Oral Corticosteroids

Commonly called ‘rescue medicine’, ‘steroid tablets’, ‘pred’, ‘oral corticosteroids’ or ‘systemic corticosteroids’.   

Those commonly used in asthma include: prednisolone, prednisone or dexamethasone.

Tablets
Tablets

Liquid

HOW DO ORAL CORTICOSTEROIDS WORK? 

Oral corticosteroids are a powerful medicine that works to reduce inflammation. For people with asthma, it quickly reduces the swelling in your lungs, helping you to breathe more easily. Oral corticosteroids usually start working within 2 hours. 

Oral corticosteroids are taken by mouth and are absorbed into your blood to be transported to your lungs, where they are needed. But they also reach other parts of your body, which can result in unpleasant side effects. This is why oral corticosteroids should be prescribed with care.  

In contrast, inhaled corticosteroids are breathed in right to the lungs where they are needed. At normal doses recommended for most people with asthma they don’t affect the rest of your body much, if at all. 

WHY MIGHT YOU NEED ORAL CORTICOSTEROIDS?   

There are a few reasons you might be prescribed oral corticosteroids: 

  • You might be prescribed a short course of oral corticosteroids to treat a flare-up or an asthma attack. 
  • Oral corticosteroids might be prescribed as part of your Asthma Action Plan if you have a flare-up.  
  • If you have severe asthma, you might need to take them more often to keep well. 

Taking a lot of oral corticosteroids in your lifetime can increase your risk of side effects, so your doctor will try to help you avoid them if they can. 

If you have used oral corticosteroids twice or more in a year, it is important to have a focused conversation about your asthma control with your doctor.  

HOW DO YOU USE ORAL CORTICOSTEROIDS?  

Oral corticosteroids are usually prescribed as a tablet that you swallow for adults or a liquid for children. You will usually take this medicine for 5-10 days for adults and 3-5 days for children.   

Weaning down doses of oral corticosteroids is usually only needed when taken longer term (more than 14 days).  

WHY MIGHT YOU NEED LONG TERM ORAL CORTICOSTEROIDS?   

If you have severe asthma, you might be prescribed oral corticosteroids long-term. This could be for months or even years. Your doctor or specialist will only give you this if it is necessary to keep you from having symptoms that keep getting worse and making you unable to function. 

If you are prescribed long-term oral corticosteroids, you could ask your doctor or specialist if there may be specialised medicines available and suitable for you. For many people, specialised and targeted treatments are effective at reducing or eliminating the need for long-term oral corticosteroids. 

SIDE EFFECTS OF ORAL CORTICOSTEROIDS

Some side effects of oral corticosteroids may include changes to your mood, vision, skin, bones digestive system, hormones and more.

(Image adapted from Blakey et al. (2021). Oral corticosteroids stewardship for asthma in adults and adolescents: A position paper from the Thoracic Society of Australia and New Zealand. Respirology, 26(12), 1112-1130. doi:10.1111/resp.14147) 

 

Talk to your doctor or pharmacist if you are worried about the side effects of oral corticosteroids or any other medicine.  

If you’ve needed even one course of oral corticosteroids, ask for a focused review of your asthma so that you have all the information and tools that you need to do all you can to prevent a future flare-up and need for more oral corticosteroids.