10/3/2016
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`Prednisone and other corticosteroids: Balance the risks and benefits ­ Mayo Clinic
`
`Prednisone and other corticosteroids
`
`Weigh the benefits and risks of corticosteroids, such as prednisone, when choosing a
`medication.
`
`By Mayo Clinic Staff
`
`Corticosteroid drugs — including cortisone, hydrocortisone and prednisone — are useful in
`treating many conditions, such as rashes, lupus and asthma. But these drugs also carry a risk of
`serious side effects. Working with your doctor, you can take steps to reduce these side effects so
`that the benefits of corticosteroid treatment outweigh the risks.
`
`Corticosteroids mimic the effects of hormones your body produces naturally in your adrenal
`glands, which sit on top of your kidneys. When prescribed in doses that exceed your body's usual
`levels, corticosteroids suppress inflammation. This can reduce the signs and symptoms of
`inflammatory conditions, such as arthritis and asthma.
`
`Corticosteroids also suppress your immune system, which can help control conditions in which
`your immune system mistakenly attacks its own tissues.
`
`Corticosteroid drugs are used to treat rheumatoid arthritis, lupus, asthma, allergies and many other
`conditions. They also treat Addison's disease, a condition where the adrenal glands aren't able to
`produce even the minimum amount of corticosteroid that the body needs. And these drugs also
`help suppress the immune system in order to prevent organ rejection in transplant recipients.
`
`You can take corticosteroids:
`
`By mouth. Tablets, capsules or syrups help treat the inflammation and pain associated with
`certain chronic conditions, such as rheumatoid arthritis and lupus.
`By inhaler and intranasal spray. These forms help control inflammation associated with
`asthma and nasal allergies.
`Topically. Creams and ointments can help heal many skin conditions.
`By injection. This form is often used to treat muscle and joint signs and symptoms, such as
`the pain and inflammation of tendinitis.
`
`Corticosteroids carry a risk of side effects, some of which can cause serious health problems.
`When you know what side effects are possible, you can take steps to control their impact.
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`Prednisone and other corticosteroids: Balance the risks and benefits ­ Mayo Clinic
`10/3/2016
`Side effects of oral corticosteroids
`Because oral corticosteroids affect your entire body instead of just a particular area, this route of
`administration is the most likely to cause significant side effects. Side effects depend on the dose
`of medication you receive and may include:
`
`Elevated pressure in the eyes (glaucoma)
`Fluid retention, causing swelling in your lower legs
`High blood pressure
`Problems with mood, memory, behavior and other psychological effects
`Weight gain, with fat deposits in your abdomen, face and the back of your neck
`
`When taking oral corticosteroids longer term, you may experience:
`
`Clouding of the lens in one or both eyes (cataracts)
`High blood sugar, which can trigger or worsen diabetes
`Increased risk of infections
`Thinning bones (osteoporosis) and fractures
`Suppressed adrenal gland hormone production
`Thin skin, bruising and slower wound healing
`
`Side effects of inhaled corticosteroids
`When using inhaled corticosteroids, some of the drug may deposit in your mouth and throat
`instead of making it to your lungs. This can cause:
`
`Fungal infection in the mouth (oral thrush)
`Hoarseness
`
`If you gargle and rinse your mouth with water — don't swallow — after each puff on your
`corticosteroid inhaler, you may be able to avoid mouth and throat irritation. Some researchers
`have speculated that inhaled corticosteroid drugs may slow growth rates in children who use them
`for asthma.
`
`Side effects of topical corticosteroids
`Topical corticosteroids can lead to thin skin, red skin lesions and acne.
`
`Side effects of injected corticosteroids
`Injected corticosteroids can cause temporary side effects near the site of the injection. These may
`include skin thinning, loss of color in the skin, facial flushing, insomnia and high blood sugar.
`Doctors usually limit corticosteroid injections to three or four a year, depending on each patient's
`situation.
`
`To get the most benefit from corticosteroid medications with the least amount of risk:
`
`Try lower doses or intermittent dosing. Newer forms of corticosteroids come in varying
`strengths and lengths of action. Ask your doctor about using low-dose, short-term medications
`or taking oral corticosteroids every other day instead of daily.
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`Prednisone and other corticosteroids: Balance the risks and benefits ­ Mayo Clinic
`Switch to nonoral forms of corticosteroids. Inhaled corticosteroids for asthma, for example,
`reach lung surfaces directly, reducing the rest of your body's exposure to them and leading to
`fewer side effects.
`Make healthy choices during therapy. When you're taking corticosteroid medications for a
`long time, talk with your doctor about ways to minimize side effects. Eat a healthy diet and
`participate in activities that help you maintain a healthy weight and strengthen bones and
`muscles.
`Take care when discontinuing therapy. If you take oral corticosteroids for a long time, your
`adrenal glands may produce less of their natural steroid hormones. To give your adrenal
`glands time to recover this function, your doctor may reduce your dosage gradually. If the
`dosage is reduced too quickly, you may experience fatigue, body aches and lightheadedness.
`Wear a medical alert bracelet. This or similar identification is recommended if you've been
`using corticosteroids for a long time.
`Get regular checkups. If you're taking long-term corticosteroid therapy, see your doctor
`regularly to check for side effects.
`
`Corticosteroids may cause a range of side effects. But they may also relieve the inflammation, pain
`and discomfort of many different diseases and conditions. If you work with your doctor to make
`choices that minimize side effects, you may achieve significant benefits with a reduced risk of such
`problems.
`
`References
`
`1. Bolognia JL, et al. Drug reactions. In: Dermatology Essentials. Philadelphia, Pa.: Saunders Elsevier; 2014.
`http://www.clinicalkey.com. Accessed Oct. 6, 2015.
`
`2. Adkinson NF, et al. Glucocorticosteroids. In: Middleton's Allergy: Principles and Practice. 8th ed. Philadelphia, Pa.:
`Saunders Elsevier; 2014.
`
`3. Nieman LK. Pharmacologic use of glucocorticoids. www.uptodate.com/home. Accessed Oct. 6, 2015.
`
`4. Firestein GS, et al. Glucocorticoid therapy. In: Kelley's Textbook of Rheumatology. 9th ed. Philadelphia, Pa.: Saunders
`Elsevier; 2013.
`
`5. Brunton LL, et al. Adrenocortical steroids. In: Goodman & Gilman's the Pharmacological Basis of Therapeutics. 12th
`ed. New York, N.Y.: The McGraw-Hill Companies; 2011.
`
`6. Jameson JL, et al. Glucocorticoid therapy. In: Endocrinology: Adult and Pediatric. 7th ed. Philadelphia, Pa.: Saunders
`Elsevier; 2016.
`
`7. AskMayoExpert. Glucocorticoid therapy. Rochester, Minn.: Mayo Foundation for Medical Education and Research;
`2015.
`
`8. AskMayoExpert. Corticosteroid injections. Rochester, Minn.: Mayo Foundation for Medical Education and Research;
`2014.
`
`9. Judd LL, et al. Adverse consequences of glucocorticoid medication: Psychological, cognitive and behavioral effects.
`American Journal of Psychiatry. 2014;171:1045.
`
`10. Saag KG, et al. Major side effects of systemic glucocorticoids. www.uptodate.com/home. Accessed Oct. 12, 2015.
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`Prednisone and other corticosteroids: Balance the risks and benefits ­ Mayo Clinic
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`11. Glucocorticosteroid-induced osteoporosis. American College of Rheumatology.
`http://www.rheumatology.org/practice/clinical/patients/diseases_and_conditions/gi-osteoporosis.asp. Accessed May 1,
`2015.
`
`12. Colditz GA. Healthy diet in adults. www.uptodate.com/home. Accessed Oct. 12, 2015.
`
`13. Wyand CM, et al. Giant-cell arteritis and polymyalgia rheumatica. New England Journal of Medicine. 2014;371:50.
`
`14. Joint injections (joint aspirations). American College of Rheumatology. http://www.rheumatology.org. Accessed Oct. 6,
`2015.
`
`15. Dorland's Illustrated Medical Dictionary. 32nd ed. Philadelphia, Pa.: W.B. Saunders; 2011.
`http://dorlands.com/index.jsp. Accessed Oct. 12, 2015.
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`Nov. 26, 2015
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`Original article: http://www.mayoclinic.org/steroids/art-20045692
`
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