Also known as: steroids, glucocorticoids, cortisone
Synthetic versions of cortisol that switch off inflammation of any cause: inhaled for asthma, as tablets or injections for flares of many diseases, and as creams, drops and joint injections for local use.
Glucocorticoids enter cells and bind receptors that move to the nucleus, where they switch off genes for inflammatory cytokines and switch on anti-inflammatory ones, shrinking the whole inflammatory response regardless of its trigger. The same receptors in liver, bone, skin, eye and brain produce the side effects of systemic use, and prolonged dosing suppresses the pituitary-adrenal axis, so the body stops making its own cortisol. Inhaled and topical forms deliver tiny doses where they are needed and largely avoid these effects.
Systemic: raised glucose and blood pressure, weight gain, mood change, thin skin, bone loss, infection risk, cataracts
Inhaled: oral thrush and hoarseness
Cautions
Courses over three weeks must be tapered; carry a steroid card
Sick-day and surgery doses; adrenal crisis if stopped abruptly
Bone protection and a proton pump inhibitor for long courses
Live vaccines avoided on high doses
Class warnings
Systemic corticosteroids raise blood glucose and blood pressure, thin bone and skin, increase infection risk, disturb mood and sleep, and suppress the adrenal glands; courses over three weeks are tapered, and a steroid card is carried. Chickenpox and measles exposure needs urgent advice in non-immune people. UK
Inhaled corticosteroids at high doses can also suppress the adrenal glands and affect growth and bone; the lowest dose that controls asthma is used and the mouth is rinsed after use. UK
Class interactions
With
Effect
Source
NSAIDs and aspirin
Increased gastrointestinal ulceration and bleeding.
Educational content. A drug class page describes what a family of medicines has in common. Individual medicines differ in dose, licensing and interactions; treatment choices belong to a prescriber.
