Corticosteroids - Who can use corticosteroids

For most people, steroid inhalers and steroid injections should not cause any troublesome side effects. Steroid tablets are generally prescribed with more caution, as these can potentially cause more problems.

Steroid tablets

Corticosteroid tablets are the most powerful type of steroid medication, because they can affect the whole body.

They shouldn't be used if you have an ongoing widespread infection, because they could make it more severe. However, you should continue to take corticosteroids if you develop an infection while already being treated, unless advised otherwise.

Steroid tablets should be used with caution in people with:

• liver problems, such as liver disease ‐ corticosteroids may not be broken down by the liver at a normal rate, leading to increased levels of the medication in the blood
• mental health or behavioural problems, such as depression or alcohol dependence ‐ corticosteroids can have unpredictable effects on behaviour and mood
• wounds ‐ oral corticosteroids can delay wound healing

They should also be used with caution in people with a health condition that could be made worse by taking oral corticosteroids, including:

• heart failure
• a recent heart attack
• high blood pressure
• diabetes
• epilepsy
• glaucoma
• underactive thyroid gland
• osteoporosis
• obesity
• psychosis
• stomach ulcers

In these situations, you will only be prescribed oral corticosteroids if the benefits of treatment clearly outweigh any potential risks.

Steroid injections

Most people can safely have corticosteroid injections, but they should be avoided or used with caution if you have an ongoing infection or a blood clotting disorder (such as haemophilia).

Steroid inhalers and sprays

There is generally no reason why someone shouldn't be able to use a steroid inhaler or steroid spray, but these should be used with caution in people with ongoing infections, such as tuberculosis (TB).

Pregnancy

Corticosteroids are generally safe to use during pregnancy. However, they're not usually recommended unless the potential benefits outweigh the risks.

For example, steroid tablets may be recommended if you're pregnant and have severe asthma, because the risk to your baby from uncontrolled asthma is higher than from the medication.

There is no evidence that using a steroid inhaler during pregnancy increases the risk of problems such as birth defects, so you can usually continue to use this as normal while you're pregnant.

Breastfeeding

If a woman needs to take steroid tablets while she is breastfeeding, a type called prednisolone is usually recommended, because it is thought to have the least chance of causing the baby any adverse effects. As a precaution, it's usually recommended that a breastfeeding mother waits three to four hours after taking a tablet before feeding her baby.

Steroid injections, inhalers and sprays are not thought to pose a risk to babies being breastfed.