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Steroid tablets

Also called corticosteroid tablets or oral steroids

Key points about steroid tablets

Steroids are hormones that your body produces naturally.
Artificial steroids act like natural steroids and some of them are used to reduce inflammation.
Find out how to take steroid tablets safely and possible side effects.

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There are several different forms of steroid medicines. This page is about tablets, taken by mouth. Other types of steroids include creams, inhalers, nasal sprays and injections into joints.

Prednisone is the most commonly prescribed steroid tablet. Other examples of steroid tablets include dexamethasone, hydrocortisone and methylprednisolone.

Steroid tablets are very effective to reduce inflammation. They suppress your body’s immune system, and can also block a chemical called histamine (which is released during an allergic reaction).

Steroid tablets are used to treat a number of conditions associated with inflammation. They don’t cure the condition but do suppress the symptoms.

Examples of conditions associated with inflammation

Inflammatory bowel diseases (eg, Crohn's disease, ulcerative colitis).
Autoimmune diseases (eg, systemic lupus erythematosus (SLE), autoimmune hepatitis).
Joint and muscle diseases (eg, rheumatoid arthritis, polymyalgia rheumatica, gout).
Allergies.
Asthma.
Chronic obstructive pulmonary disease (COPD).

Steroid tablets are also used as part of some cancer treatment. Steroids can be prescribed as replacement treatment for people whose own natural steroids are lacking (eg, in Addison's disease, congenital adrenal hyperplasia and hypopituitarism).

Take your medicine as prescribed by your doctor. They'll explain how much to take and how often. Steroid tablets are usually taken once a day, preferably in the morning, with or after food. They are sometimes prescribed to be taken every other day or for just a short course of a few days or a week.

Dose

Your doctor will advise you on the correct dose, which depends on your condition and your weight. Your dose is likely to be reduced as your symptoms improve.

If you’ve been taking steroids for a long time, your doctor will make any reductions very slowly. They may decide that you should continue on a small dose (a maintenance dose) for a long time.

Stopping steroids

You shouldn’t stop taking your steroid tablets or change the dose unless advised by your doctor. If you’ve been taking steroid tablets for more than 2 weeks, it’s dangerous to stop them suddenly. You usually need to reduce your dose slowly.

Stopping suddenly can cause your adrenal gland, which makes important hormones for your body, to stop working. This is known as adrenal insufficiency.

Depending on the dose you take and the reason you’re taking them, steroid tablets can work very quickly. You may notice an improvement within a few days.

Here are some things to know when you're taking steroid tablets. Other things may be important as well, so ask your healthcare provider what you should know about.

Other medicines: Steroid tablets can interact with some medications, herbal supplements and rongoā Māori, so check with your doctor or pharmacist before starting steroid tablets and before starting any new products.
Tell your healthcare providers: It's important to tell any health professional taking care of you that you are taking steroid tablets. Also let your prescriber know if you have glaucoma, osteoporosis, high blood pressure, epilepsy or stomach ulcers.
Increased risk of infections: Taking steroid tablets for a long time can increase your risk of all types of infections. Tell your doctor if you come into contact with someone who has a contagious illness such as chickenpox or measles, or if you feel unwell.
Vaccines: It's safe to have most vaccines, including the flu vaccine, while you're taking steroid tablets. Protecting yourself against infection is important because steroid tablets suppress your immune system. However, vaccination with 'live' vaccines should be postponed. Ask your doctor for advice before you have any vaccines while you're taking steroid tablets.

Like all medicines steroid tablets can cause side effects, although not everyone gets them. Most side effects are related to the dose you are taking and how long you are taking steroid tablets for.

Tendon problems

Steroid tablets can cause tendon problems, eg, tendinitis or tendon rupture. The Achilles tendon in your ankle or calf is most likely to be affected but other tendons can also be involved.

You're at higher risk if you:

are over 60 years of age
are taking statins, eg, atorvastatin
have chronic kidney disease or have had a kidney, heart or lung transplant.

Let your healthcare provider know straight away if you get pain and swelling in your joints. This can happen from a few hours after the first dose to several months after you've stopped the treatment. Read more about medicines and tendon problems.

Other side effects

Side effects	What should I do?
Difficulty sleeping	It's best to take your steroid dose in the morning or at least 3 hours before bedtime.
Headache Muscle weakness, feeling tired	These are quite common when you first start taking steroid tablets and usually go away with time. Tell your doctor if they bother you.
Increased appetite	Steroid tablets increase your appetite. Follow a healthy, balanced diet to maintain your weight. Develop an eating schedule and stick to it.
Fluid retention causing swollen ankles and feet	Whenever possible, sit with your feet raised. Avoid foods with high salt content. Tell your doctor if this happens.
Raised blood glucose	Steroid tablets can cause an increase in blood glucose. If you have diabetes, you may need to increase the dose of your diabetic medication to control your blood glucose. Talk to your doctor about this. Steroid tablets can also cause the onset of diabetes in people who are at risk of diabetes. Your doctor will monitor your blood glucose levels regularly.
Changes in mood or behaviour Mood swings, irritability, anxiety, bad dreams, anxiety or depression	Tell your doctor immediately or phone Healthline 0800 611 116.
Eye pain and changes to your vision	Tell your doctor immediately or phone Healthline 0800 611 116.
Problems with your stomach such as stomach pain, blood in your stool, or dark coloured stool	Tell your doctor immediately or phone Healthline 0800 611 116.