What are corticosteroids?

Corticosteroids (such as prednisone) are anti-inflammatory medications that are used to treat asthma, sinusitis, eczema, poison ivy and a number of other allergic conditions.  When taken properly, they are very effective medications for the treatment of asthma and allergies.  Steroids come in various forms including topical (creams), nasal sprays, inhalers (for asthma) and as pills or liquids.

Do inhaled steroids have any side effects?

Inhaled corticosteroids are considered the most effective medications for long-term control of persistent asthma. They provide good control of asthma with minimal effect on the rest of the body at usual doses.  Minor side effects from using corticosteroid inhalers can include hoarseness and thrush (a fungal infection of the mouth and throat). Both are less likely if you gargle with water after use.

Long-term use of inhaled corticosteroids in children could potentially result in slightly slowed height growth (about 1/2 inch) in the first year with most kids catching up to their expected growth.  In most cases the benefit of having the asthma controlled is far greater than the potential for any significant side effects.

What are oral steroids used for?

Oral steroids (such as prednisone, Orapred, or a Medrol dose pak) may be required to control severe asthma or other allergic conditions.  They are often used during severe exacerbations when inhaled or other medications are not effective.  When used, oral corticosteroids are usually considered as short-term medications for flare-ups until the condition can be calmed and returned to good control.

What are the side effects of oral steroids?

Side effects of short-term use may include weight gain, increased appetite, insomnia/increased energy, menstrual irregularities, muscle cramps, heartburn or irritation of the stomach lining.  Blood sugar levels can go up as well.  These side effects should go away shortly after stopping the corticosteroids.  Rarer side effects of high doses of oral steroids include avascular necrosis of the hip or other joints.

Long-term use (months to years) of oral corticosteroids may be associated with ulcers, weight gain, cataracts, decreased density of the bones, thinner skin and easy bruising, high blood pressure, elevated blood sugar, and potential decreased growth in children.

What can be done to minimize side effects?

Steroids should only be used when necessary and only when recommended by your doctor.  If you have taken a number of courses of prednisone, you should add Calcium (at least 2000mg) and Vitamin D (400 units) to your diet to help minimize any effects on your bones.  Your doctor may also recommend a bone scan called a DEXA.

This is a handout from the Asthma and Allergy Affiliates reviewing the risks and benefits of using prednisone or systemic corticosteriods.  These handouts are intended for our patients and are not a substitute for discussing your (or your child’s) unique situation with one of our physicians.