Steroid tablets

Steroid tablets, also called corticosteroid tablets, are a type of anti-inflammatory medicine used to treat a range of conditions.

They can be used to treat problems such as allergies, asthma, eczema, inflammatory bowel disease and arthritis.

Steroid tablets are only available on prescription. Dissolvable, liquid and syrup versions are also available.

Common examples include prednisolone, betamethasone and dexamethasone.

How and when to take steroid tablets

Take your medicine as instructed by your doctor. They'll explain how much to take and how often.

It's normally best to take steroid tablets with or soon after a meal – usually breakfast – because this can stop them irritating your stomach.

If you miss a dose or take too much

If you forget a dose, take it as soon as you remember. If it's almost time for your next dose, skip the one you missed.

Don't take a double dose to make up for a forgotten one.

Accidentally taking too many steroid tablets is unlikely to be harmful if it's a one-off. Speak to your doctor or a pharmacist if you're worried.

Taking too many steroid tablets over a long period can make you more likely to get side effects.

Coming off treatment

Don't stop taking your medicine without talking to your doctor.

If you've been taking steroid tablets for more than a few days, you usually need to reduce your dose gradually.

This can help avoid unpleasant side effects (withdrawal symptoms) – such as severe tiredness, joint pain, vomiting and dizziness – and stop your original symptoms coming back suddenly.

Side effects of steroid tablets

Taking steroid tablets for less than three weeks is unlikely to cause any significant side effects. But you may get some side effects if you need to take them for longer or at a high dose.

Side effects of steroid tablets can include:

• indigestion or heartburn
• increased appetite, which could lead to weight gain
• difficulty sleeping
• changes in mood and behaviour, such as feeling irritable or anxious
• an increased risk of infections – especially chickenpox, shingles and measles
• high blood sugar or diabetes
• weakening of the bones (osteoporosis)
• high blood pressure
• Cushing's syndrome – symptoms such as thin skin that bruises easily, stretch marks on the thighs, and fat deposits in the face
• eye conditions, such as glaucoma and cataracts 
• mental health problems, such as depression or suicidal thoughts

Most side effects will pass once treatment stops. Tell your doctor if they bother you.

You can report any suspected side effect to a UK safety scheme.

Coping with side effects of steroid tablets

The following tips may help reduce the side effects of steroid tablets:

• take your tablets in the morning with breakfast (although some specially coated tablets can be taken without food) – this may help prevent indigestion, heartburn and sleeping difficulties
• eat a healthy, balanced diet and exercise regularly – this may help prevent weight gain and osteoporosis
• avoid close contact with people who are ill – get medical advice as soon as possible if you think you may have been exposed to someone with an infection
• ensure your vaccines are up-to-date – but don't have any "live" vaccines, such as the shingles vaccine

Your doctor may reduce your dose or suggest taking your tablets less often (for example, every other day) if you're having side effects.

They may also sometimes recommend other medicines to take alongside steroids to protect you from some of the side effects, such as medicines to help prevent indigestion or heartburn.

You may be given a special steroid treatment card that explains how you can reduce the risk of side effects.

Taking steroid tablets with other medicines, food or alcohol

Some medicines interfere with the way steroid tablets work. Tell your doctor if you take any other medicines, including herbal remedies and supplements, before starting steroid tablets.

If you're already taking steroid tablets, ask your doctor or a pharmacist for advice before taking any other medicines, remedies or supplements.

You can usually drink alcohol while taking steroid tablets, but don't drink too much as this may irritate your stomach.

You can also eat most foods while taking steroid tablets. Don't eat liquorice while taking prednisolone, however, as this can increase the amount of the medicine in your body.

Who can take steroid tablets

Most people can take steroid tablets.

Tell your doctor before starting treatment if you:

• have had an allergic reaction to steroids in the past
• have an infection (including eye infections)
• you have recently had, or are about to have, any vaccinations
• have an open wound that hasn't healed yet
• are pregnant, breastfeeding or trying for a baby
• have any other conditions, such as diabetes, epilepsy, high blood pressure, or problems with your liver, heart or kidneys

Steroid tablets may not be suitable in these cases, although your doctor may recommend them if they think the benefits outweigh any risks.

How steroid tablets work

Steroids are a man-made version of hormones normally produced by the adrenal glands, two small glands found above the kidneys.

When taken in doses higher than the amount your body normally produces, steroids reduce redness and swelling (inflammation). This can help with inflammatory conditions such as asthma and eczema.

Steroids also reduce the activity of the immune system, the body's natural defence against illness and infection.

This can help treat autoimmune conditions, such as rheumatoid arthritis or lupus, which are caused by the immune system mistakenly attacking the body.

Steroid tablets are different from the anabolic steroids used by athletes and body builders to improve their performance.