Oral Steroids (Steroid Pills and Syrups)

How are steroid pills and syrups used?
What is a steroid burst?
What about routine steroids?
What about routine steroid use and side effects?
Want to learn more about steroids?

 

How are steroid pills and syrups used?

Steroid pills and syrups are very effective at reducing swelling and mucus production in the airways. They also help other quick-relief medication work better. They are often necessary for treating more severe episodes of lung disease.

Common steroid pills and liquids include:

Medicine name

How the medicine works

How the medicine is used

  • Deltasone® (prednisone)
  • Medrol® (methyl-prednisolone)
  • Orapred®, Prelone®, Pediapred® (prednisolone)
  • Very effective in reducing inflammation in the airways
  • Help other quick-relief medicines work better
  • The steroids used treating lung disease are corticosteroids and are not the same as the anabolic steroids used illegally by some athletes for bodybuilding. Corticosteroids do not affect the liver or cause sterility
  • Available as pills and syrups. Often necessary for treating more severe episodes of asthma
  • Usually prescribed as a "burst": 2-7 days, occasionally up to several weeks (see below)
  • Side effects with a burst may include increase appetite, fluid retention, moodiness and upset stomach
  • For very severe lung disease, routine daily steroid pills may be required. Because long-term treatment can lead to significant side effects, anyone on daily steroid pills should be under the care of an asthma or pulmonary specialist.

 

What is a steroid burst?

Many people with chronic lung disease periodically require a short-term burst of steroid pills or syrups to decrease the severity of acute attacks and prevent an emergency room visit or hospitalization. A burst may last two to seven days and may not require a gradually decreasing dosage. For others, a burst may need to continue for several weeks with a gradually decreasing dosage. You may experience a few mild side effects such as increased appetite, fluid retention, moodiness and stomach upset. These side effects are temporary and typically disappear after the medicine is stopped.

Learn more about both inhaled and oral steroids in the treatment of asthma.

 

What about routine steroids?

Some people with a chronic lung disease require the use of steroid pills or syrups as part of their routine treatment for weeks, months or longer. In several lung diseases, the main treatment is high-dose steroid pills for several months or longer. If you have asthma, it is important that your treatment include an adequate dosage of an inhaled steroid before beginning routine steroid pills. We recommend that anyone requiring routine steroid pills be under the care of a specialist (pulmonologist or allergist).

 

What about routine steroid use and side effects?

The use of routine steroid pills or frequent steroid bursts can cause a number of side effects. Steroid side effects usually occur after long-term use with high doses of steroid pills. Side effects, which may occur in some people taking high-dose steroid pills, include:

Side Effects

Prevention &/or Treatment of Side Effects

Endocrine (hormones):

  • Suppression of the adrenal glands 
  • Delayed sexual development
  • Changes in menstrual cycle
  • Increase and change in fat placement causing fullness in the face and weight gain
  • Increased blood sugar (diabetes)
  • Emotional changes such as moodiness, depression, euphoria or hallucinations.

Endocrine (hormones):

  • Your healthcare provider may prescribe your steroid pills at specific times. Make sure you take your steroid pills as prescribed and do not stop them suddenly.
  • If you have taken oral steroids, talk with your healthcare provider about obtaining a medical alert bracelet.
  • Talk with your healthcare provider if you are having moodiness or depression that doesn't seem to get better.

Fluid and Electrolytes

  • Salt and water retention
  • High blood pressure (hypertension)
  • Loss of potassium

Fluid and Electrolytes

  • Limit the amount of salt and foods that are high in sodium to prevent fluid retention and swelling. Condiments and processed foods tend to be high in sodium.
  • Add foods that are high in potassium to your diet.

Eyes

  • Increased pressure in the eye (glaucoma)
  • Clouding of vision in one or both eyes (cataracts)

Eyes

  • Visit the eye doctor (Ophthalmologist) at least yearly. Inform him or her that you take steroid pills routinely.

Skin

  • Increase in body hair and acne
  • A tendency to bruise easily
  • Thinning of the skin and poor wound healing

Skin

  • Ask your healthcare provider about how acne can be treated.
  • Keep the skin well moisturized.

Nutrition

  • Increase in appetite
  • Irritation of stomach and esophagus with possible ulcer symptoms and, rarely, bleeding

Nutrition

  • If you are eating more food, be sure you choose low-fat, low-sugar items to control calories. Ask your healthcare provider or dietitian to help you with a specific diet plan.
  • Eat a well balanced diet that meets the Food Pyramid Guidelines.
  • Take your steroid dose with food to decrease stomach irritation.

Muscles

  • Muscle weakness or cramps

Muscles

  • Routine exercise may be recommended to prevent or decrease muscle weakness.

Bones

  • Joint pain (especially as steroids are decreased)
  • Thinning of bones (osteoporosis) may lead to fractures or compressions, especially of the backbone and the hip
  • Loss of blood supply to bones (aseptic necrosis) may cause severe bone pain and may require surgical correction

Bones

  • To prevent osteoporosis (loss of calcium in the bones), it is important to eat foods high in calcium, such as dairy products. If you need to control calories, low fat dairy products may be used.
  • Your healthcare provider or dietician may recommend certain supplements, such as calcium, vitamin D and a multi-vitamin.
  • Weight bearing exercise may also be recommended by your healthcare provider.
  • Medication may be prescribed to improve osteoporosis.

Immune System

  • General suppression of the immune system causes an increased risk to a variety of infections, for example chickenpox

Immune System

  • Good handwashing
  • Avoid exposure to any infectious disease.
  • If you or your child is exposed to chicken pox or measles while receiving oral steroids or high dose inhaled steroids, notify your healthcare provider immediately to determine if any special treatment is needed.

 

Want to learn more about steroids?

Learn the basics about steroids including what corticosteroids are; what steroids are produced in the body; some more steroid medicines; important dosing considerations; and our research on steroids.

Learn more about some common inhaled steroids including how inhaled steroids are typically prescribed; how the dosage of steroids is determined; side effects of inhaled steroids, and some recommendations to decrease or prevent side effects.

 

This information has been approved by David Tinkelman, MD (August 2012).

Bookmark and Share