What are corticosteroids?
Corticosteroids are similar to hormones your body makes. When given in doses higher than what is normally made by your body, corticosteroids can suppress inflammation. They are used to relieve symptoms of inflammation like those seen in rheumatoid arthritis. Corticosteroids also lower your immune system. There are many forms of corticosteroids; Prednisone and Medrol dose packs are often the most commonly prescribed in rheumatic diseases.
How do I take it?
For people with rheumatic diseases corticosteroids can be taken/given:
- By mouth. Prednisone and medrol dose packs are common examples.
- By injection into muscle.
- By injection into veins (IV infusion).
- By injection directly into a swollen joint.
Oral (by mouth) corticosteroids are taken daily, usually for short periods of time. The dose depends on the patient needs. Your doctor will tell you how many pills to take and how often. Follow your doctor’s directions. For the best results, take these pills at the same time every day. Do not take more or less medicine than ordered. This medicine may be taken with or without food.
What about side effects?
Corticosteroids have side effects, especially if high doses (greater than 10 mg a day) are taken for a long time. Corticosteroids work on your whole body, not just your joints. Because of this, side effects can be very broad. Report any unpleasant effects to your doctor. Side effects include:
- Glaucoma – elevated eye pressure which if not diagnosed can result in lower vision
- Fluid retention, swelling in your lower legs
- High blood pressure
- Mood swings
- Weight gain, especially in the face, neck and abdomen
- Cataracts – Clouding of the lens in one or both eyes
- High blood sugar, which may result in diabetes
- Increased risk of infections
- Osteoporosis (thinning bones) and fractures
- Slow wound healing
- Difficulty in sleep
There are additional side effects that may occur if steroids are injected into the joint. These may include pain or infection in the joint. Injections are generally safe, well tolerated but limited to no more than three or four a year in the same joint. Please follow your physician’s instructions after receiving a corticosteroid injection in the joint.
What about other medications?
Corticosteroids can be taken with other medications; however it is best to have your doctor’s advice before adding another drug to your daily routine.
What else should I know?
Corticosteroids are often used for a short period of time, less than 2 weeks, to treat a flare of disease. They are fast acting and can control painful swollen joints within a few days. This is often referred to as a steroid taper.