Prednisolone (Deltasone®)

 

This is the ‘P’ in the CHOP chemotherapy regime

 

I once read a very interesting article on steroids, and the question was posed; How do steroids work

The answer was ‘Don’t ask—they just do’

 

While you are taking steroids, you may notice that you have a bigger appetite than usual, feel more energetic and find it difficult to get to sleep. If you are taking steroids for a long time (over months, rather than weeks), you may develop other side effects including:

swollen ankles from fluid retention

raised blood pressure

reduction in size and strength of muscles

tiredness

increased risk of infection

raised level of sugar in the blood

sugar in your urine

weight gain

All these side effects are temporary and will gradually disappear when you stop taking steroids.

 

Possible side effects

 

Irritation of the stomach lining.

Steroids can increase the production of stomach acid and lower the production of protective stomach mucus. This can irritate the lining of the stomach and may cause or aggravate a stomach ulcer. To reduce this side effect the tablets should be taken with meals or a drink of milk. Tell your doctor if you have indigestion, stomach pains or abdominal discomfort.

 

Blood sugar levels may change temporarily.

This may happen if you have high-dose or long-term treatment. While you are having your steroid therapy your blood sugar levels may be checked by blood tests. You may be asked to test your urine for sugar. You will be shown how to do this.

People with diabetes should be more careful than usual about checking their blood sugar levels and should contact their doctor if there is any problem with controlling their diabetes. Tell your doctor if you get very thirsty or if you are passing more urine than usual.

 

Fluid retention due to changed salt and water balance.

You may notice that your ankles and/or fingers swell. Some people have a bloated feeling in the abdomen. This is usually only a problem with long-term treatment.

 

Increased appetite.

You may notice that you feel hungrier than usual while taking steroids, and this can make you want to eat more than usual.

 

Increased chance of infection and delayed healing of injuries.

This happens mainly with high-dose or long-term treatment.

Tell your doctor if you notice signs of infection (inflammation, redness, soreness or a temperature) or if cuts take longer than usual to heal. It is important to maintain good personal hygiene to prevent infection.

 

Menstrual changes.

Women may find that their periods become irregular or stop.

 

Behavioural changes. You may notice mood swings, difficulty in sleeping and perhaps anxiety or irritability. These happen mainly with high-dose or long-term treatment and will stop when the steroid therapy ends. Tell your doctor about any behavioural changes which are worrying you. Difficulty in sleeping may be reduced by taking the steroids in the early part of the day, but discuss this with your doctor first.

 

Less Common Side Effects

 

Eye changes.

With long-term use of steroids, cataracts or glaucoma may develop. There is also an increased risk of eye infections. Tell your doctor if you notice any eye problems.

 

Cushing's syndrome.

This is usually caused only by long-term use of steroids. It can cause acne, puffiness of the face, dark marks on the skin and facial hair in women. Cushing's syndrome can be partially reduced by taking the steroids early in the morning, by taking them on alternate days instead of every day, or by reducing the dose, but discuss this with your doctor first.

 

Muscle wasting.

With very long-term use of steroids, wasting of leg muscles may occur. This can cause weakness. When the steroids are stopped some people experience muscle cramps for a short time.

 

Osteoporosis.

With very long-term use of steroids, calcium may be lost from the bones. This can result in pain (especially in the lower back), an increased susceptibility to fractures and loss of height.

 

Additional Information

 

You will be given a steroid card if you have to take the steroids at home. A card is not necessary if the steroids are just being given as a short course, such as for anti-sickness medication. The card should be carried with you at all times so that in an emergency a doctor will know you are having steroid treatment.

 

If you need to have any dental work, it is important to tell your dentist that you are having steroid treatment.

 

If long-term steroids are suddenly stopped withdrawal effects can occur, so it is very important to take the prescribed dose at the times recommended by your doctor. When the steroid treatment is over, the dose is gradually reduced. Your doctor will advise you on this.

 

If dexamethasone is given quickly into a vein, it can cause a strange sensation in the anal (back passage) area. This only lasts for a short time.

 

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