Steroidal Anti inflammatory drugs side effects

January 1, 2016
Figure 1

What Are Corticosteroid (Anti-Inflammatory) Medications?

Steroids or glucocorticosteroids are medications used in the treatment of COPD that control swelling. They are called anti-inflammatory drugs because they decrease swelling in the airways of the lungs. These drugs are not the same as anabolic steroids, which are used by "body builders" to build muscles.

What kinds of corticosteroid medications are there?
Steroids are generally taken in tablet form or by inhalation. An intravenous form of steroids can be given but only in the hospital or an urgent setting. The different types of steroids in tablet form include: prednisolone, prednisone and medrol. Generic inhaled forms include: beclomethsone, budesonide, flunisolide, fluticasone and triamcinolone. Not all COPD patients benefit from treatment with steroids. One way your provider can determine if you will benefit is by trying the medication by the inhaled route or tablet form for 1-3 months. A limited period of oral steroids is also not uncommon to treat exacerbations or worsening of COPD.

Steroids used to treat COPD are usually given through inhalers. When the medication is inhaled, most of it goes directly to the lungs. This way the medication can be given in smaller doses, with fewer side-effects. Inhaled steroids, however, do not work quickly. It may take several days to weeks before benefits are felt.

Steroids taken as a tablet (also called taken systemically) require a higher dose of the medication in order to have the desired effects on the lungs. If taking an oral course of steroids, the tablets should be taken in one dose. Some patients find that taking their steroid tablets at mealtimes reduces stomach upsets.

What problems (side-effects) should I watch for with corticosteroid medications?
Side-effects normally depend on the dosage of the medication. Side-effects from inhaled steroids are less likely than with the tablet form. The most common side-effects of inhaled steroids are a sore mouth, hoarse voice, and infections in the throat and mouth. These side-effects can often be avoided or reduced by rinsing the mouth after taking the medication, or by using a spacer/chamber device. The high doses of steroids in tablet form (or in smaller doses given for long periods of time) may cause problems including: bruising of the skin, weight gain, weakening of the bones (osteoporosis), high blood sugar levels (diabetes), cataracts, swelling of the ankles or feet, and, while these side-effects can produce significant problems for patients, the lack of steroids to treat COPD can create severe, life-threatening problems. You should discuss any concerns about taking steroids with your provider in order to weigh the benefits against the risks.

How often and how much should I take?
The amount of steroids you are prescribed will depend on your provider’s evaluation. In some instances steroids in tablet form are needed to control exacerbations or pneumonia. The dosage will vary depending on how well your symptoms are controlled.

What should I do if I forget to take my corticosteroid medication?
If you forget to take your steroids, take another dose as soon as you remember. If your next dose is due in a few hours, however, do not take an additional dose. If you cannot remember when you last took a dosage of medication contact your healthcare provider for instructions.

Listing of inhaled steroids

Generic name Brand name How it is given Dosage
Aerobec MDI or breath-actuated inhaler 100-800µg
Aerobec Forte 250 µg
Asmabec Breath-actuated inhaler 200-400 µg
Beclazone 250-500 µg
Beclomet DPI 200 µg
Beclovent MDI 252-672 µg
Beclodisk 100-400 µg
Becotide MDI or DPI
Filair 50-25 µg
budesonide Pulmicort MDI, DPI or liquid solution
flunisolide Aerobid
Flixotide 100-500µg
Flovent 44, 110, 220 µg
triamcinolone Azmacort
µg stands for micrograms. The doses are average doses and are normally taken twice daily.
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