Steroids for Asthma
Lots of people with asthma need to take short courses of steroids, known as oral corticosteroids, prescribed by a healthcare professional, when their asthma symptoms get worse. A small number of people with severe asthma need to take higher doses of steroids for longer periods; this may mean months or years. Usually these will be given as tablets.
The many types of steroids that are made naturally in our bodies are made by two small glands called adrenal glands which sit above the kidneys. Steroids produced by the adrenal glands are also made artificially.
Even if you have to take steroid tablets for a few weeks or months, this doesn’t necessarily mean you’ll always need them, as the aim is to stop the tablets altogether if possible. Your healthcare professional will consider assessing you for other treatments and other medicines. These treatments can stop you needing to take steroid tablets as often, and at such high doses. If your asthma is controlled, you’ll be gradually taken off the tablets. You should never stop taking them suddenly as your asthma symptoms may get worse.
Steroids can be given topically or systemically.
Topically – medication is delivered directly to where the illness is. For this purpose, inhalers are used which are the main treatment for asthma. Very little gets into the blood stream so there are few side-effects. Because topical drugs can only travel a short distance into the diseased area they won’t work as well when the inflammation is severe. Inhaled steroids benefit asthma because they are mainly for diseases of the airways. Preventer inhalers contain a low dose of steroids to help you or your child manage asthma symptoms over time. You can find out more about preventers and relievers for asthma via this link.
Since asthma is usually a long-term condition you often need daily long-term inhaled steroids. These steroids will help your cough disappear and help to keep your airways open. If treatment is stopped inflammation may resume.
If you’ve been prescribed a preventer inhaler and are using it correctly, you’re less likely to need to take steroid tablets but, if your asthma symptoms do become worse and/or you have an asthma attack, your GP or asthma nurse may give you a course of steroid tablets. These come in dissolvable or soluble form and contain a much higher dose of steroids than a preventer inhaler.
Systemically - the medication travels to the area of the disease.
Systemic drugs are used when topical medication is not able to treat the disease fully. Oral steroids are available as both a pill, a liquid formulation and through an intravenous line if you are in the emergency department or hospital. Taking steroids intravenously can be useful if you or your child has difficulty swallowing solid tablets.
Systemic steroids reduce inflammation throughout your entire body. In your lungs, oral steroids decrease swelling, inflammation and mucus production. As a result, oral steroids will decrease asthma symptoms.
Oral steroid treatments do come with possible side effects, like most medication. However, the vast majority of people who take oral steroids, especially in the form of short or occasional courses, will not experience significant side effects. However, if you or your child do get side effects from taking steroid tablets, it is important to remember that the benefits far outweigh the risks and your GP or asthma nurse will aim to get you on the lowest doses that will completely control your symptoms. Some of the possible side effects of steroid tablets are:
- Stomach irritation
- Lower resistance to infection and longer healing time for cuts and wounds
- Feeling hungrier than usual
- Weight gain
- Higher blood pressure
- Mood swings
- Worsening control of sugars in diabetic patients
If you take steroid tablets on a long-term basis you will need regular checks with your doctor to see whether:
- your diagnosis is right
- the disease has become less active or inactive
- the dose can be reduced by adding in other medication
- you should receive a regular test for osteoporosis
You should also:
- not stop taking them suddenly
- carry a ‘steroid card’ around with you at all times
- consult your doctor if you have an infection or you are undergoing an operation
Sources used in writing this article are available on request
Information contained in this Articles page has been written by talkhealth based on available medical evidence. Our evidence-based articles are certified by the Information Standard and our sources are available on request. The content is not, though, written by medical professionals and should never be considered a substitute for medical advice. You should always seek medical advice before changing your treatment routine. talkhealth does not endorse any specific products, brands, or treatments.
Information written by the talkhealth team
Last revised: 5 April 2018
Next review: 5 April 2021