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Medical Author:

Catherine Burt Driver, MD

Catherine Burt Driver, MD

Catherine Burt Driver, MD, is board certified in internal medicine and rheumatology by the American Board of Internal Medicine. Dr. Driver is a member of the American College of Rheumatology. She currently is in active practice in the field of rheumatology in Mission Viejo, Calif., where she is a partner in Mission Internal Medical Group.

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Medical Editor:

William C. Shiel Jr., MD, FACP, FACR

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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Medical Editor:

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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Drugs in this class include prednisone (Deltasone, Orasone), methylprednisolone (Solu-Medrol, Depo-Medrol), betamethasone (Celestone, Soluspan), cortisone (Cortone), dexamethasone (Decadron), prednisolone (Delta-Cortef), and triamcinolone (Aristocort).

• How corticosteroids work: These drugs decrease swelling and inflammation by suppressing immune response.



• Who should not use these medications: People with the following conditions should not use corticosteroids:



• Allergy to corticosteroids



• Active infections caused by viruses, fungi, or Mycobacterium tuberculosis



• Active peptic ulcer disease



• Liver impairment



• Use: Corticosteroids can be taken in various ways (by mouth, intravenously, intramuscularly or intra-articularly (injected directly into a joint). The goal is to use the smallest dose that controls symptoms. The length of treatment should be as short as possible in order to decrease the risk of developing side effects. When taken orally, take with food to decrease stomach upset. Corticosteroids are generally not used as long-term medications in ankylosing spondylitis due to the risk of side effects such as injury to bone (see below).



• Drug or food interactions: Many drug interactions are possible, therefore, consult with a doctor or pharmacist before taking new prescription or over-the-counter medications. Aspirin, NSAIDs, such as Advil or Aleve, or other drugs associated with stomach ulcers may increase the risk of developing stomach ulcers. Corticosteroids may decrease potassium levels and must be used with caution with other drugs that decrease potassium levels (for example, diuretics such as Lasix).



• Side effects: Ideally, corticosteroids are used in low doses only long enough to bring sudden flares in symptoms under control. Long-term use is associated with serious side effects, such as osteoporosis, osteonecrosis, glaucoma, cataracts, mental changes, abnormal blood glucose levels and diabetes, or arrested bone growth in children who are prepubescent. After prolonged use, the corticosteroid dose must be gradually decreased over weeks to months to avoid corticosteroid withdrawal syndrome.

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