Glucocorticoids (‘steroids’)


What are ‘steroids’?


‘Steroids’ is the name given to a group of chemicals which exist naturally in nature including in the human body (e.g. cortisol which is made in the adrenal gland). Steroids can also be made synthetically and some types of steroids can be effective as medicines at treating inflammation (e.g. glucocorticoid steroids).


Which is the most commonly used glucocorticoid?


In the UK, Prednisolone is the name of the most commonly prescribed anti-inflammatory glucocorticoid (steroid) and it is taken as tablets. However glucocorticoids can also be given as an injection or as an inhaler (e.g. methylprednisolone injection - directly into a joint or intravenously for severe conditions or as a general injection given into a big muscle to spread though the body).


Why is Prednisolone prescribed?


Prednisolone helps to control symptoms due to inflammation in various conditions, such as:

  • Rheumatoid arthritis and other inflammatory arthritis
  • Systemic Lupus (SLE)
  • Polymyalgia rheumatic
  • Vasculitis
  • Other medical conditions like asthma, allergy, Crohn’s Disease, eczema

Does Prednisolone cure the condition?

No, but these steroids help to control the symptoms but do not cure arthritis.


What are the side effects?

When treatment is used for just a few weeks side effects are few, if any. However in the longer term the most common side effects are:

  • Weight gain or increase of appetite
  • Skin bruising and thinning
  • Osteoporosis (thinning of bones making them fragile and easily broken)
  • Worsening diabetes (or triggering it in the first place)
  • Stretch marks
  • Some fat accumulation in certain places  round face or upper back
  • Indigestion
  • Changes in mood, insomnia
  • Risk of infections

For how long do I need to take Prednisolone?


This will depend on the condition and the severity of the condition. Many doctors sensibly minimize the duration of prednisolone treatment.


What dose would I need to take?


The dose will depend on the severity of the condition and your weight. Many doctors sensibly minimize the dose of prednisolone treatment.


How do I take Prednisolone?


Prednisolone should be taken first thing in the morning with or without food.


Are there any other precautions when taking Prednisolone?


You should carry a ‘steroid card’ that lists the name and dose of the steroid you take. You should not stop steroids abruptly if you have been on them for a while. Your doctor will advise you on how to gradually reduce the dose. Sometimes medications are needed to counteract the side effects of Prednisolone (e.g. effect on your skeleton increasing the risk of osteoporosis and effect on your stomach lining where it can contribute to increased gastric acid production).


Is infection a side-effect of Prednisolone (and other steroid) treatment?


Yes! If you get an infection while taking Prednisolone then please consult your GP. Basically, you will need to continue to take your prednisolone (can’t be stopped suddenly!) but the infection may need prompt treatment. In some cases the dose of prednisolone often needs to be increased temporarily a small amount 10-20%. Alternatively, discuss what to do with your Rheumatology Practitioner directly or via the Helpline Telephone contact number. Please also see BSR Patient Information on Infection risks and Immunosuppressant drugs (DMARDs, steroids and Biologics).


Do I need winter vaccinations?


Its advisable for patients taking glucocorticoids long-term to have the winter flu vaccination each year and to be brought up to date with the pneumovax vaccination each year. Please discuss this with your GP surgery staff. Your Rheumatology practitioner can advise further.


Is Prednisolone safe in pregnancy and breastfeeding?


Most steroids are usually safe during pregnancy and breastfeeding but should only be taken on doctors advice.


Useful Links


www.wikipedia.org/wiki/Steroid
www.wikipedia.org/wiki/Prednisolone
www.arthritisresearchuk.org
Any Prednisolone PILS document at www.medicines.org.uk

For further detail please also see the relevant Summaries of Product Characteristics (SPC) document at www.medicines.org.uk