Commonly called rescue medication, steroid tablets, or oral or systemic corticosteroids.
Includes medications such as Panafcortelone, Predmix, Predsolone, Redipred, Solone, Panafcort or Sone. The active ingredient is prednisolone or prednisone.
HOW DO ORAL CORTICOSTEROIDS HELP ASTHMA?
Oral corticosteroids are a powerful anti-inflammatory medicine which helps by quickly reducing the swelling in your lungs. They are much stronger than the inhaled corticosteroid in preventer inhalers. They usually only take up to 1-2 hours to start working.
Most people should not need to rely on oral corticosteroids to keep their asthma under control. Frequent or long-term use of oral corticosteroids increases your chance of side effects. It is much safer to take a daily preventer, then rely on having high dose oral corticosteroids to treat a flare-up.
WHY MIGHT YOU NEED ORAL CORTICOSTEROIDS?
You might be prescribed a short course of oral corticosteroid to help regain asthma under control during a flare-up or ‘asthma attack’.
Your doctor may include oral corticosteroid medication on your written Asthma Action Plan as a step to take if your asthma worsens. Asthma Action Plans that include instructions for the use of oral corticosteroids as well as instructions to increase the dose of inhaled corticosteroid, are effective in improving lung function and reducing hospital admissions.
Needing two doses of oral corticosteroids in a year is a sign of uncontrolled asthma. If you need to use oral corticosteroids more than twice a year or for long periods, it is important to discuss other options with your doctor for improving your asthma control.
This might include:
- Checking your inhaler technique to make sure you are getting the most from your preventer
- Discussing the possibility of add-on therapies for your asthma
- Addressing other health conditions impacting your breathing.
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, over 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 months or even years. Your doctor or specialist will only prescribe this if it is necessary to prevent you from having regular flare-ups.
If you are prescribed long term oral corticosteroids, ask your doctor or specialist if any monoclonal antibodies are suitable for you. Monoclonal antibodies could reduce or eliminate your need for long term oral corticosteroids.
POSSIBLE SIDE EFFECTS OF ORAL CORTICOSTEROIDS
Side effects are more likely if you’re on long-term oral corticosteroid tablets, compared to if you only take a short course when your symptoms get worse. Your doctor will be aware of the possible side effects of steroid tablets and will monitor the doses and medicines you need for your asthma. To reduce the risk of side effects, your doctor will keep you on the lowest possible dose of steroid tablets.
Side effects associated with short term use include:
- Mood changes
- increased appetite
- diarrhoea or constipation
Side effects associated with long term use include:
- Bloating and rounding of face
- weight gain
- redistribution of body fat
- water retention
- cramps or weakness
- slowed growth in children
- irregular menstrual periods
- changes to the skin
- changes to the immune system
- changes in behaviour
- changes in the eyes.
- changes in bone which can result in an increased chance of fractures due to brittleness or softening of the bone
- changes in hormone levels in your body
- changes in the body’s ability to handle glucose (steroid diabetes)
- effects on the parathyroid and thyroid glands which control calcium and body metabolism
- increased amounts of cholesterol in the blood
- increased blood pressure
Some of these changes can only be detected by a doctor, so if you are on long-term oral corticosteroids your doctor may arrange extra monitoring.
Please discuss all side effects with your doctor.