Corticosteroids (steroids) are powerful anti-inflammatory drugs. They control a flare within days, which makes them essential in polymyalgia rheumatica, vasculitis, lupus and myositis, and useful as a short bridge while slower DMARDs start to work. The goal in every case is the lowest dose that controls the disease, for the shortest possible time.
How long it takes
Within days. In polymyalgia rheumatica the improvement is often dramatic within 48 to 72 hours.
How to take it
- In the morning, with food.
- Never stop suddenly if you have taken them for more than about three weeks. Your body stops making its own steroid hormone, and stopping abruptly can cause a dangerous collapse. Doses are reduced step by step, exactly as prescribed.
- Carry a note or card saying you take steroids, in case of an emergency or operation.
Common side effects
Most are mild and many settle. Mention them at your next visit; there is often a simple fix.
- Increased appetite and weight gain
- Difficulty sleeping, restlessness or mood changes
- Raised blood sugar and blood pressure
- Indigestion
- With long-term use: thinning bones, bruising, thinner skin, cataracts
Call the clinic the same day if you have
- Fever or signs of infection. Steroids can hide the usual warning signs, so infections can be more serious than they look.
- Very high blood sugar readings, extreme thirst or passing a lot of urine
- Black stools, vomiting blood or severe stomach pain
- Severe low mood, confusion or agitation
- Blurred vision or eye pain
Clinic: +91 70571 19999. If you are very unwell, go to the nearest emergency department and take your medicine strip with you.
Blood tests & checks
- Blood pressure, blood sugar and weight at clinic visits
- Bone protection (calcium, vitamin D, and often a bone-strengthening drug) if steroids are expected for three months or more
- A bone density (DEXA) scan for long-term use
Pregnancy & family planning
- Prednisolone at low to moderate doses is acceptable in pregnancy and breastfeeding, as most of it does not reach the baby. Blood sugar and blood pressure are watched more closely.
Alcohol, infections, vaccines & other medicines
Hidden steroids
Some unlabelled pain powders, 'desi' remedies and injections given for joint pain contain steroids. They cause the same side effects, and stopping them suddenly is just as dangerous. Bring anything you take to the clinic.
Surgery and illness
Tell the surgeon or anaesthetist that you take steroids. During a severe illness the dose sometimes needs to be increased temporarily.
Vaccines
Inactivated vaccines are safe. Live vaccines are avoided on higher doses.