Talk:Corticosteroid

Bold
Why are some of the drugs bolded and some not? Prednisone is widely used and not bolded, which seems odd to me.Drchazz (talk) 01:43, 7 September 2009 (UTC)

No information on side-effects?
Being so dependent on this drug for my asthma, I'm appalled by the lack of information about any side-effects / unexpected effects in users. Is there anyone who could provide this?

Whats with the safety section.. "Corticosteroids were voted Allergen of the Year in 2005 by the American Contact Dermatitis Society"? Following the link to Allergen of the Year provides hardly any additional information. Besides, aren't corticosteroids used to treat contact dermatitis reactions? This is yet another source of confusion. 65.208.210.98 (talk) 19:52, 12 July 2009 (UTC)

Quote from article: The most common natural hormones are corticosterone (...), cortisone (...) and aldosterone. Isn't cortisol the active form of cortisone? Is it more abundant in tissues and body fluids than cortisone? Kosebamse 17:23 Mar 16, 2003 (UTC)

Reference section added & a minor addition to the effects of corticosteroids --David McQuillan 15:45, 10 July 2007 (UTC)


 * Avascular necrosis is one of the worst side effects of systemic (injected) corticosteroids - where's the reference?184.144.69.217 (talk) 06:00, 22 August 2011 (UTC)

Withdrawal issues after long-term use of corticosteroids-should they be discussed in the article?
As a long-term (7 yrs and counting, with 2 yrs being high dose, i.e. 20mg steadily with boosts that went up to 50mg & tapered back to 20mg, and both joint and systemic injections) user of prednisone, one thing that really needs mentioned is the issue of adrenal suppression which leads to problems of withdrawal in patients who have regularly taken corticosteroids for a length of time. My doctors NEVER told me that and I first heard it mentioned by another patient in the mid to late 1990s when I was part of an online support group. A passing remark from a member led me to dig more into the issue and I found some doctors even go so far as to recommend their patients wear a medical alert bracelet. Not a single one of my doctors has EVER suggested that or seemed to think much of it when I asked. I think my pain doctor and/or his NP may have agreed it may be a good idea but not specifically for my use of prednisone but ALL of my meds in general and more specifically my pain medication.

As a patient, I know that the length of time a person is on corticosteroids as well as the dose taken can affect how much suppression of the adrenal gland occurs. But, it amazes me how many people are not told about adrenal suppression by either their doctors or pharmacists not to mention the risks of stopping a corticosteroid without tapering. My best friend of 25 years was diagnosed with RA and scleroderma and given prednisone. But she was never told about tapering or the risks of osteoporosis, cataracts, or those associated with suddenly stopping the medication. When she first took it, I didn't mention those issues, taking for granted her doctor told her. But, when I mentioned I was tapering, she asked what I meant. As I told her, she and I both were not happy her doctor hadn't told her. Needless to say, I began with the most basic of information when she had a new medication or procedure, just so that she knew in case her doctor failed to tell her. It's one thing for my doctors and I to have worked it out together that they don't waste our time giving me medication information since they know I am going to read the FDA's PI on it when I get home and look it up on other sites as well, all before ever filling the script. It helps them save time discussing meds when we could be covering more issues.

increased appetite and weight gain deposits of fat in chest, face, upper back, and stomach water and salt retention leading to swelling and edema high blood pressure diabetes black and blue marks slowed healing of wounds acne muscle weakness thinning of the skin increased susceptibility to infection stomach ulcers increased sweating mood swings psychological problems such as depression adrenal suppression and crisis

Granted the goal for most people is to be on the lowest possible dose for the shortest time possible, but that is, unfortunately, not a reality for many patients. Stopping corticosteroids suddenly when a patient has been on them for awhile can have side effects that range anywhere from annoying and uncomfortable to rather dangerous. While uncommon and hopefully very unlikely to happen in this day and age of typically quick medical care, the worst risk can be a cascade of problems that end up as a life-threatening illness. Symptoms of corticosteroid withdrawal can include: joint pain muscle pain fatigue headache fever low blood pressure nausea and vomiting

The following are symptoms of acute adrenal crisis (defined as:"...a life-threatening condition that occurs when there is not enough cortisol, a hormone produced by the adrenal glands."): Abdominal pain Confusion or coma Darkening of the skin Dehydration Dizziness or light-headedness Fatigue Flank pain Headache High fever Joint pain Loss of appetite Loss of consciousness Low blood pressure Nausea Profound weakness Rapid heart rate Rapid respiratory rate (see tachypnea) Shaking chills Skin rash or lesions Slow, sluggish movement Unintentional weight loss Unusual and excessive sweating on face or palms Vomiting

The symptoms of exogenous adrenal insufficiency are: Decreased ability to respond to emotional or physical stress Fatigue Joint pains (arthralgias) Low blood pressure (hypotension), which may cause light-headedness or fainting when you stand after sitting or lying down Muscle pains (myalgias) Nausea and vomiting Shock Weakness Exogenous adrenal insufficiency is: "a condition in which the adrenal glands release too little of the hormone cortisol, but there is no problem with the glands themselves."

Adrenal crisis can lead to shock which can be life-threatening as can shock caused by exogenous adrenal insufficiency. Among the causes for these conditions is decreasing corticosteroids too quickly or stopping them abruptly. In some patients, a faster taper can occur, especially if the patient was on what many doctors call a "burst pack" or a "burst and taper" in which the patient takes a higher dose for a few days, then lowers by 5mgs or so for a few days, and so on until stopping. Taken this way, some patients can even drop 10 mg at a time with no symptoms of withdrawal. But for patients who have been on corticosteroids for a longer time (which isn't really a concrete definition but varies from doctor to doctor and situation to situation), even at a low dose, tapering must be done much more slowly. I have known patients who do fine dropping from >20mg doses in 10mg increments when on a short burst and taper only to have trouble dropping from 20mg to 10mg. That drop causes problems, where going from say 30mg to 20mg is tolerated fairly well.

While I am uncomfortable writing a section on the dangers of stopping a corticosteroid too quickly (because unless done carefully listing these kind of cautions can sound like a scare tactic) I do feel it needs to be stated.The reason I am not the person to write the section is a bit convoluted, so I will try to be brief, please bear with me though if it is a bit too long to you. I know that to go from 20mg down to 10mg, I started by dropping 2.5mg at a time. I was on 20mg for around 2 years though. We began by trying a 5mg drop and after 2 days I was calling my doctor, almost in tears, and nearly begging to go back up to 20mg then try again but only drop to 17.5mg. I'd successfully gotten to 15mg when I became so ill I nearly died due to multiple, hard to treat infections and ended up in the hospital for 11 months, then spent 2 yrs in a nursing home learning to walk again, which is pretty good since I was originally told by my doctors that I would likely never walk or live outside of a hospital or nursing home again. PT seemed to disagree, saying I might learn to stand after 2-3 years of daily, intensive PT and even longer PT to stand.

I have not let my problems with the major infections that nearly killed me stop me from any medications my health-care provider and I feel are worth trying and would not want a caution to be worded in a way to come across as "this is a BAD drug, do not take it, there's too much danger and not enough benefit", which is why I don't feel right composing it. I don't blame corticosteroids alone for all of my infection issues (I was also on Remicade every 4 weeks as well as Arava 20mg/day and a number of other medications for other issues) in addition to having risk factors such as dental problems caused by Sjogren's Syndrome as well as having infections that were unfortunately asymptomatic. It wasn't an issue of not knowing the symptoms of an specific infection; I was all too well acquainted with what a UTI felt like, but between 2006 and Nov. 2008 I had at least 3 ER visits for episodes of N/V lasting 3-5 days where I had NO UTI symptoms but tested positive each time. I went through a period of time from 18-25 where I had frequent UTIs and knew all too well the symptoms. That said, while I was taken off of Remicade, Arava and prednisone during the time I was in the hospital because of the many infections I had (back to back UTI/bladder/kidney infections from Dec. 2008 through mid 2009), sepsis, a shocking 5 bouts of shingles (plus another 2 over the next 2 years), C-Diff, VRE, etc. I still find all three medications quite useful in the right situation. For me, this meant not taking Remicade, restarting Arava and prednisone but keeping prednisone at or below 5mg except for occasional burst and tapers. In addition to all of this, I have cataracts that are likely corticosteroid induced. The only typical side effects I have that are generally triggered by corticosteroids that I can definitively say were not related to my high dose of prednisone are my issues with hypertension and osteoporosis. I had a doctor argue with me that my osteoporosis WAS caused by prednisone use but did not appear happy when I asked how that was possible when the osteoporosis diagnosis was made in 1989 and I didn't have ANY form of a corticosteroid until 2002. I have had hypertension since the mid 1980s around my diagnosis. Given all of that, I would not want to come off as trying to scare people away from corticosteroids and am afraid I would do so inadvertently, which is why I am not the person to write the section. Well, that and my tendency to be too wordy. I currently take a low dose (5mg) of prednisone with occasional bursts to 10mg for a week or so. It was not until I re-started both Arava and prednisone, two of the drugs that worked together to cause a number of the problems I had while hospitalized, that I was able to begin PT at the nursing home and re-learn to walk. So I am definitely not wanting to scare anyone away from taking it, I just feel that for an encyclopedic article especially, the text should go more into the important issues for patients taking a corticosteroid, especially since not all health-care providers tell patients the full truth about the medications they prescribe. I know my writing would be tinged with my POV as an advocate of not fearing corticosteroids, yet taking them carefully and responsibly which cannot be done unless the patient has all of the information. I would write it in a heartbeat if it were not for that, but there is no point since I will not be able to maintain NPOV. I know all too well that my ability to keep moving has been dependent on prednisone as part of a group of meds that keep me moving, which definitely is apparent in my writing. WayneyP (talk) 22:58, 1 June 2013 (UTC)

Betamethasone
I noticed Betamethasone is listed in Group C of the Coopman classification while Betamethasone valerate and Betamethasone dipropionate are listed in Group D. Just wondering if this is an oversight, or not? I suppose the issue is the binding agent and the action of absorbtion involved accounting for the split, but does seem odd to layperson. --Symmerhill (a.k.a. Summerhill) (talk) 22:40, 31 July 2009 (UTC)

Strength classification?
I notice that this link has a table of the classification by strength of corticosteriods, which would be useful information to add here. —Preceding unsigned comment added by 146.115.71.238 (talk) 21:14, 23 November 2009 (UTC)

Adrenocortical steroid
Adrenocortical steroids links here but is not explicitly mentioned in the article. The term should be mentioned or the redirect should be removed. Thanks. pgr94 (talk) 15:10, 27 July 2011 (UTC)

Reverse Side Effects after one no longer needs Corticosteroids?
Is is possible to reverse side effects after one no longer needs to eat Corticosteroids? Or lower risk of side effects that occur after a delay? ee1518 (talk) 12:58, 30 May 2016 (UTC)

Disputed history
Removed to Talk to allow resolution: " Corticosteroids were first used in 1944. "--Smokefoot (talk) 04:08, 23 December 2017 (UTC)

During pregnancy - needs update
On the article for cerebral palsy, it states "Corticosteroids are sometimes taken by pregnant women expecting a preterm birth to provide neuroprotection to their baby. "

Which contradicts the current text on this page recommending against their use during pregnancy, citing a 2002 source. Could this please be investigated further to resolve the apparent contradiction? Thank you. --122.108.141.214 (talk) 02:02, 7 March 2018 (UTC)

Linked article does not discuss link subject
This article links to the article on anabolic steroids in mentioning steroid psychosis as a possible side-effect, but that term does not appear anywhere in the article on anabolic steroids, nor does the article have any lengthy discussion of what steroid psychosis is. 174.28.35.236 (talk) 12:45, 8 December 2021 (UTC)