MedShadow Blog

Need to Know: Corticosteroids

Corticosteroids are used for a wide variety of ailments, from pain due to arthritis to asthma. Find out more about them to improve your use of these drugs.
By Jenna Aronson
Published: July 18, 2016
 

Corticosteroids are often used in the treatment of joint pain or inflammation (arthritis), as well as irritable bowel disease (ulcerative colitis and Crohn’s disease), skin diseases, allergies, asthma and even brain tumors. However, this class of drugs can cause many complications. Knowing and understanding the facts can improve corticosteroid use.

Common Names

Celestone (betamethasone), Cortone (Cortisone acetate), Decadron (dexamethasone), Cortef (hydrocortisone), Aristocort (hydrocortisone), Medrol (methylprednisolone), Prelone (prednisolone), Deltasone (prednisone)

Side Effects and What to Do About Them

Corticosteroids can be taken in tablet form or through inhalation, and the side effects will differ based on what form of medication is used.

The most common side effects of inhaled corticosteroids include a sore mouth, hoarse voice, and infections in the throat and mouth. To avoid or reduce these side effects, it’s highly recommended to rinse the mouth out with water after taking the medication.

The most common side effects of corticosteroids in tablet form include bruising of the skin, weight gain, weakening of the bones, high blood sugar levels, cataracts, and swelling of the feet or ankles. Side effects can lessen during treatment as your body adjusts to the medicine, but if these side effects continue or are bothersome, you may want to check with your doctor to discuss alternative medications.

Diet is very important if you take a corticosteroid for a long time. Doctors might want you to follow a low-sodium or a potassium-rich diet.

Before giving corticosteroids to children or teenagers, doctors should discuss the possible side effects. They may cause infections like chickenpox or measles, or slow growth in children and teenagers.

According to a Cochrane review, clinical trials cannot prove that inhaled corticosteroids reduce inflammation in the lungs of cystic fibrosis patients. However, one trial reveals that inhaled corticosteroids can inhibit a child’s growth when used in high doses.

Older patients who take corticosteroids may be at risk of high blood pressure or osteoporosis. Women, in particular, are at risk of developing bone disease. Because of this, women should ensure they are getting enough calcium and vitamin D in their diet. If not, they should consider taking supplements. In severe cases, bisphosphonates may be prescribed to treat the osteoporosis.

In another Cochrane review, there is convincing evidence that corticosteroids can reduce the rate of erosion progression in rheumatoid arthritis. Unfortunately, there is some concern that the long-term effects of corticosteroids, such as increased cardiovascular risk and osteoporosis, may outweigh the benefits.

Drug Interactions

Other medicines can interact with corticosteroids, and as a result the side effects of either medicine can be altered.

Mixing corticosteroids and anticoagulant medicines (such as heparin, warfarin, dabigatran, apixaban, and rivaroxaban) can make anticoagulants less effective. Additionally, it can cause bleeding inside the digestive system.

If you need to take both corticosteroids and a diabetes medication, then your blood glucose levels should be checked regularly and your dose of diabetes medication might need to be adjusted.

Combining NSAIDs (non-steroidal anti-inflammatory drugs) such as aspirin, ibuprofen, Voltaren (diclofenac), naproxen and corticosteroids increases your risk of developing stomach ulcers and internal bleeding. If you need to take both medications, you may be given a proton pump inhibitor (PPI) to minimize the risk of stomach ulcers.

Effectiveness & Considerations

Corticosteroids are intended to provide relief for inflamed areas of the body. They are used to lessen swelling, redness, itching, and allergic reactions. Typically, corticosteroids are used to treat severe allergies or skin problems, asthma, and arthritis.

The body naturally produces cortisone-like hormones to maintain good health, but if your body doesn’t produce enough cortisol, then your doctor might suggest corticosteroids to help make up the difference. This type of medicine is available by prescription only. The duration of corticosteroid treatment depends on the condition being treated.

Alternatives to Corticosteroids

Corticosteroids are the most popular therapy to treat inflammation, but patients should consider the safety concerns. Herbs and dietary supplements might offer just as effective results as prescribed corticosteroids. Natural anti-inflammatory treatments include omega-3 fatty acids (fish oil), white willow bark, curcimin (turmeric), and green tea. Always make sure your health care providers know all the medicines, herbs and supplements you are taking or considering taking. Every product you put in your body can cause interactions you may not know to expect.

Since the late 18th century, fish oil has been used to treat muscular, skeletal, and discogenic diseases. The therapeutic benefits of fish oil have shown to be an effective, natural anti-inflammatory agent. The active ingredients in fish oil can directly reduce inflammation in cartilage. There have been positive clinical studies that show the efficacy of fish oil in treating arthritis.

One of the oldest herbal remedies for pain and inflammation is bark from a white willow tree.  White willow bark works similarly to aspirin by blocking swelling. Usually, the dose of white willow bark is 240 mg/day. White willow bark is available as a supplement in a pill form, as well as a liquid extract.

Curcumin is yellow in pigment and derived from turmeric, a plant of the ginger family. Curcumin is considered to inhibit inflammation by suppressing NF-kB, a protein complex that controls transcription of DNA. Clinical studies have shown that curcumin has anti-inflammatory effects. It’s possible to be a viable natural alternative to nonsteroidal agents.

Green tea is used in the treatment of arthritic disease as an anti-inflammatory agent. The constituents of green tea have shown to inhibit aggrecanases, enzymes found in cartilage, which degrade cartilage. Research on green tea demonstrates anti-inflammatory effects.

How They Work (Method of Action)

Corticosteroids imitate the effects of cortisol, a natural hormone in your body, to suppress inflammation. They also lower the activity of your immune system by reducing white blood cells, which help to prevent damage to body tissue.

What Worked for You?

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MedShadow Coverage on Corticosteroids

Further Reading

Corticosteroids Method of Action

Jenna Aronson

Jenna Aronson is a rising sophomore at Arizona State University. She is pursuing a degree in broadcast journalism at the Walter Cronkite School of Journalism and Mass Communications.

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