Side Effects of Oral Corticosteroids
The side effects of oral corticosteroids tend to be of two types: those that are immediate and those that occur as a consequence of long-term use. The frequency of these side effects varies in accordance with dose, length of treatment, and the individual. In general, small daily doses (5 mg of prednisone, for example) cause few side effects, whereas larger doses (more than 20 mg of prednisone daily) are commonly associated with side effects if continued for more than a month. Corticosteroids injected into the joints rarely cause any of the side effects. Nausea, bloating, and changes in mood are the most common immediate side effects of oral corticosteroid therapy. Long-term use can affect the muscles, bones, eyes and hormones as well as making the person susceptible to infection. Many of the side effects resulting from long-term use will subside after corticosteroid treatment is discontinued. If a person develops a serious infection, the infection needs to be treated and the person gradually taken off the corticosteroids if possible.

Cautionary Notes
Before starting oral corticosteroid therapy discuss the following with your physician:
•  A history of diabetes, glaucoma, high blood pressure, heart disease, osteoporosis, thyroid problems, stomach ulcer, or tuberculosis or positive tuberculin skin test.
While taking this medication:
•  Contact your physician if you notice fever or chills; cough; sore throat; blurred vision; increased frequency, duration, or severity of headaches; eye pain; increased thirst; frequent urination; increased weakness.
• Take with meals, preferably breakfast.
• Avoid alcohol and tobacco products.
• Never stop corticosteroids abruptly. This can be hazardous if you have been on corticosteroids for an extended period. If you run out of medication, call your doctor immediately. Corticosteroid use must be supervised by a doctor, and discontinuation of it must also be supervised by a doctor.
• If you have a surgical or another medical procedure planned, inform your doctor that you are on corticosteroids. Your doctor may want to increase your dose temporarily. This is called stress dosing.
• If you have been on corticosteroids for more than one month, wear a medical identification tag that states that you have RA and lists the medications you are taking. This will provide valuable medical information if you are ever in an accident or become so ill that you are unable to speak for yourself.
• If you have severe nausea, vomiting, or diarrhea, you may not be absorbing your medication and should alert your physician immediately.
Pregnancy and breastfeeding. Corticosteroid use is considered relatively safe during pregnancy.
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