Corticosteroids are prescribed in pathologies associated with an inflammatory phenomenon. Very effective during flare-ups, they cause sometimes serious side effects when they are misadministered or taken for a long time.
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The corticosteroids Where anti-inflammatories steroids (cortisoneprednisone, methylprednisolone…) are used to relieve acute inflammation, linked in particular to pulmonary, rheumatological, digestive or allergic. They are administered orally, by injection or locally (eye drops, cream aerosols…). Their prescription is generally short and well tolerated, but they are nevertheless powerful drugs that cause fairly frequent side effects, the risk of which increases according to two main factors:
- dose greater than 20 mg/day
- duration of treatment longer than three months
The side effects of corticosteroids also vary greatly from one individual to another (some will tolerate high doses, others being sensitive even to low doses), depending on the type of corticosteroid and the route of administration.
Corticosteroids: side effects
- digestive disorders (sicknessstomachulcers, pancreatitis)
- insomnia (it is recommended to take your treatment in the morning)
- euphoria, excitement, irritability
- swelling of the face and stomach, bump in the neck (modifies the distribution of fat in the body)
- weight gain
- stretch marks
- acne, folliculitis
- weakening of the skin, poor healing
- increase in hairiness
- Water retention
- decrease in immune defenses
- hypokalemia
- osteoporosis (fractures, cerebral collapse) and osteonecrosis
- weakening of muscles and tendons
- change in the menstrual cycle in women
- cataract and glaucoma (in case of prolonged treatment)
- hypertension (in predisposed patients)
- diabetes (in predisposed patients)
Corticosteroids: how to limit side effects?
The side effects of corticosteroid therapy can be compensated by supplements in calcium and vitamin D (against bone demineralization), potassium (against hypokalaemia) and taking anti-ulcer drugs (against pains stomach). Controls eyepieces and regular blood tests are recommended in case of prolonged intake.
A diet high in protein is recommended to limit the melting muscular. On the other hand, a salt-free diet is not necessary.
Beyond three weeks of treatment, it is recommended to reduce the doses in stages, to allow the adrenal glands, which have reduced their activity, to take over. A sudden stop can indeed lead to adrenal insufficiency, a vital risk.
Corticosteroids: contraindications
The real contraindications to corticosteroid therapy are rare:
- infectious conditions or vaccine alive during the duration of the treatment (due to the drop in the immune defences). Corticosteroids should also be stopped at least 2 weeks before surgery.
- psychotic states
- Hyper-sensitivity to one of the compounds
- athletes: cortisone and glucocorticoids induce a positive reaction to anti-doping tests. Local administration (ointment, spray, gel ocular…) causing only a small increase in the blood level, it remains compatible with the practice in competition.
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