks
  • acne
  • black and blue marks on the skin from easy bruising
  • changes in body minerals (electrolytes), especially potassium
  • depression
  • high blood pressure
  • osteoporosis (bone thinning)
  • increased risk of certain types of infections, especially by yeast or fungus
  • higher blood sugar, leading to type 2 diabetes
  • a bigger appetite and weight gain
  • mood swings, including aggressive behavior
  • increased sweating.

The side effects depend on the dosage and how long you take the medicine, as well as your medical history and conditions. Your healthcare provider will try to have you use the lowest dosage possible to keep side effects to a minimum.

Although steroids can cause many side effects, they can be very effective, even lifesaving.

What about steroid shots into joints?

Steroids can be given as a shot into a joint to reduce pain and swelling in the joint. Getting a shot into a specific area lowers the chance that you will have side effects. Rare side effects of steroid shots are:

  • joint infection
  • lightening or wasting away of the skin where you got the shot.

Too many shots in one joint can damage cartilage or tendons. Your healthcare provider will use steroid shots sparingly and will try to limit the number of shots.

When should I call my healthcare provider?

If you develop side effects, call your provider. Do not stop taking the medicine without your provider's approval. You may have to slowly lower your dosage. If you have any questions about your medicine, ask your provider or pharmacist.

Disclaimer: This content is reviewed periodically and is subject to change as new health information becomes available. The information provided is intended to be informative and educational and is not a replacement for professional medical evaluation, advice, diagnosis or treatment by a healthcare professional.

HIA File drug4259.htm Release 13/2010

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