Depending on the drug, steroids may be given
intravenously, as pills, as an injection, or applied
to the skin in a cream or ointment.
High doses of prednisone may
be used for short periods of time. The dose is then gradually reduced.
How It Works
Corticosteroids suppress the
immune system and reduce
inflammation caused by
lupus (systemic lupus erythematosus, or SLE).
Why It Is Used
Corticosteroids are used to control
moderate to severe problems caused by lupus, including inflammation, pain, and
tissue damage throughout the body.
Low-dose corticosteroids may be
used to treat:
- Joint or muscle pain, skin rash, fatigue,
fevers, and other symptoms that affect your quality of life and are not
relieved by nonsteroidal anti-inflammatory drugs (NSAIDs) or antimalarials.
- Severe skin
rashes, which may respond to steroid creams or ointments, shots, or pills.
But the skin symptoms may return when you stop using the steroid.
High-dose corticosteroids are used to treat severe or
life-threatening problems including:
High-dose corticosteroids may also ease
central nervous system symptoms such as severe
headache, confusion, and nerve damage that causes problems with
How Well It Works
Corticosteroids often dramatically
improve many symptoms of lupus. Some conditions respond in as little as a few
days, while others may take several weeks of corticosteroid therapy.1
effects of corticosteroids can include:
- Decreased pain in joints and
- Decreased pain and inflammation from skin
- Decreased inflammation in blood vessels and in the tissues
surrounding the heart and lungs.
- Decreased central nervous system
symptoms, such as severe headaches and confusion.
Corticosteroids are often combined with other drugs such as mycophenolate mofetil, or
cyclophosphamide with or without azathioprine.
Corticosteroids are prescribed and monitored carefully because they cause
significant side effects.
All medicines have side effects. But many people don't feel the side effects, or they are able to deal with them. Ask your pharmacist about the side effects of each medicine you take. Side effects are also listed in the information that comes with your medicine.
Here are some important things to think about:
- Usually the benefits of the medicine are more important than any minor side effects.
- Side effects may go away after you take the medicine for a while.
- If side effects still bother you and you wonder if you should keep taking the medicine, call your doctor. He or she may be able to lower your dose or change your medicine. Do not suddenly quit taking your medicine unless your doctor tells you to.
Call911or other emergency services right away if you have:
- Trouble breathing.
- Swelling of your face, lips, tongue, or throat.
Call your doctor if you have:
- Signs of an infection, such as a sore throat, fever, sneezing, or coughing.
- Belly pain, nausea, or vomiting that won't go away.
- Bloody or black, tarry stools.
- Rapid weight gain.
- Changes in your eyes, including blurred vision or eye pain.
- Muscle cramps, pain, or weakness.
- Changes in skin, including acne or reddish purple lines.
- Increased thirst, especially with frequent urination.
Common side effects of this medicine include:
- Increased appetite.
- Nervousness or restlessness.
See Drug Reference for a full list of side effects. (Drug
Reference is not available in all systems.)
What To Think About
Corticosteroids can keep your immune system from fighting infection. When you are taking this medicine (and even after you stop taking it), try not to be around people who are sick. And make sure you talk to your doctor before you get any vaccinations.
If your main symptoms are pain,
fatigue, or fever, many experts consider it best to avoid the side effects of
steroids and try to control your symptoms with other medication, such as NSAIDs
It is common to try to find a maintenance dose
of steroids (taken daily or on alternate days) that is low enough to avoid
serious side effects but high enough to control symptoms. You may start at a
higher dose and then reduce the dose gradually after your symptoms have been
controlled. If the dose that controls symptoms causes unacceptable side
effects, another medication may also be used, such as an antimalarial or
To prevent osteoporosis while taking long-term
corticosteroids, get plenty of
vitamin D, and consider a preventive medicine, such as
alendronate or risedronate. To come up with a plan that fits your needs, you
may want to work with your doctor or a
registered dietitian. Weight-bearing exercise also
helps reduce the risk of osteoporosis. For more information, see the topic
Medicine is one of the many tools your doctor has to treat a health problem. Taking medicine as your doctor suggests will improve your health and may prevent future problems. If you don't take your medicines properly, you may be putting your health (and perhaps your life) at risk.
There are many reasons why people have trouble taking their medicine. But in most cases, there is something you can do. For suggestions on how to work around common problems, see the topic Taking Medicines as Prescribed.
Advice for women
Women who use this medicine during pregnancy have a slightly higher chance of having a baby with birth defects. If you are pregnant or planning to get pregnant, you and your doctor must weigh the risks of using this medicine against the risks of not treating your condition.
Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.
Complete the new medication information form (PDF)(What is a PDF document?) to help you understand this medication.
Crow MK (2008). Systemic lupus erythematosus. In L
Goldman, D Ausiello, eds., Cecil Textbook of Medicine,
23rd ed., pp. 2022–2032. Philadelphia: Saunders Elsevier.
Primary Medical Reviewer
||Anne C. Poinier, MD - Internal Medicine
Specialist Medical Reviewer
||Nancy Ann Shadick, MD, MPH - Internal Medicine, Rheumatology
Current as of
||May 10, 2012