Corticosteroids can interact with other medicines, and the effects of either medicine can be altered as a result. There is less chance of this happening with steroid injections or sprays, although it can occasionally happen if they're used at high doses and for a long time.
Some of the more common interactions are listed below, but this is not a complete list. If you want to check your medicines are safe to take with corticosteroids, ask your GP or pharmacist, or read the patient information leaflet that comes with your medicine. Anticoagulant medicines are medications that make the blood less sticky. They are often prescribed to people with a history of blood clots or an increased risk of developing them.
Combining corticosteroids with anticoagulant medicines can sometimes make anticoagulants less effective. Alternatively, it can increase their blood-thinning effect, which can cause bleeding inside the digestive system. Anticonvulsants are medicines used to prevent seizures fits and are often used to treat epilepsy , but they can reduce the effectiveness of corticosteroids.
Depending on how frequent and severe your seizures are and the condition the steroids are being used to treat, you may be advised to temporarily stop taking anticonvulsants. Corticosteroids can decrease the effectiveness of medications used to treat diabetes. If you need to take both of these medications, your blood glucose levels will usually be checked more regularly and your dose of diabetes medication may need to be adjusted.
Corticosteroids, including steroid inhalers, can sometimes interact with a type of medication known as protease inhibitors such as ritonavir used to treat HIV. The HIV medication may increase the level of corticosteroid in your body, which might increase your risk of experiencing side effects.
Some vaccinations contain a weakened form of the infection they are designed to protect against. These are known as live vaccines. Examples of live vaccines include:. As corticosteroids can weaken your immune system and make you more vulnerable to infection, you should avoid any live vaccine until at least three months after your course of corticosteroids has finished.
Non-steroidal anti-inflammatory drugs NSAIDs are a group of commonly used painkillers, such as ibuprofen , that are available over the counter at pharmacists. Combining NSAIDs and corticosteroids can increase your risk of developing stomach ulcers and internal bleeding. If you need to take both medications, you may be given an additional medication called a proton pump inhibitor PPI to reduce the risk of stomach ulcers. Some of the main side effects are listed below, but this is not a complete list.
To learn about all the possible side effects of your medication, read the patient information leaflet that comes with it. Inhaled steroids usually have few or no side effects if used at normal doses. However, they can sometimes cause:. Rinsing your mouth out with water after using your medication can help to prevent oral thrush, and using a device called a spacer with your medication can help to prevent many of the other problems.
There is also some evidence that steroid inhalers used by people with chronic obstructive pulmonary disease COPD can increase the risk of chest infections such as pneumonia. Inhaled steroids at high doses can sometimes cause some of the more serious side effects that are more often linked with steroid tablets see below , but this is rare. Steroids that are injected into muscles and joints may cause some pain and swelling at the site of the injection.
However, this should pass within a few days. Steroid injections can also cause muscle or tendon weakness, so you may be advised to rest the treated area for a few days after the injection. Other possible side effects can include infections, blushing, and thinning and lightening of the skin in the area where the injection is given. Because of the risk of side effects, steroid injections are often only given at intervals of at least 6 weeks and a maximum of 3 injections into one area is usually recommended.
Steroids that are injected into a blood vessel intravenous steroids may sometimes cause some of the more widespread side effects described below. Short, occasional courses of steroid tablets taken for no longer than three weeks are very unlikely to cause troublesome side effects. Most side effects should improve if you're able to reduce your dosage or eventually stop taking the medication. You may have regular checks and tests for conditions such as diabetes, high blood pressure and glaucoma if you need to take steroid tablets on a long-term basis.
Home Tests and treatments Medicines and medical aids Types of medicine Corticosteroids. Corticosteroids See all parts of this guide Hide guide parts 1. Introduction 2. Who can use them 3. Medicines that interact with them 4. Side effects. Introduction Corticosteroids, often known as steroids, are an anti-inflammatory medicine prescribed for a wide range of conditions.
Corticosteroids are available in different forms, including: tablets oral steroids injections — which can be into blood vessels, joints or muscles inhalers — such as mouth or nasal sprays lotions, gels or creams topical steroids What are corticosteroids used for?
Corticosteroids are mainly used to reduce inflammation and suppress the immune system. They are used to treat conditions such as: asthma allergic rhinitis and hay fever urticaria hives atopic eczema chronic obstructive pulmonary disease COPD painful and inflamed joints, muscles and tendons lupus inflammatory bowel disease IBD — including Crohn's disease and ulcerative colitis giant cell arteritis and polymyalgia rheumatica multiple sclerosis MS Corticosteroids can also be used to replace certain hormones that are not being produced by the body naturally — for example, in people with Addison's disease.
Possible side effects Corticosteroids will only be prescribed if the potential benefits of treatment outweigh the risks. Potential side effects of long-term treatment include: increased appetite — potentially leading to weight gain acne thinned skin that bruises easily increased risk of infections mood changes, mood swings and depression diabetes high blood pressure osteoporosis weak and brittle bones withdrawal symptoms caused by suppression of the adrenal glands If you have troublesome side effects after taking corticosteroids, don't stop taking your medication until your doctor says it's safe to do so, because of the possibility of these unpleasant withdrawal effects.
Cautions and interactions For most people, including pregnant or breastfeeding women, steroid inhalers and injections are safe. Accessing medicines self-help guide Visit our self-help guide on accessing medicines if you have difficulty getting the medicines you need. Who can use them For most people, steroid inhalers and steroid injections should not cause any troublesome side effects. Steroid tablets Corticosteroid tablets are the most powerful type of steroid medication, because they can affect the whole body.
Steroid tablets should be used with caution in people with: liver problems, such as liver disease — corticosteroids may not be broken down by the liver at a normal rate, leading to increased levels of the medication in the blood mental health or behavioural problems, such as depression or alcohol dependence — corticosteroids can have unpredictable effects on behaviour and mood wounds — oral corticosteroids can delay wound healing They should also be used with caution in people with a health condition that could be made worse by taking oral corticosteroids, including: heart failure a recent heart attack high blood pressure diabetes epilepsy glaucoma underactive thyroid gland osteoporosis obesity psychosis stomach ulcers In these situations, you will only be prescribed oral corticosteroids if the benefits of treatment clearly outweigh any potential risks.
Steroid injections Most people can safely have corticosteroid injections, but they should be avoided or used with caution if you have an ongoing infection or a blood clotting disorder such as haemophilia. Steroid inhalers and sprays There is generally no reason why someone shouldn't be able to use a steroid inhaler or steroid spray, but these should be used with caution in people with ongoing infections, such as tuberculosis TB.
Pregnancy Corticosteroids are generally safe to use during pregnancy. They're different from anabolic steroids , which are often used illegally by some people to increase their muscle mass. Most steroids are only available on prescription, but a few such as some creams or nasal sprays can be bought from pharmacies and shops.
Steroids do not tend to cause significant side effects if they're taken for a short time or at a low dose. But sometimes they can cause unpleasant side effects, such as an increased appetite, mood changes and difficulty sleeping. This is most common with steroid tablets. The side effects will usually pass once you finish the treatment, but do not stop taking your medicine without speaking to your doctor. Stopping a prescribed course of medicine can cause further unpleasant side effects withdrawal symptoms.
You can report any suspected side effect to the Yellow Card Scheme. Steroids are a man-made version of hormones normally produced by the adrenal glands which are 2 small glands found above the kidneys. When taken in doses higher than the amount your body normally produces, steroids reduce redness and swelling inflammation.