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Corticosteroids for asthma (oral)

Translations available: Spanish

Generic name Brand name
___ prednisolone Pediapred®, Prelone®, Orapred®
___ prednisone many brands

How does the medicine work?

Corticosteroids (kore-tuh-ko-stair-oyds) are hormones made in the adrenal glands 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 help reduce the swelling and mucus inside the airways. Swelling and mucus plug the airways and make it hard to breathe. This medicine is often used when asthma symptoms have not been controlled with other medicines.

A "steroid burst" is a term often used to describe 5 to 10 days of oral corticosteroids. A burst is usually used to treat an asthma episode or keep it from getting worse. It often takes 6 to 12 hours before you can tell that the corticosteroids are working.

A goal of asthma therapy is to have your child take the minimum amount of oral corticosteroids needed to control symptoms.

How should I give it?

The dose of this medicine 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, 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, you may want to 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 medicine to a whole bottle because if your baby does not finish it, you will not know how much of the medicine was taken.

___ If the prescription is a tablet and your child cannot swallow pills, crush it between 2 spoons or inside a plastic bag or folded paper. Mix with a small amount (about 1 teaspoon) of soft food such as applesauce, yogurt, ice cream, jelly, or chocolate syrup. It does not taste good, so give it quickly and follow with something to drink right away.

Other instructions:

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Are there any precautions about food or other medicines?

Give this medicine with food or milk to prevent an upset stomach.

Before starting corticosteroids, tell your doctor if your child is taking any of these:

  • anti-coagulants such as warfarin (Coumadin®)
  • aspirin
  • diuretics (water pills)
  • insulin
  • ketoconazole
  • Nizoral®
  • phenytoin (Dilantin®)
  • rifampin
  • troleandomycin (TAO®)

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, give it as soon as you remember, unless it is closer than 6 hours to the next dose. In that case skip the missed dose and continue with the regular schedule. Do not give a double dose.

If your child vomits (throws up) within 30 minutes after receiving a dose, give it again. If your child vomits the second dose, do not repeat it again.

Call the doctor if your child misses or vomits 2 doses in a row.

What are the side effects of this medicine?

The side effects are related to how much, how often, and for how long corticosteroids are taken. These side effects may occur while taking a steroid burst:

  • stomachache
  • increased appetite
  • weight gain
  • high blood sugar
  • mood changes
  • acne
  • fullness of the face and neck

If your child takes more than 5 or 6 steroid bursts in a year, talk to the doctor about the potential side effects of corticosteroids. You may also want to discuss better ways to control your child's asthma so oral corticosteroids are not needed as often.

When should I call the doctor?

Call the doctor if:

  • you start a burst of steroids on your own; this needs to be recorded
  • you are not sure whether your child needs a burst of steroids
  • your child is not better in 12 to 24 hours after starting a burst of steroids
  • your child has diabetes and the blood sugar goes up
  • exposure to chickenpox or measles
  • fever, chills, sore throat, runny nose
  • sores or white patches in mouth or throat
  • asthma symptoms get worse
  • signs of allergic reaction:
    - rash or hives
    - swelling or tingling in hands, face, mouth, or throat
    - trouble breathing - call 911

What else do I need to know?

Your child may get infections easier while taking corticosteroids, and should avoid people who are sick or have infections. If your child is exposed to chickenpox or measles, tell your doctor right away.

Tell any doctor or dentist who treats your child that he or she sometimes takes corticosteroids for asthma.

You and your child should know the names of all the medicines he or she is taking. Share this information with anyone involved in your child's care.

Always make sure you have enough medicine on hand for red zone management of your child's asthma. 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 container 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 sheet is not specific to your child, but provides general information. If you have any questions, please call the clinic or pharmacy.

Children's Hospitals and Clinics of Minnesota
Patient/Family Education
2525 Chicago Avenue South
Minneapolis, MN 55404
Last reviewed 8/2015 ©Copyright

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This page is not specific to your child, but provides general information on the topic above. If you have any questions, please call your clinic. For more reading material about this and other health topics, please call or visit Children's Minnesota Family Resource Center library, or visit www.childrensmn.org/educationmaterials.

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