Corticosteroids — what they do and how to use them safely

One quick steroid dose can stop a severe asthma attack, but long-term use can change how your body makes hormones. That contrast—fast relief vs. long-term risk—makes knowing the basics useful. This page gives clear, practical facts so you can talk with your doctor and avoid common problems.

How corticosteroids work & common uses

Corticosteroids cut inflammation. That’s why doctors use them for asthma, COPD, allergic reactions, rheumatoid arthritis, inflammatory bowel disease, severe skin problems, and some eye conditions. You’ll see them as pills (prednisone, prednisolone, dexamethasone), inhalers (budesonide, fluticasone), creams, injections, or IV in hospital settings. Inhaled and topical forms act mostly where they’re applied, so they usually have fewer whole-body effects than oral or IV steroids.

Quick tip: if you have breathing trouble, injectable or oral steroids often improve symptoms within hours. For long-term control of inflammation, inhaled or topical options are usually safer.

Safety tips, side effects, and tapering

Short courses (often under 14 days) of oral steroids usually don’t require tapering. But if you’ve been on a moderate-to-high dose for weeks or months, stopping suddenly can cause adrenal insufficiency — that’s when your body can’t make enough natural steroid. Doctors taper doses down to give your adrenal glands time to recover.

Common short-term side effects include sleep trouble, mood swings, increased appetite, and fluid retention. Long-term or high-dose use may raise blood sugar, weaken bones, increase infection risk, cause weight redistribution ("Cushingoid" look), raise blood pressure, and affect eyes (cataracts, glaucoma). If you have diabetes, check glucose more often when starting steroids.

Drug interactions matter. Steroids can affect how vaccines work (avoid live vaccines on high doses) and can interact with medicines that affect liver enzymes or blood thinners. Tell your doctor about all drugs and supplements you take.

Practical habits that help: take oral steroids with food to reduce stomach upset; use the lowest effective dose; prefer inhaled or topical steroids when suitable; and if you need long-term systemic steroids, ask about bone protection (calcium, vitamin D, or prescription options) and eye checks.

Carry a steroid alert card if you’re on chronic systemic steroids. If you get fever, sudden weakness, severe abdominal pain, chest pain, severe mood changes, or vision changes, contact your doctor fast. For planned surgeries or severe illness, tell the treating team you take steroids — you may need extra doses during stress.

Have questions about a prescription or side effects? Bring a list of symptoms and meds to your next visit. Clear, specific notes help your provider make safer choices for your treatment.