Systemic Corticosteroids for Relief During Asthma Attacks

Example(s): A-Methapred,Solu-Medrol (methylprednisolone),Kenalog (triamcinolone),Medrol (methylprednisolone),Pediapred,Prelone (prednisolone) (prednisone)

Systemic Corticosteroids for Relief During Asthma Attacks

Examples

The following medicines can be given as an
injection:

Generic Name Brand Name
methylprednisolone A-Methapred, Solu-Medrol
triamcinolone Kenalog

The following medicines can be given as pills or
liquid:

Generic Name Brand Name
methylprednisolone Medrol
prednisolone Pediapred, Prelone
prednisone  

How It Works

All corticosteroids reduce
inflammation in the airways that carry air to the
lungs (bronchial tubes). They also decrease the
mucus made by the bronchial tubes and make it easier
for you to breathe.

Systemic corticosteroids travel throughout the
body before reaching the airway. This results in more side effects and more
serious side effects than with inhaled corticosteroids, which treat
inflammation in the airways only.

Why It Is Used

Systemic corticosteroids help
control narrowing and inflammation in the airways of the lungs in
asthma. They are used to:

  • Get relief of asthma symptoms during a
    moderate or severe
    asthma attack.
  • Get control of symptoms
    when you start long-term treatment of asthma after your initial diagnosis.

Corticosteroids by mouth or injection
may be used as short-term treatment after an asthma attack or when asthma has not
been under control. "Burst" treatment with corticosteroids may be continued for 3 to
14 days or longer. A person who continues to have asthma attacks while being
treated with inhaled corticosteroids may need to have the dose of medicine increased.

Corticosteroids may make the episode shorter and prevent
early recurrence of episodes. The length of treatment with corticosteroids can
be different depending on the person. It your attack wasn't very severe, you
could take corticosteroids for only 3 days. But you may need to take them for
as long as several weeks for a very severe attack.

People who have
severe persistent asthma may need to take corticosteroid pills or liquid by
mouth daily or every other day to control their symptoms.

Different types of medicines are often used together in the treatment of
asthma. Medicine treatment for asthma depends on a person's age, his or her
type of asthma, and how well the treatment is controlling asthma
symptoms.

  • Children up to age 4 are usually treated a
    little differently than those 5 to 11 years old.
  • The least amount
    of medicine that controls the asthma symptoms is used.
  • The amount
    of medicine and number of medicines are increased in steps. So if asthma is not
    controlled at a low dose of one controller medicine, the dose may be increased.
    Or another medicine may be added.
  • If the asthma has been under
    control for several months at a certain dose of medicine, the dose may be
    reduced. This can help find the least amount of medicine that will control the
    asthma.

Your doctor will work with you to help find the number and
dose of medicines that work best.

How Well It Works

A review of research shows that
treatment with systemic corticosteroids during an asthma attack reduced
hospital admissions and the frequency of relapse in adults.footnote 1

A review of research on treatments for asthma in children found that systemic corticosteroids during an asthma attack shortened the duration of hospital visits for asthma attacks for children.footnote 2

In children, corticosteroid pills reduce the severity and length of an asthma
attack
. But for the pills to stop an asthma attack, it is important to give
them at the first sign of symptoms.footnote 3

Side Effects

All medicines have side effects. But many people don't feel the side effects, or they are able to deal with them. Ask your pharmacist about the side effects of each medicine you take. Side effects are also listed in the information that comes with your medicine.

Here are some important things to think about:

  • Usually the benefits of the medicine are more important than any minor side effects.
  • Side effects may go away after you take the medicine for a while.
  • If side effects still bother you and you wonder if you should keep taking the medicine, call your doctor. He or she may be able to lower your dose or change your medicine. Do not suddenly quit taking your medicine unless your doctor tells you to.

Common side effects of long-term treatment with
corticosteroids given by mouth include:

  • Slower growth or stunted growth in
    children.
  • Problems with the body's ability to use glucose (diabetes).
  • Bone weakening (osteoporosis) or possibly bone death (aseptic necrosis
    of the femur) from changes in blood supply.
  • High blood pressure
    (hypertension).
  • Repeated infections,
    bruising, and skin thinning (atrophy). Corticosteroids also make it less likely
    you will have a fever, so that an infection is not always recognized
    immediately.
  • Clouding of the lens of the eye (cataract).

To minimize or prevent side effects of
corticosteroids keep the dose of corticosteroids as low as
possible while still maintaining asthma control.

See Drug Reference for a full list of side effects. (Drug
Reference is not available in all systems.)

What To Think About

If you have been using systemic corticosteroids for more
than 3 weeks and are going to stop taking them, you need to gradually decrease
the amount you use, rather than stopping them all at once. This will help avoid
problems with the adrenal glands.

Taking medicine

Medicine is one of the many tools your doctor has to treat a health problem. Taking medicine as your doctor suggests will improve your health and may prevent future problems. If you don't take your medicines properly, you may be putting your health (and perhaps your life) at risk.

There are many reasons why people have trouble taking their medicine. But in most cases, there is something you can do. For suggestions on how to work around common problems, see the topic Taking Medicines as Prescribed.

Advice for women

If you are pregnant, breastfeeding, or planning to get pregnant, do not use any medicines unless your doctor tells you to. Some medicines can harm your baby. This includes prescription and over-the-counter medicines, vitamins, herbs, and supplements. And make sure that all your doctors know that you are pregnant, breastfeeding, or planning to get pregnant.

Women who have gone through menopause and who use corticosteroids by mouth or injection for long periods of time need to take extra calcium and vitamin D—and
possibly bisphosphonates (such as Fosamax)—to prevent bone loss
(osteoporosis).

Checkups

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

Complete the new medication information form (PDF) ( What is a PDF document? ) to help you understand this medication.

References

Citations

  1. Rodrigo G (2011). Asthma in adults (acute), search date April 2010. BMJ Clinical Evidence. Available online: ://www.clinicalevidence.com.
  2. Okpapi A, et al. (2012). Asthma and other recurrent wheezing disorders in children (acute), search date June 2010. BMJ Clinical Evidence. Available online: ://www.clinicalevidence.com.
  3. Rachelefsky G (2003). Treating exacerbations of asthma in children: The role of systemic corticosteroids. Pediatrics, 112(2): 382–397.

Credits

ByHealthwise StaffPrimary Medical Reviewer E. Gregory Thompson, MD - Internal Medicine Adam Husney, MD - Family Medicine Specialist Medical Reviewer Elizabeth T. Russo, MD - Internal Medicine

Current as ofDecember 6, 2017