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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 (see Table 13 for examples of these medications). 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.

Table 13

Oral Corticosteroids

Note: mg = milligram; mL = milliliter

If you require short bursts of oral corticosteroids, you can be taken off of them by quickly tapering (decreasing the dose) or at times even abruptly stopping the medications.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 (eczema, hives), 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.

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