The Asthma Center

Short term oral corticosteroid treatment

Occasional short term use of oral corticosteroids may control your acute asthmatic episodes when bronchodilators and other anti-inflammatory agents fail to control symptoms. This method is an important technique in resolving acute flares of asthma and preventing more severe episodes. The Asthma Center specialists have found that this treatment program decreases the need for emergency room visits or hospitalizations. It may take many hours to notice relief with the use of oral corticosteroids. Therefore it is essential to start their use early on in an asthmatic attack. You can begin corticosteroid use according to a protocol provided by your treating physician, but you should inform your treating physician that you have started this medication within 24 hours of its use.

You should not use this medication whenever you feel your chest is tight or when you are just mildly short of breath. Indiscriminate use of oral corticosteroids in an unsupervised manner may lead to steroid-dependence as well as increased risk of side effects. Even small doses of oral corticosteroids can produce serious side effects when used on a long term daily basis.

Although there are many dosage schedules for short term oral corticosteroid treatment, a typical short term burst-dosage schedule for an adult might look like this:

Day 1 40mg of prednisone
Day 2 30mg of prednisone
Day 3 20mg of prednisone
Day 4 10mg of prednisone
Day 5 5mg of prednisone

 

Children may receive smaller doses based on body weight.

This schedule is only an example. You should receive your own individualized short term oral corticosteroid schedule from your treating physician. Oral corticosteroids are sometimes also used to treat sinusitis or severe allergies. Corticosteroids decrease inflammation in the sinuses and nose. They are actually the most effective anti-inflammatory medications available. With decreased inflammation, the mucous membranes lining the sinus cavities and nose shrink back toward their normal size. Corticosteroids are often used in conjunction with antibiotics, allowing the antibiotic better entry into inflamed tissue. Corticosteroids are also useful in shrinking nasal polyps. However after corticosteroid treatment stops, polyps often return to their previous size. Oral corticosteroids can also be used to treat allergic fungal sinusitis. However as with nasal polyps, symptoms may return after treatment ceases.

 

Oral Corticosteroids

Brand Name

Active Ingredient

Concentration

Aristocort®

triamcinolone

Tablets: 4, 8mg

Decadron®

dexamethasone

Tablets: 0.5, 0.75mg

Deltasone®

prednisone

Tablets: 1, 2, 10, 20mg
Oral Solution: 5mg/mL

Medrol® Medrol® Dosepak

methylprednisolone

Tablets: 2, 4, 6, 8, 16 and 32mg

Methylprednisolone

methylprednisolone

Tablets: 2, 4, 8, 16 and 32mg

Orapred®

prednisolone

Oral Solution, dye free: 15mg/5mL

Pediapred®

prednisolone

Oral Solution, dye free: 5mg/mL

Prednisone

prednisone

Tablets: 2.5, 5, 10, 20mg

Prelone®

prednisolone

Syrup: 5mg/mL, 15mg/mL

 

Note: mg = milligram; mL = milliliter

If you require short bursts of oral corticosteroids, you can be taken off of them by quickly decreasing the dose or at times even abruptly stopping the medications. In contrast, long term use of corticosteroids require slow, careful reduction in dosing. You may experience unpleasant side effects upon discontinuing short or long term oral corticosteroid administration. This is known as "steroid withdrawal." These adverse effects may include muscle aches, joint pains, fatigue, poor appetite, and even fever. When coming off corticosteroids, you may even be at risk for symptoms that were suppressed while on corticosteroids such as skin problems, hayfever, sinus symptoms, and arthritis-like symptoms. If you are at risk for "steroid withdrawal" symptoms, a slow taper over a long period of time may be necessary in addition to supplemental aspirin-like medication to relieve musculo-skeletal discomfort.