Getting the best from your oral corticosteroid medicines

Oral corticosteroid medicines, usually taken as a tablet or liquid, help treat a range of health conditions and relieve symptoms. This topic provides information on how you can take an active role in managing your health condition while taking oral corticosteroids. Make sure you see your doctor frequently to monitor your condition, and follow their advice.

What are corticosteroid medicines?

Oral corticosteroids are synthetic hormones similar to those made naturally by the body. They work by decreasing inflammation and are used to manage a range of inflammatory and allergic conditions, including:

• Rheumatoid arthritis
• Asthma
• Chronic Obstructive Pulmonary Disease (COPD)
• Eczema
• Polymyalgia

The many types of oral corticosteroid medicines include:

• Prednisolone (e.g. Panafcortelone^®, Solone^®, Predmix^®, Redipred^®)
• Cortisone (e.g. Cortate^®)
• Hydrocortisone (e.g. Hysone^®)
• Prednisone (e.g. Panafcort^®, Predsone^®)
• Dexamethasone (e.g. Dexmethsone^®).

Oral corticosteroid medicines are not the same as anabolic steroids which are inappropriately used by weightlifters and bodybuilders.

How do I take oral corticosteroid medicines safely?

If you need to take oral corticosteroid medicines for a long period, see your doctor regularly to monitor your medical condition. Talk to your doctor about your individual treatment plan for your condition and follow their advice.

Your doctor will determine the appropriate dose and length of time you will need to take your oral corticosteroid medicines. Although your doctor will try to maintain the lowest possible dose, from time to time a higher dose may be needed when your condition is more active or worse.

Once your symptoms are under control, your dose may be reduced slowly and if appropriate the medicine may be stopped. Your pharmacist can also provide help and advice if you are changing your dose.

What can I do while taking corticosteroids?

Oral corticosteroid medicines can affect bone strength, blood sugar levels, heart health, eyes and skin. They may also cause weight gain. However, there are many things you can do. Together with your doctor you can take an active role to reduce these effects and manage your condition.

Keep your bones & muscles strong

Maintaining good bone health is one of the most important things you can do while taking your oral corticosteroid medicines. Talk to your doctor about:

• Arranging a bone mineral density (BMD) test to monitor your bone strength
• Whether you need medicine to strengthen your bones, or vitamin D and calcium supplements.

Eating a healthy balanced diet rich in calcium (such as dairy foods, sardines and nuts), getting vitamin D from natural sunlight by spending time outdoors, and being physically active will also help keep your bones strong. Ask your doctor or physiotherapist to suggest the best type of exercise for you, such as walking or strength training.

Tell your doctor if you experience any new muscle weakness after you start taking an oral corticosteroid.

Take your medicines and supplements as prescribed by your doctor.

Check your blood sugar

Oral corticosteroids may increase blood sugar levels. Whether or not you have diabetes, ask your doctor to check your blood sugar level to make sure that it stays in a normal range.

Keep your heart healthy

Oral corticosteroid medicines can affect heart health. Your doctor may want to check your blood pressure and cholesterol more often. Eating a healthy diet, regular exercise, not smoking and limiting alcohol intake will also help to keep your heart healthy.

People who take oral corticosteroids can often experience fluid retention, weight gain and changes to their body shape.

Tell your doctor if you are concerned about any changes to your weight or body shape.

Maintain healthy skin & eyes

Oral corticosteroids can affect your skin and eye function. Your doctor may recommend an eye check with an optometrist. Talk to your doctor if you become concerned about changes in your vision.

Take care of your skin. See your doctor if a wound does not heal quickly or if you get a skin tear or develop a skin infection.

Keep your skin moist by using an emollient (non-cosmetic moisturiser) twice daily and use a soap substitute cleanser when bathing. Take care as soap substitute cleansers may make surfaces slippery (for practical tips on using emollients see www.veteransmates.net.au/VB_emollients). Talk to your pharmacist for advice about the skin emollients you can use.

What else should I talk to my doctor about?

While taking oral corticosteroids, tell your doctor if you:

• experience mood changes that are not usual for you, such as feeling very happy, sad or anxious, experience strange thoughts, or if you have difficulty sleeping.
• have any stomach upsets, such as nausea.
• are taking non-steroidal anti-inflammatory (NSAIDs) pain killers such as ibuprofen or diclofenac, as these can increase the risk of stomach ulcers when combined with oral corticosteroid medicines. Your doctor may prescribe medicine to treat stomach ulcers if required. Avoid purchasing over-the-counter NSAIDs (e.g. Nurofen^®, Voltaren^®) unless recommended by your doctor.

Your doctor may suggest you wear a MedicAlert bracelet or carry a treatment card. Make sure everyone in your healthcare team knows you are taking oral corticosteroids.

Take an active role in your oral corticosteroid treatment

Take this brochure with you to your next appointment with your doctor to discuss your oral corticosteroid treatment.

Think about what questions you might like to ask your doctor.

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