Introduction

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

They're a man-made version of hormones normally produced bythe 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)

These pagesare aboutsteroid tablets, inhalers and injections. Steroid lotions, creams and gels are covered separately.

What are corticosteroids used for?

Corticosteroids are mainlyused to reduce inflammation and suppress the immune system.

They are used to treat conditions such as:

• asthma
• allergic rhinitis and hay fever
• urticarial (hives)
• atopic eczema
• chronic obstructive pulmonary disease (COPD)
• painful and inflamedjoints, muscles and tendons
• lupus
• inflammatory bowel disease (IBD) including Crohn's disease and ulcerative colitis
• giant cell arteritis and polymyalgia rheumatica
• multiple sclerosis (MS)

Corticosteroids can also be used toreplace 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:

• increased appetite potentially leading to weight gain
• acne
• thinned skinthat bruises easily
• increased risk of infections
• mood changes, mood swings and depression
• diabetes
• high blood pressure
• osteoporosis (weak and brittle bones)
• withdrawal symptoms caused by suppression of the adrenal glands

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.

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
• havingmental health or behavioural problems such asdepression 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 youre pregnant or breastfeeding, although your doctor will only prescribe them if the risks of not being treated outweigh the risks associated with the medication.

and interactions of corticosteroids .