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Steroid medicines (known as corticosteroids) are man-made versions of natural steroids.

There are several different forms of steroid medicines. The form discussed in this leaflet is the tablet form, taken by mouth, called oral steroids.

Other types of steroids include creams, inhalers, drops and sprays. These are discussed in the separate leaflets called Topical Steroids (excluding Inhaled Steroids), Topical Steroids for Eczema and Asthma Inhalers.

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What oral steroids are there?

Steroids (also known as cortisone or corticosteroids) are chemicals that occur naturally in the body. Steroids reduce inflammation, suppress the body's immune system, and block DNA from being made, as well as blocking a chemical called histamine (released during an allergic reaction).

Steroid medicines are man-made but are similar to these natural hormones.

Steroids used to treat disease are called corticosteroids. They are different to the anabolic steroids which some athletes and bodybuilders use. Anabolic steroids have very different effects.

Steroids are available as tablets, soluble tablets, and liquids (solutions), creams, ointments, inhalers and injections.

Types of oral steroids

The most commonly used group is glucocorticoids. This group includes steroids such as:

• Prednisolone

• Betamethasone

• Dexamethasone

• Hydrocortisone

• Methylprednisolone

• Deflazacort

The other group is called mineralocorticoids. This is the type usually used for replacing steroids the body isn't producing itself, and the common one used is fludrocortisone.

They usually come as tablets, but some also come as dispersible (dissolvable) tablets or solutions.

What are oral steroids usually prescribed for?

Oral steroids are used to treat a large number of conditions. Some examples include:

• Inflammatory bowel diseases (for example, Crohn's disease, ulcerative colitis).

• Autoimmune diseases (for example, systemic lupus erythematosus (SLE), autoimmune hepatitis).

• Relapses that occur in multiple sclerosis.

• Joint and muscle diseases (for example, rheumatoid arthritis, polymyalgia rheumatica).

• Allergies.

• Asthma.

• Chronic obstructive pulmonary disease (COPD).

• Croup.

They are also used to treat the effects of some cancers. In addition they can be prescribed as replacement treatment for people whose own natural steroids are lacking (for example, in Addison's disease, congenital adrenal hyperplasia and hypopituitarism).

What is the dose?

This will vary with individual steroids and with the condition for which they are prescribed. For short courses, usually a relatively high dose is prescribed each day, for a few days or a week or so, and then stopped abruptly at the end of the course. If taken for more than three weeks, the dose will need to be tailed off gradually.

For those who have to take steroids for a longer time, a common treatment plan is to start with a high dose to control symptoms. Often the dose is then slowly reduced to a lower daily dose that keeps symptoms away. The length of treatment can vary, depending on the disease. Sometimes the steroid treatment is gradually stopped if the condition improves. However, steroids are needed for life for some conditions, as symptoms return if the steroids are stopped.

When do I take it?

Your pharmacist will give you exact instructions. It will depend on which steroid you take, and what it is for. Mostly steroids are taken first thing in the morning, with food.