Your child needs to take a medicine that belongs to a group of drugs called corticosteroids which include cortisone, dexamethasone, hydrocortisone, methylprednisolone, prednisone, prednisolone and triamcinolone. This information sheet explains what corticosteroids do, how to give them and what side effects or problems your child may have when they take these medicines.
What are corticosteroids?
A corticosteroid is a steroid hormone that may be used to treat many different conditions. Medicines in this group include:
- cortisone
- dexamethasone
- hydrocortisone
- methylprednisolone
- prednisone
- prednisolone
- triamcinolone
Corticosteroids are not the same type of steroid that athletes use to make them better at their sports.
Your child may need to take corticosteroids for a long time (e.g., more than two weeks) to treat problems caused by inflammation (e.g., asthma, Crohn’s disease, juvenile arthritis, nephrotic syndrome) and to decrease the body’s immune response (after an organ or bone marrow transplant). Corticosteroids are also used in the treatment of some cancers.
You may hear corticosteroids called steroids or by their brand names, such as Solu-Cortef, Medrol, Solu-Medrol, Depo-Medrol, Winpred, or Pediapred. Corticosteroids come in tablet, liquid and injection forms. Some liquids need to be specially compounded by a pharmacy.
Before giving this medicine to your child
Tell your child’s health-care provider if your child has ever reacted badly to a corticosteroid or any other medication.
Talk with your child’s health-care provider if your child has any of the following conditions. Precautions may need to be taken with this medicine if your child has:
- infection or recent exposure to infection, such as chickenpox
- diabetes or problems with blood sugar
- stomach or intestine problems
- eye problems, such as glaucoma
- any heart, kidney or liver problems
- high blood pressure
- bone problems, such as bone weakening or thinning
- behavioural problems
How should you give your child this medicine?
Your child may receive corticosteroids by a needle from a nurse or by liquid or tablets that they swallow. If your child is getting corticosteroids by mouth:
- Give the corticosteroid exactly as your child’s health-care provider tells you, even if your child seems better.
- Give the corticosteroid at the same time(s) every day. If your child is only taking one dose per day, give the corticosteroid in the morning.
- Have your child take the corticosteroids with food to prevent them from getting an upset stomach.
- Do not suddenly stop giving this medicine to your child. Talk with your child's health-care provider before you stop giving this medicine for any reason. The health-care provider may want to gradually reduce the amount of corticosteroid your child gets before completely stopping the medicine.
- If your child is taking corticosteroid tablets, the tablets should be swallowed whole, with water. If your child is unable to swallow whole tablets, speak to your pharmacist about other options.
- If your child is taking a liquid corticosteroid, shake the bottle well and measure the dose with the special spoon or syringe that the pharmacist gave you.
If your child is prescribed a corticosteroid injection, a nurse will give it by needle into your child’s muscle or vein.
What should you do if your child misses a dose?
If your child misses a dose of corticosteroid:
- Give the missed dose as soon as you remember.
- If it is almost time for the next dose, skip the missed dose. Give the next dose at the regular time.
- Do not give your child two doses to make up for one missed dose.
What are the possible side effects of this medicine?
The risk of side effects with corticosteroids depends on how long your child needs to take the corticosteroid, and how big a dose your child needs. Your child may have some of these side effects while they take a corticosteroid.
Check with your child's health-care provider if your child continues to have any of these side effects, if they do not go away or if they bother your child:
- Increased appetite or weight gain
- Indigestion, upset stomach or vomiting
- Trouble sleeping
- Restlessness
- Headache
- Changes in mood or behaviour
- Physical changes to the skin, such as acne or unexplained bruising
- Rounding out of the face (moon face)
Call your child’s health-care provider during office hours if your child has any of these side effects:
- Signs of infection, such as fever, chills, sore throat, cough
- Symptoms of high blood pressure (e.g., thirstier than usual, urinating more often)
- Muscle weakness
- Pain or swelling in the arms or legs
- Bone or joint pain
- Burning sensation or pain of throat or stomach
- Changes in menstrual periods
Most of the following side effects are not common, but they may be a sign of a serious problem. Call your child's health-care provider right away or take your child to the nearest Emergency Department if your child has any of these side effects:
- Black, tarry stools or blood in stools
- Vomiting blood or material that looks like coffee grounds
- Seizures
What safety measures should you take when your child is using this medicine?
Check with your child’s health-care provider if your child’s condition reappears or gets worse when the dose has been lowered or when treatment has stopped.
Your child’s health-care provider should check your child’s progress at regular visits. Your child’s progress may also be checked after stopping the corticosteroid, since some effects may continue.
Your child’s health-care provider may also:
- suggest changing your child’s diet
- have your child take calcium and vitamin D to prevent bone problems while getting a corticosteroid
- have your child take medicine to protect their stomach while getting a corticosteroid
- suggest your child have their eyes checked by an eye doctor (optometrist or ophthalmologist)
Your child should not receive any live vaccines (immunizations) without their health-care provider’s approval. Non-live vaccines may need to be given before the corticosteroid treatment is started or after treatment is finished for the vaccine to be fully effective. Your child should keep up to date on their routine vaccinations, including the flu shot.
While your child is treated with a corticosteroid, and for some time after stopping treatment, they may not be able to fight infection well. To prevent infections:
- Avoid people with infections, such as the cold or the flu, or wear a mask if close contact is unavoidable.
- Be careful when brushing or flossing your child’s teeth. Your child’s health-care provider or dentist may suggest different ways to clean your child’s mouth and teeth.
- Wash hands regularly with soap and water or clean with hand sanitizer.
- Follow your child’s health-care provider’s instructions on what to do in case of fever.
There are some medicines that should not be taken together with corticosteroids, or, in some cases, the dose of the corticosteroid or the other medicine may need to be adjusted. It is important that you tell your child’s health-care provider if your child takes any other medications (prescription, over the counter or herbal), including:
- NSAIDs (such as ibuprofen)
- antifungals (such as ketoconazole)
- cyclosporine
- warfarin
- aprepitant, fosaprepitant
What other important information should you know?
- Keep a list of all medications your child is on and show the list to the health-care provider.
- Do not share your child’s medicine with others and do not give anyone else’s medicine to your child.
- Make sure you always have enough corticosteroids to last through weekends, holidays and vacations. Call your pharmacy at least two days before your child runs out of medicine to order refills.
- Keep all appointments at the clinic or health-care provider’s office so that they can check your child's reaction to the corticosteroid.
- Keep the corticosteroid tablets at room temperature in a cool, dry place away from sunlight. Do NOT store it in the bathroom or kitchen.
- Check with your pharmacist on how to store the corticosteroid liquid. Storage will depend on the type of corticosteroid your child is taking.
- Do not keep any medicines that are out of date. Check with your pharmacist about the best way to throw away outdated or leftover medicines.
Keep corticosteroids out of your child’s sight and reach and locked up in a safe place. If your child takes too much corticosteroids, call your local Poison Information Centre at one of these numbers. These calls are free.
- Call 1-844 POISON-X, or 1-844-764-7669, from anywhere in Canada except Quebec.
- Call 1-800-463-5060 if you live in Quebec.