Oral Corticosteroid

What is this medication for?

The adrenal glands which lie just above the kidney produce steroid hormones. Corticosteroids are medications which act in the same way as steroid hormones. Certain corticosteroids such as hydrocortisone are used to replace the body’s production when the adrenal glands are not working normally. 

Corticosteroids such as prednisolone can also be used to reduce inflammation (signs include warmth, redness, swelling and pain) or calm an overactive immune system. Therefore, steroids can help to reduce swelling, redness, itchiness and allergic reactions. They are used in different conditions such as severe allergies, skin problems, asthma, arthritis (joint inflammation) and autoimmune diseases (where the immune system attacks the body).

How should I take or use this medication?

• Your doctor will tell you how much and how often to take the medication. Your doctor will prescribe the lowest effective dose for you.
• You need to take it as instructed to get the best benefit. Do not take more than the prescribed dose or more often than directed as this may increase the risk of having side effects.
• Do not stop this medication unless instructed by the doctor as there may be a need to slowly reduce the dose before stopping the medication completely.
• Take corticosteroids with or after food to prevent stomach upset.

What should I do if I forget to take or use this medication?

If you forget a dose, take it as soon as you remember and then continue to take it as you normally would. However, if it is almost time for the next dose, skip the missed dose and take the next dose at the usual time. Do not double or increase the dose to make up for the missed dose.

What precautions should I take when taking or using this medication?

Inform your healthcare professional if:

• You are allergic to this medication or any of the other ingredients of this medication
• You are pregnant, intending to get pregnant or are breastfeeding
• You have diabetes
• You have high blood pressure
• You have thyroid disease
• You have epilepsy (fits), kidney, liver, thyroid or heart problems
• You have osteoporosis, a condition where you have brittle or weak bones
• You have severe depression (feeling extremely sad, having low mood)
• You, or anyone in your family, have glaucoma (abnormally high pressure in the eye)
• You have stomach ulcers
• You have any visual disturbances (abnormal changes in vision)
• You have tuberculosis (a type of lung infection) or other infections
• You have myasthenia gravis, a rare condition that affects the way your muscles respond to signals from nerves, leading to muscle weakness
• You have been taking corticosteroids for a long period of time and
  • intend to have any vaccination (an injection that protects you from future infections)
  • are going to undergo any surgery, skin tests
  • have a serious infection or injury

You should take note of the following:

• Keep to your regular appointments so that your doctor can check on your response and adjust your medication accordingly.
• Do not allow anyone else to take this medication.
• If you are taking corticosteroids to replace your body’s steroid level, inform your doctor if you are sick. You may need extra oral corticosteroids on these days.
• You may get infections more easily while being treated with corticosteroids. Avoid crowded places or being near people who are sick. Avoid close contact with people who have chicken pox, shingles or measles. Check with your doctor immediately if you develop a fever, sore throat or other signs of infection.

What are some common side effects of this medication? ​

• Stomach discomfort, nausea or vomiting
• Being unable to sleep or feeling restless
  • Take the medication earlier in the day to minimise this side effect, avoid taking at night unless instructed by your doctor or pharmacist
• Water retention (excess fluid build up in the body), increase in weight
• Muscle weakness or cramps (if you have been using the medication for a long period of time)
• Getting bruised more easily

Inform your doctor if any side effect lasts for more than a few days, or the side effects become serious or bothersome. 

What are some rare but serious side-effects that I need to seek medical advice immediately? 

The symptoms of a drug allergy include one or more of the following:

• Swollen face/eyes/lips/tongue
• Difficulty in breathing
• Itchy skin rashes over your whole body

You can also find out about drug allergies by watching these videos:

For videos in 中文, Melayu and தமிழ், click here

Other rare but serious side effects that may occur include:

• Signs of infection like fever, chills, sore throat, mouth sores, or wounds that will not heal
• Signs of high blood sugar, like confusion, feeling tired, increased thirst, increased hunger, frequent urination, flushing or fast breathing
• Severe abdominal or stomach pains
• Swelling, warmth, numbness, change of skin colour, or pain in a leg or arm
• Change in eyesight or vision
• Bone pain or fractures
• Having a full or very round face
• Mood changes such as feeling depressed, anxious, frequently changing emotions
• Unusual bruising or bleeding, including black tarry or bloody stools or vomiting
• Severe nausea and vomiting, or unable to take the medication by mouth

If you experience any of these symptoms, you should stop your medication and see your healthcare professional immediately.

What food or medication should I avoid when I take or use this medication?

Avoid taking alcohol with corticosteroids as this combination can cause stomach problems.

Please inform your doctor if you are taking any of the following medications, before you start taking any corticosteroids:

• Aspirin
• Certain medications for pain such as Ibuprofen, Diclofenac, Naproxen
• Oral medications to treat fungal infection
• Medications to thin your blood such as warfarin
• Oral hormone pills
• Medications used to reduce the activity of your body’s immune system such as Cyclosporin or Tacrolimus

Inform your doctor if you are on any other medications. This includes prescription medications or over-the-counter medications, including supplements, traditional medications and herbal remedies.

If your doctor has advised you to take a low salt diet, follow the dietary instructions strictly. This helps to prevent excessive water retention.

How should I store this medication?

Store in a cool and dry place, away from direct sunlight. Keep this medication away from children. 

How do I throw away this medication safely? ​

Pack this medication into a black trash bag and seal it tightly before throwing into the rubbish chute or bin. 

What else should I know about this medication? 

A steroid emergency card may be given to you if your body is dependent on corticosteroid medications and is unable to produce enough of the natural hormone cortisol.

• Always keep the steroid emergency card with you, and for at least 12 months after stopping corticosteroid treatment.
• Always show the healthcare professionals your steroid card if you go to the emergency department or visit any doctor.
• Inform your next-of-kin that you are taking corticosteroids.
• Bring along the card when travelling.

What to do if you feel unwell (e.g. fever, vomiting, or diarrhoea)?

• Do not stop your steroid suddenly unless advised by your doctor.
• See a doctor as soon as possible and let them know that you are taking steroids.
• If you are still able to take your corticosteroid medications, increase your steroid dose when you are unwell (follow your doctor's specific instructions) and resume your old dose when you have fully recovered.
• If you are vomiting or you are unable to take your corticosteroid medications, go to the emergency department as this is dangerous and you may need an injection form of corticosteroids.