Systemic cortisone therapy involves corticosteroid tablets taken orally, or injections into the muscle or bloodstream.
Used in rheumatoid arthritis, when simpler medication has
failed or in the treatment of injuries to reduce swelling and inflammation.
The use of systemic cortisone (taken as tablets or
injected into the muscle or bloodstream) can suppress the adrenal glands’ own
cortisone production, and this can lead to a whole range of side-effects one
would prefer to avoid in the long term.
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Cortisone’s effect on the body They :
1. Reduce redness, swelling and inflammation 2. suppress
the immune system if taken in high dosages
Name a cortisone tablet Prednisone
is the most commonly used steroid tablet for people with rheumatic diseases.
Who can benefit from steroid
tablets? 1. Steroids can very effectively relieve the symptoms
of swelling, redness and inflammation in people with rheumatoid arthritis,
systemic lupus erythematosus (SLE), in the treatment of polymyalgia rheumatica
and temporal arteritis and polymyositis. 2. Rheumatologists recommend
the use of oral corticosteroids in cases of severe synovitis not responding well
to NSAID’s 3. Elderly frail RA-sufferers with ongoing synovitis and who
are not suitable for disease-modifying anti-rheumatic drug (DMARD) use.
4. Ankylosing spondylitis does not respond well to cortisone.
5. Not routinely recommended for osteoarthritis.
They act by suppressing disease activity; prednisone does not cure rheumatic disease. Cortisone is
no cure.
When do I take
prednisone? Prednisone is usually taken in the morning.
Coated tablets should not be chewed but swallowed whole.
What dose do I take? The dose will
depend on your disease and your body weight. The use of oral corticosteroids
for RA is usually limited to 10 mg daily, for up to 6 months. You will
be weaned off your steroid tablets slowly, to make sure you body’s own cortisone
production is controlled.
How long will steroids take to
work? You will notice a benefit within ten days.
What are the possible
side-effects? The longer you are taking prednisilone and the higher
the dose, the higher your risk of side-effects. This is why the lowest possible
dose is prescribed to keep your disease under control. Side-effects may
include: 1. weight gain, 2. a round moon face,
3. thinning of the bones (osteoporosis) and skin,
4. indigestion, 5. bruising and 6. stomach pains.
7. Muscle weakness, 8. mood swings, and 9. cataracts
can occur. 10. Your blood glucose sugar level may rise, 11. If
you have diabetes you may require a change in the treatment of your diabetes.
12. If you suffer from epilepsy, then it is possible that prednisone
could make the epilepsy worse. 13. Prednisone can also make glaucoma
worse. 14. Taking prednisone can also suppress your immune system and
make you more likely to develop infections. If this happens or if you have a
fever you should report to your doctor. Signs of infection can be disguised by
prednisone. So if you feel unwell or develop any new symptoms after starting
prednisolone, it is important to tell your doctor. 15. High doses of
prednisolone can cause a rise in blood pressure. 16. If you have not had
chicken-pox but come into contact with someone who has chicken-pox or shingles,
you should report to your doctor immediately as you may need special treatment.
If you develop chicken-pox or shingles you should report to your doctor
immediately. 17. In children, taking steroids can suppress growth.
However, some of the conditions for which steroids are prescribed can also
affect growth.
What about interaction with other medication?
Some drugs can interact with cortisone. Avoid:
immunisation injections which involve live vaccines such as polio, rubella
(German Measles) and yellow fever. Flu vaccines are safe and
recommended. Most drugs can be safely taken with cortisone.
Do cortisone tablets affect
pregnancy? It is best not to take cortisone during pregnancy. If you
fall pregnant while on cortisone therapy, consult your doctor. Never
stop cortisone tablets abruptly.
What about alcohol while taking cortisone
tablets? Both can upset the stomach. Alcohol should be avoided.
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