Microsoft word - glucocorticoids.doc

Patient Information Regarding Use of Glucocorticoids

You have been prescribed one of the glucocorticoid (or steroid) medications (Prednisone,
Entocort EC or Cortenemas). These are the most common and best medications used to induce
remission (control the symptoms of your disease) and typically work quickly with an improvement in
symptoms within a couple of weeks.
These medications can cause side effects that may be permanent and it is important for you to know about these so, you can report them to your treating physician. Most of these side effects occur with higher doses of the medication and rarely occur with the lower doses. For this reason, the treatment course is usually short (two months). The major side effects include: • Weight gain and fat redistribution. This occurs because of a direct effect of the glucocorticoids and because of an increase in appetite that typically occurs while on steroids. You may develop fat in the face, the back of your neck and abdomen. These side effects resolve when the dose is tapered (lowered gradually) and at the lower doses. • Glucose intolerance, also known as steroid-induced diabetes mellitus, may occur and typically at the higher doses. Sometimes it is necessary to take diabetic medications to bring the blood sugar back to normal values. • Neuropsychiatric symptoms may occur and include insomnia and mood swings from a sense of well being to depression. These symptoms may be severe enough to warrant the use of anti-depressant medications or stopping the glucocorticoid medication. • Cosmetic side effects may occur and include: hair loss, acne, increase facial and neck fat, hirsuitism (increase in body and facial hair) and striae (purple stripes, usually on the abdomen). • High blood pressure (Hypertension) may also occur and may require blood-pressure-lowering • Narrow angle glaucoma may occur resulting in a change in your vision. This will require a consultation with the Ophthalmologist (eye specialist). Long-term use may result in cataract formation. • The bones may be affected with bone loss and even osteoporosis. A baseline bone densiometry study (measurement of the density of your bones) will be obtained. When high doses of glucocorticoids are used, aseptic necrosis of the femoral head o (bone death of the head of the bone that fits in your hip socket) may occur and typically, • Weakness of the shoulder and hip muscles may also occur, but, usually with prolonged use of high • An increased risk of infection and poor wound healing may occur at the higher doses and usually • Suppression of the adrenal glands may occur and is the reason the dose is usually tapered slowly.

Source: http://www.sutterdavis.org/services/gastroenterology/pdf/glucocorticoids.pdf