Corticosteroids

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  1. 1. Introduction
  2. 2. Who can use them

Introduction

Corticosteroids, often known as steroids, are an anti-inflammatory medicine prescribed for a wide range of conditions.

They're a man-made version of hormones normally produced by the adrenal glands (two small glands that sit on top of the kidneys).

Corticosteroids are available in different forms, including:

  • tablets (oral steroids)
  • injections – which can be into blood vessels, joints or muscles
  • inhalers – such as mouth or nasal sprays
  • lotions, gels or creams (topical steroids)

What are corticosteroids used for?

Corticosteroids are mainly used to reduce inflammation and suppress the immune system.

They are used to treat conditions such as:

Corticosteroids can also be used to replace certain hormones that are not being produced by the body naturally – for example, in people with Addison's disease.

Possible side effects

Corticosteroids will only be prescribed if the potential benefits of treatment outweigh the risks. They will also be prescribed at the lowest effective dose for the shortest possible time.

There aren't usually any severe side effects if you take steroid injections, a steroid inhaler, or a short course of steroid tablets. However, prolonged treatment at high doses – particularly with steroid tablets – can cause problems in some people.

Potential side effects of long-term treatment include:

If you have troublesome side effects after taking corticosteroids, don't stop taking your medication until your doctor says it's safe to do so, because of the possibility of these unpleasant withdrawal effects.

Your dose may need to be reduced slowly over a few weeks or months, and you may have to have tests to ensure that your adrenal glands are still working properly before stopping corticosteroids altogether, if you have been taking them for a long time.

Read more about the side effects of corticosteroids.

Cautions and interactions

For most people, including pregnant or breastfeeding women, steroid inhalers and injections are safe. However, they will still only be used if a doctor thinks the potential benefits outweigh the risks.

As steroid tablets are more likely to cause side effects, there are some circumstances when they shouldn't be used or should only be used with caution. These circumstances include:

  • having an ongoing widespread infection
  • having mental health or behavioural problems – such as depression or alcohol dependence
  • having certain underlying physical conditions – such as liver problems, heart failure, high blood pressure or diabetes
  • taking another medication that may interact with corticosteroids

Corticosteroids can often be taken while you’re pregnant or breastfeeding, although your doctor will only prescribe them if the risks of not being treated outweigh the risks associated with the medication.

Read more about who can use corticosteroids and interactions of corticosteroids.

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Who can use them

For most people, steroid inhalers and steroid injections should not cause any troublesome side effects. Steroid tablets are generally prescribed with more caution, as these can potentially cause more problems.

Steroid tablets

Corticosteroid tablets are the most powerful type of steroid medication, because they can affect the whole body.

They shouldn't be used if you have an ongoing widespread infection, because they could make it more severe. However, you should continue to take corticosteroids if you develop an infection while already being treated, unless advised otherwise.

Steroid tablets should be used with caution in people with:

  • liver problems, such as liver disease – corticosteroids may not be broken down by the liver at a normal rate, leading to increased levels of the medication in the blood
  • mental health or behavioural problems, such as depression or alcohol dependence – corticosteroids can have unpredictable effects on behaviour and mood
  • wounds – oral corticosteroids can delay wound healing  

They should also be used with caution in people with a health condition that could be made worse by taking oral corticosteroids, including:

In these situations, you will only be prescribed oral corticosteroids if the benefits of treatment clearly outweigh any potential risks.

Steroid injections

Most people can safely have corticosteroid injections, but they should be avoided or used with caution if you have an ongoing infection or a blood clotting disorder (such as haemophilia).

Steroid inhalers and sprays

There is generally no reason why someone shouldn't be able to use a steroid inhaler or steroid spray, but these should be used with caution in people with ongoing infections, such as tuberculosis (TB).

Pregnancy

Corticosteroids are generally safe to use during pregnancy. However, they're not usually recommended unless the potential benefits outweigh the risks.

For example, steroid tablets may be recommended if you're pregnant and have severe asthma, because the risk to your baby from uncontrolled asthma is higher than from the medication.

There is no evidence that using a steroid inhaler during pregnancy increases the risk of problems such as birth defects, so you can usually continue to use this as normal while you're pregnant. 

Breastfeeding

If a woman needs to take steroid tablets while she is breastfeeding, a type called prednisolone is usually recommended, because it is thought to have the least chance of causing the baby any adverse effects. As a precaution, it's usually recommended that a breastfeeding mother waits three to four hours after taking a tablet before feeding her baby.

Steroid injections, inhalers and sprays are not thought to pose a risk to babies being breastfed.

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Last updated:
07 January 2022

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