Corticosteroids: Types, Uses, Side Effects, & Interactions

Corticosteroids, classified as synthetic steroids, could mimic the natural hormone cortisol produced by the body to reduce inflammation.

Doctors may prescribe corticosteroids to treat conditions like hives, rheumatoid arthritis, lupus, or asthma, as they help ease irritation and swelling. They may help decrease inflammation, manage hormonal imbalances, and suppress overactive immune system responses.

These drugs are widely used for treating both short-term and long-term medical conditions. However, corticosteroids may cause side effects and potential health complications depending on their form, dosage, and health interactions.

This article will provide an informative and scientific analysis of corticosteroids, covering their working mechanism, uses, types, side effects, and more.

What Are Corticosteroids?

Corticosteroids are a class of medications that may help lower inflammation levels and suppress an overactive immune response in the body. These drugs could help treat various medical conditions due to their anti-inflammatory effects.

Corticosteroids are commonly used to reduce symptoms associated with autoimmune diseases, allergic reactions, skin conditions, and respiratory issues like asthma. They may be administered orally, through injections, or topical applications.

Some examples of corticosteroids include hydrocortisone, cortisone, betamethasone, prednisone, and methylprednisolone. They may be administered in various forms, including oral tablets, topical creams, inhalers, and injections.

Naturally occurring corticosteroids like hydrocortisone and cortisone support regular bodily functions. However, synthetic corticosteroids are often prescribed to manage medical conditions effectively.

Long-term or improper use of corticosteroids may lead to side effects. Signs of such adverse interactions may include weight gain, osteoporosis, high blood pressure, diabetes, and increased risk of infections.

Therefore, doctors should carefully weigh the benefits against the risks when prescribing corticosteroids to patients.

How Do Corticosteroids Work?

Corticosteroids work by mimicking the effects of natural hormones your body produces in the adrenal glands. It may replicate the anti-inflammatory effects of hormones like cortisol, restoring them to a balanced state.

The immune system is responsible for triggering inflammation in response to various stimuli. Corticosteroids might help decrease the activity and number of immune cells, preventing the body from attacking its tissues in autoimmune diseases.

Such anti-inflammatory effects may be helpful in managing conditions like arthritis, asthma, and autoimmune diseases, where inflammation plays a chief role in disease progression.

Corticosteroids may disrupt the production of prostaglandins, which are hormone-like substances that trigger inflammation, pain, and fever. They could also block the release of histamine, a compound that may induce allergy symptoms.

They could also help modify the body’s response to stress, helping minimize symptoms associated with stress-related conditions.

Types of Corticosteroids

Based on their method of application, corticosteroids may be categorized as either systemic or localized:

1. Localized Corticosteroids

   Localized corticosteroids target specific body areas and are commonly applied through skin creams, ointments, eye drops, ear drops, and inhalers. These localized corticosteroids may help manage conditions like asthma or hives topically.

   Some examples of localized corticosteroids may include Hydrocortisone, Fluticasone propionate (to manage asthma), and Mometasone furoate (to manage allergic rhinitis).

2. Systemic Corticosteroids

   Systemic corticosteroids intend to move through the bloodstream to provide a more widespread therapeutic effect. They could be administered orally, injected into a muscle, or delivered through an intravenous (IV) line.

   The two main categories of systemic corticosteroids are:

   • Glucocorticoids: These are involved in the metabolism of carbohydrates, proteins, and fats and have potent anti-inflammatory and immunosuppressive properties.
   • Mineralocorticoids: These corticosteroids help control salt and water balance within the body.

   Systemic corticosteroids are often used to manage complex conditions like lupus and multiple sclerosis. They may be helpful in cases where the treatment needs to reach multiple organs or systems within the body.

   Examples of systemic corticosteroids may include Cortisone, Prednisolone, Betamethasone, Methylprednisolone, and Dexamethasone.

Side Effects of Corticosteroids

1. Side effects from inhaled corticosteroids

   • Coughing: Inhaled corticosteroids may sometimes irritate the throat, leading to a persistent cough. This side effect is usually mild and may improve over time as the body adjusts to the medication.
   • Difficulty Speaking (Dysphonia): Some people may experience hoarseness or changes in their voice quality when using inhaled corticosteroids. The side effect typically occurs due to the corticosteroid’s local effects on the vocal cords.
   • Oral Thrush: Inhaled corticosteroids may increase the risk of developing oral thrush, a fungal infection in the mouth. It is essential to adhere to good oral hygiene, like rinsing the mouth after each use of the inhaler, to reduce this risk.
   • Bone Density Reduction: Prolonged use of high-dose inhaled corticosteroids may lead to decreased bone density over time, potentially increasing the risk of fractures.

2. Side effects from oral corticosteroids

   Oral corticosteroids may cause high blood pressure, mood or behavioral changes, osteoporosis, glaucoma, diabetes, and skin or muscle atrophy.

   Long-term use of oral corticosteroids may be linked to complications like weight gain, facial swelling or puffiness due to fluid retention, depression, nausea, vomiting, and stomach irritation. It might also increase the risk of bone fractures.

   Monitoring for changes in mood, weight, blood pressure, and bone health is vital during oral steroid treatment. You should adhere strictly to the prescribed dosage and not make sudden changes or discontinue the medication without medical advice.

3. Side effects from injected corticosteroids

   Injected corticosteroids may lead to various side effects, including:

   • Temporary Pain and Soreness: You may experience pain or soreness at the injection site shortly after receiving the corticosteroid injection. The discomfort usually subsides within a few days.
   • Loss of Skin Color: Some people may notice changes in skin color at the corticosteroid injection site. The discoloration is usually temporary and fades over time as the skin heals.
   • High Blood Sugar: Corticosteroids may cause a temporary increase in blood sugar levels, especially in those with diabetes. Monitoring blood sugar levels closely is vital when receiving corticosteroid injections.
   • Facial Flushing and Insomnia: Facial flushing, where the face becomes warm and red, may occur as a side effect of corticosteroid injections. Some people may experience difficulty sleeping or insomnia after receiving the injection.

4. Side effects from topical corticosteroids

   Topical corticosteroids (directly applied to the skin) may cause side effects, including acne, rosacea, atrophy, stretch marks, perioral dermatitis, and delayed wound healing. You should consider these side effects when using corticosteroids to manage skin conditions.

   Side Effects	Description
   Acne	A skin condition characterized by pimples
   Rosacea	Chronic skin condition causing redness
   Atrophy	Thinning of the skin layers
   Stretch Marks	Striae on the skin due to stretching
   Perioral Dermatitis	Facial rash around the mouth
   Delayed Wound Healing	Slower healing of skin wounds

Uses Of Corticosteroids

Corticosteroids may be useful in managing sudden and severe symptoms, such as allergic reactions and other acute conditions. These medications are commonly used to manage allergies, eczema, asthma, hives, and psoriasis.

They might also help manage chronic conditions, such as:

• Chronic obstructive pulmonary disease (COPD)
• Inflammatory bowel diseases like Crohn’s disease and ulcerative colitis
• Multiple sclerosis
• Lupus
• Addison’s disease
• Rheumatoid arthritis

Doctors could also prescribe corticosteroids to accelerate the recovery of patients who have undergone organ transplants.

Their ability to suppress inflammation, immune responses, and hormonal imbalances could help manage various health conditions.

Considerations for Corticosteroids

• Long-Term Effects: Long-term use of corticosteroids may pose serious health risks. Adults and older adults may be more prone to high blood pressure and osteoporosis, while women have a higher risk of developing osteoporosis. Children may experience stunted growth, and infections like measles or chickenpox (due to immune suppression) may be more severe.
• Special Populations: Pregnant or breastfeeding women should use corticosteroids cautiously as these drugs may transfer to the child either in the womb or through breastfeeding.
• Medical Monitoring: Regular medical check-ups are essential while on corticosteroids to monitor for any emerging side effects or complications. Discussing any concerns with your doctor promptly may help manage potential issues.
• Dosage and Adherence: Adhering strictly to the prescribed corticosteroid dosage and schedule is vital to optimize the benefits of corticosteroid therapy. Any adjustments to the dose should only be made in consultation with a doctor to ensure safe and effective treatment.

Common Corticosteroids

Some of the common corticosteroids available include:

• Prednisone (Deltasone, Prednicot, Cotolone)
• Prednisolone (Orapred, Omnipred)
• Cortisone (Cortone)
• Hydrocortisone (Cortef, Hydrocort)
• Triamcinolone (Aristocort)
• Dexamethasone (Decadron)
• Mometasone (Nasonex spray).

These corticosteroids come in topical, oral, and injectable forms, providing versatility in treatment options based on patient needs.

Cortisone, Hydrocortisone, Triamcinolone, Dexamethasone, and Mometasone are frequently prescribed to tackle multiple conditions requiring corticosteroid therapy.

Interactions Of Corticosteroids

Before using corticosteroids, it’s important to consider any existing health issues you have and how corticosteroids might interact with other drugs you are taking. Therefore, informing your doctor of any existing health issues is essential.

Conditions like HIV, diabetes, high blood pressure, gastrointestinal problems, and infections may influence the effectiveness and safety of corticosteroid treatment. Corticosteroids have the potential to interact with other medications, altering their effects negatively.

Some medications that might interact with corticosteroids include those used for blood clotting, seizures, diabetes, and HIV. The likelihood of interactions may be lower with corticosteroid sprays or injections than with systemic corticosteroids, but caution should still be exercised.

People with a history of heart, liver, thyroid, or kidney disease, recent surgeries, or serious injuries should disclose this information to their doctor before starting corticosteroid therapy.

Certain corticosteroids may have negative interactions with food. You should be cautious about what you eat while taking corticosteroids, as specific corticosteroids may have interactions with food sources like certain high-fat and sugary foods.

Tips to Minimize Side Effects of Corticosteroids

• Inform Your Doctor: Ensure your doctor is aware of all medications and supplements you are taking to avoid potential interactions that might exacerbate side effects.
• Prevent Infections: You should take necessary precautions to prevent infections. Getting the recommended vaccines, keeping wounds clean, and avoiding contact with people who are sick could help reduce the risk of infections.
• Maintain Bone Health: Take part in regular weight training exercises, consume a nutritious diet rich in calcium and vitamin D, and consider calcium formulations. These tips are especially beneficial for older adults, as they may support bone health and reduce osteoporosis risk associated with corticosteroid use.
• Follow Prescribed Dosages: Adhere strictly to the corticosteroid dosages prescribed by your doctor to prevent sudden changes that may lead to withdrawal symptoms or other complications. Avoid self-adjusting your medication without consulting your doctor to ensure safe and effective corticosteroid therapy.

Frequently Asked Questions

1. Can Corticosteroids Cause Changes in Mood or Behavior?
   Corticosteroids may influence the body’s stress response and hormones, causing changes in mood or behavior. These changes may include mood swings, anxiety, irritability, or even depression. You should consult a mental care professional if concerning mood changes occur after using corticosteroids.
2. Are Corticosteroids Safe for Pregnant Women?
   Corticosteroids’ safety for pregnant women requires careful evaluation by healthcare providers. Benefits and risks must be weighed due to potential effects on fetal development. Personal discussions and monitoring are essential during pregnancy when considering corticosteroid use.
3. What Are the Potential Long-Term Effects of Corticosteroid Use?
   Prolonged use of corticosteroids may cause health interactions like weight gain, fluid retention, high blood pressure, muscle weakness, and psychiatric disturbances. It might also lead to infections, osteoporosis, adrenal gland issues, and adrenal crisis upon sudden withdrawal.
4. Do Corticosteroids Interact With Over-the-Counter Medications?
   Taking corticosteroids with over-the-counter medications like aspirin and nonsteroidal anti-inflammatory drugs, such as ibuprofen, may cause negative reactions. You should inform your doctor of all medications taken to prevent any harmful interactions.
5. Can Corticosteroids Affect Blood Sugar Levels?
   Corticosteroids might have the potential to increase blood sugar levels, especially in people having diabetes or those at risk of hyperglycemia (high blood glucose). Regularly monitoring blood sugar levels is vital when using corticosteroids.

Conclusion

Corticosteroids are synthetic medications that may replicate the anti-inflammatory potential of the body’s natural stress hormone cortisol. They could help manage inflammatory conditions like rheumatoid arthritis, lupus, rashes, asthma, or other inflammatory conditions.

However, due to their synthetic nature, corticosteroids may have both short-term and long-term implications on your health. Common risks include high blood pressure, weight gain, osteoporosis, diabetes, and increased susceptibility to infections.

You must use corticosteroids under close medical supervision, particularly considering existing health conditions and potential interactions with other medications.