Corticosteroids for immune disorders

Generic name	Brand name
___ cortisone	Cortone®, other brands
___ dexamethasone	Decadron®, other brands
___ hydrocortisone	Cortef®, other brands
___ methylprednisolone	Medrol®, other brands
___ prednisolone	Pediapred®, Prelone®, other brands
___ prednisone	many brands

How does this medicine work?

Corticosteroids (kore-tuh-ko-stair-oyds) are hormones made in the adrenal gland to help the body respond to stress such as injury or illness. They are not the same as steroids that some athletes have misused to increase muscle mass and strength.

Corticosteroids are given to reduce inflammation and to lower the level of certain antibodies that may be causing the destruction of platelets, or may be targeted against other organs.

Your child may receive a high dose at first. Your doctor will then decide whether to stop the medicine or taper off it by reducing the amount or frequency of the dose.

How should I give it?

Corticosteroids can be given by mouth as a pill or liquid, or by injection into the muscle or vein. It may be given 1 to 4 times per day and the dose varies for each person. Follow the doctor's directions exactly. Too much or too little of this medicine can be harmful.

Your child should be awake and alert when taking any medicine.

Follow the checked instructions below:

___ If using the liquid form, shake well right before using. Draw up the correct amount in the medicine dropper or oral syringe. Give a small squirt of the medicine inside the cheek. To avoid choking, let your child swallow each squirt before giving more.

___ For babies, mix the medicine with a small amount of formula or breast milk and give it with a bottle nipple before a feeding. Do not add the medicine to a whole bottle because if your baby does not finish the bottle you will not know how much of the medicine was taken.

___ If the prescription is a tablet and your child cannot swallow pills, then crush it between 2 spoons, inside a plastic bag, or in folded paper. Mix the powder with a very small amount of soft food such as applesauce, chocolate syrup, ice cream, jelly or yogurt. Make sure your child takes all of the mixture. It does not taste good, so give it quickly and follow with something to drink right away.

___ Other instructions:

 

Are there any precautions about food or other medicines?

Give this medicine with food or milk to prevent an upset stomach. If stomach upset persists, check with your doctor about using an antacid.

If your child will be taking corticosteroids for more than a month, see the education sheet "Corticosteroids and nutrition" to prevent some side effects.

Check with the doctor, nurse practitioner, or pharmacist before giving any other prescription or non-prescription medicines, herbs, or vitamins.

What should I do if a dose is missed?

If a dose is missed, and it is prescribed once daily, take the missed dose as soon as you remember that day. For medicines that are prescribed more often, follow these guidelines:

If it is prescribed:	Give it no closer than:
twice daily	6 hours from the next dose
3 times daily	3 hours from the next dose
4 times daily	skip the missed dose

If it is too close to the next dose, skip the missed dose and continue with the regular schedule. Never give a double dose.

If your child vomits (throws up) within 15 minutes after receiving a dose, give it again. If your child vomits the second dose, do not repeat it again.

If your child misses or vomits two doses, please call the clinic.

What are the side effects?

The side effects are related to how much, how often, and for how long corticosteroids are taken. They may include:

Common

• stomachache
• increased appetite
• weight gain
• mood changes

Occasional

• acne
• headaches
• aches and pains
• trouble sleeping
• impaired wound healing
• high blood sugar
• high blood pressure
• fullness of the face and neck
• damage to large bones near the joints

When should I call the clinic?

• fever, cold, sore throat or infections
• if your child has diabetes and the blood sugar goes up
• increase in drinking or urinating
• muscle weakness
• black, tarry stool (bowel movement)
• blood in the vomit
• trouble breathing - call 911

What else do I need to know?

If corticosteroids are taken for more than one month, they should be stopped gradually as directed by the doctor to allow the body to start making its own again. In case of injury or illness please tell the doctor that your child is on or has been on steroids. An identification band is important if your child is taking corticosteroids for a long time.

Long-term use of corticosteroids can cause short stature, decreased bone density, and cataracts. If you have concerns, talk to your doctor.

You and your child should know the names and doses of all medicines he or she is taking. Share this information with anyone involved in your child's care. Please remember to bring the medicine container when your child comes to the clinic or emergency department.

Always make sure you have enough medicine on hand. Each time you refill the prescription, check to see how many refills are left. If no refills are left the pharmacy will need 2 or 3 days to contact the clinic to renew the prescription.

Check the label and expiration date before giving each dose. Ask your pharmacist what to do with outdated or unused medicines. If there is no "take-back" program:

• Empty them into a leak-proof container.
• Add a liquid to help pills break down.
• Add coffee grounds, dirt, flour, kitty litter, salt, or other substance.
• Put on the lid and throw it in the trash.

Store all medicines in their original containers and away from direct sunlight or heat. Do not store in humid places such as the bathroom. Keep them out of children's reach, locked up if possible.

If too much or the wrong kind of medicine is taken, call the Poison Control Center at 1-800-222-1222. If your child is unconscious or has a seizure, call 911.

Questions?

This is not specific to your child but provides general information. If you have any questions, please call the clinic or pharmacy.

Reviewed 6/2017

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