Corticosteroids

Corticosteroids Overview

Corticosteroids are anti-inflammatory medicines used for many conditions, including hay fever, asthma and skin allergies. Your adrenal glands make natural corticosteroid hormones; the medicines are man-made versions. For seasonal allergies, intranasal corticosteroid sprays are the single most effective drug class (ACAAI).

How Do Corticosteroids Work?

When your immune system reacts to an allergen, it releases chemicals that cause inflammation and swelling. Corticosteroids reduce that inflammation by calming the immune response in the treated area.

Benefits of Corticosteroids

Nasal steroid sprays can significantly reduce nasal congestion, sneezing, itching and a runny nose (ACAAI). They work best when used daily but can still help when used for shorter periods (MedlinePlus). Inhaled steroids are a mainstay of asthma control, and steroid creams treat allergic skin rashes.

Steroid pills or injections are also used for autoimmune diseases, severe flares and some cancer-treatment side effects. These are prescribed and monitored by a doctor.

Because oral steroids affect the whole body, doctors usually use them for short courses or when other treatments aren’t enough.

Side Effects of Corticosteroids

Side effects depend on the form. Nasal sprays are designed to avoid the side effects of pills or injections; their most common side effects are nasal irritation and nosebleeds (ACAAI). Side effects that are mainly seen with long-term or high-dose oral or injected steroids include:

• High blood pressure,
• Irregular heartbeats (palpitations),
• Headache,
• Acne,
• Muscle weakness,
• Slow healing of wounds,
• Glaucoma,
• Loss of appetite,
• Ulcers in the gastrointestinal tract,
• Osteoporosis,
• Weight gain,
• Menstrual irregularity,
• Insomnia,
• Blurred vision,
• Slowed growth in children (some older nasal sprays showed an effect; data on some newer ones do not) (ACAAI)
• Increased susceptibility to infections,
• Increased growth of body hair.

Normal Dosage of Corticosteroids

Corticosteroids come as nasal sprays, inhalers, pills, liquids, creams, injections and IV medicine. Many nasal steroid sprays are available without a prescription.

The normal dosage varies in each case and depends upon several factors, including: 

• Type of disease
• Intensity of disease
• The autoimmune response of the patient
• Form of corticosteroid being given

Your doctor will recommend an accurate dosage after a thorough medical examination and any other testing required.

Overdosage

As stated earlier, corticosteroids can have several side effects, especially in the case of overdosage. Therefore, it is recommended to always use it according to the amounts specified by the doctor. Furthermore, these should only be used for the period prescribed by the doctor. If any side effect is observed, consult your doctor right away. Always read the drug’s prescriptions and consult your doctor about any side effects stated in the prescription. 

Corticosteroids also have a susceptibility to interfering with any other medications being taken. Therefore, we highly recommend always providing your doctor with a complete medical history. It would be best if you always inform your doctor about any medications being taken by the patient to prevent its side effects.

Treatment of Overdose

If someone has taken too much of a corticosteroid, call Poison Control at 1-800-222-1222. Call 911 if the person has a severe reaction, such as trouble breathing or collapse.

Tell the medical team which medicine was taken, how much, when, and why it was prescribed.

Storage of Corticosteroids

Store corticosteroids at room temperature away from heat, moisture and direct light, in a closed container, out of reach of children, unless the label says otherwise (Mayo Clinic).

Disposal of Corticosteroids

Any unwanted or expired medicine should be disposed of immediately to prevent any accidental intake of the medicine. Pharmaceutical companies often provide guidelines about the safe disposal of medicines. If no instruction is provided, talk to your physician or pharmacist for appropriate corticosteroids disposal methods. Avoid disposing of any medication directly into the garbage or flushing down the toilet.

Conclusion

Corticosteroids are powerful anti-inflammatory medicines. For seasonal allergies, nasal steroid sprays are the most effective option and have few side effects when used as directed, while oral steroids are reserved for short courses under a doctor’s care. Compare other options in antihistamines, decongestants and nasal sprays.

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Written by: Madiha Ather Hashmi (July 15, 2020)

This article is for general education and is not medical advice. Talk with your doctor or pharmacist about your symptoms and before starting, stopping, or combining any medicine.

What actually helps

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HEPA air purifier & filters

A portable HEPA purifier sized to the room can lower airborne particles such as pollen and dust; it only works if you replace filters on schedule. (EPA: Guide to Air Cleaners in the Home)

See the Levoit Core 300 on Amazon

Saline nasal rinse kit

Rinsing with saline can clear pollen from the nose; use distilled, sterile or boiled-then-cooled water, never plain tap water. (FDA: Is rinsing your sinuses with neti pots safe?)

See the NeilMed Sinus Rinse kit on Amazon

Dust-mite pillow & mattress covers

Allergists recommend zippered, allergen-proof encasings for pillows, mattresses and box springs, plus hot-water washing of bedding. (ACAAI: Dust Allergy)

See Hospitology zippered pillow encasements on Amazon

Corticosteroid FAQs

What is the most effective allergy nasal spray?

Intranasal corticosteroid sprays are the single most effective drug class for allergic rhinitis (ACAAI).

Do I need a prescription for a steroid nasal spray?

Not always. Many brands are sold without a prescription (MedlinePlus).

What are common side effects of nasal steroids?

Nasal irritation and nosebleeds are the most common. Avoid spraying toward the center of the nose (the septum) (ACAAI).

Are steroid nasal sprays safe for children?

Corticosteroid sprays are generally safe for children and adults; ask your pediatrician which one to use (MedlinePlus).

Sources

Looking for more treatment options? Find a full list of other seasonal allergy treatment options here.