How long do IV steroids stay in your system?

6 Side Effects of MS Steroid Treatment

2. Bad Taste, Upset Stomach a Possibility

Some people notice a funny, metallic taste in their mouth when undergoing steroid treatment. Sucking on mints or hard candies may help alleviate it.

Other common side effects of steroids include upset stomach, nausea, and vomiting.

If you experience indigestion or heartburn, ask your doctor to suggest an over-the-counter antacid to help control it.

RELATED: Quiz: What’s Your MS Management Style?

3. Mood Disturbances: Agitation, Irritability, Mood Swings

Being on a steroid can make you restless, agitated, and irritable.

“Agitation is a common symptom for some people,” McCoyd says. In addition, “Patients who have a mood disorder may be treated in the hospital to make sure they do not have a serious bout of depression or anxiety.”

Mood swings with steroid treatment can range from mild to serious. Be sure to tell your doctor if you have a history of depression, anxiety disorder, or bipolar disorder.

Simply being aware that steroids can affect your moods may make this side effect easier to tolerate, but let your doctor know if it feels intolerable.

It’s also important to let loved ones know about this possible side effect so they understand what’s going on with you. “I always warn the partner: ‘She might be a little more irritable over the next few days. It’s the medicine; it’s not her,’” notes Kaplan.

4. Water Retention Annoying but Temporary

After the initial dose of steroids, you may experience swollen ankles as well as a general swollen and bloated feeling throughout your body. Since steroids cause your body to retain more water, it’s also common to experience urinary frequency, says Kaplan.

Just knowing that this can potentially happen — and that it will soon pass — can help.

“It’s not something to worry about,” she says. “It’s not a long-lasting symptom; it will improve within a few days.”

5. Infection Risk Rises With Steroid Use

One of the functions of a steroid is to suppress your body’s immune system, which places you at higher risk of infections.

“It is a good idea to do a blood and urine test to look for any sign of infection before starting treatment,” McCoyd says. And if you develop any symptoms of infection while taking a steroid — such as a fever, chills, cough, or sore throat — let your doctor know.

You can lower your risk of infection with frequent hand-washing and by keeping your distance from people with cold or flu symptoms.

While people with MS are generally encouraged to get an annual flu shot, as well as certain other vaccines, the National Multiple Sclerosis Society cautions against getting any vaccines during a serious MS relapse — whether or not you’re receiving steroids.

People on long-term corticosteroid therapy or any other immunosuppressive therapy should talk to their neurologist before receiving any live virus vaccine, such as the measles, mumps, and rubella (MMR) vaccine and the varicella (chickenpox) vaccine.

6. Elevated Blood Sugar a Concern for Those With Diabetes

One of the most important side effects of steroids is high blood sugar levels. This is usually not a problem unless you have diabetes, but if you do have diabetes, you are likely to see higher numbers when you check your blood glucose level.

“People with diabetes should be warned that their blood sugar will go up and that they need to talk to their doctor about adjusting their insulin while they are on the steroid,” says Kaplan.

People without diabetes sometimes develop steroid-induced diabetes during steroid treatment. If you notice unusual thirst, dry mouth, frequent urination, blurred vision, or extreme weakness and fatigue while on steroids, let your doctor know.

Additional reported by Susan Jara.

Thread: How long does it take for the IV steroids to start working on fatigue?

Hi. I’m sorry your feeling so bad!
The thing about MS is that you never know when your going to start feeling better. There are things you can do to try to keep MS in control but other than that you really just have to go where it takes you.
If you’ve already finished with your steroids then they already have kicked in. Steroids don’t kick in the way that a lot of people think that means. Steroids suppress inflammation and if someone’s symptoms are coming from inflammation they might start to feel better pretty soon as the inflammation goes down. Steroids are active for about a week while they’re still circulating around in your body. That’s when they kick in. After about a week the steroids are already broken down and aren’t active anymore so there’s nothing left to kick in anymore. Everything the steroids do has already happened.
The problem is that it seems like by the time most people get started on their IV steroids the myelin and the nerves have already been damaged. Steroids don’t heal the nerve damage. Nerves have to heal by themselves and that takes as long as it takes. The idea behind steroids is that they calm the inflammation so the nerves can start to heal faster. But faster still just means as long as it takes. Sometimes its fairly quick and sometimes its pretty slow. Sometimes nerves don’t heal at all.
Steroids aren’t really a treatment for fatigue. The energy boost the nurses were talking about is a short term side effect of steroids. They usually cause insomnia and make people hyper. Back when I first started having IV steroids parts of my house got pretty clean and sometimes at odd hours in the middle of the night. That happens with a lot of people. But it only lasts for a few days or maybe a week. When the steroids break down and are gone the hyper side effects wear off.
Steroids aren’t a treatment that makes fatigue go away. It sounds like for some reason you didn’t get the hyper side effect. On the other hand steroids make some people tired. That’s more of what happens to me now. My house doesn’t get as clean anymore. You might be one of the people who just gets tired from steroids.
MS has its own kind of fatigue. For a lot of people with MS fatigue is an every day fact of life. A lot of people get help from anti-fatigue medicines which are stimulants. It sounds like you haven’t had a chance to talk to your neurologist about that yet. So at your next appointment be sure to ask about medicines that might help your fatigue.
Your so new to MS I don’t want to overwhelm you with information. For now it might just be the easiest thing to see if one of the medicines helps your fatigue. As time goes on and you get a chance to start learning more about MS you can start learning about eating more healthy and getting some gentle exercise. Both of those can help with fatigue.
Some people’s fatigue gets better with some dietary supplements and you can read about them here and in other MS forums. My fatigue got much better when I started taking enough vitamin D to get my blood level up to what’s recommended for people with MS which is about 50 to 70 ng/ml.
There’s research that shows that people with MS need more vitamin D than people in general do so its important to know what your blood level of vitamin D is. If your vitamin D wasn’t checked when you were in the process of getting diagnosed its a good idea to get that done. Your primary doctor can order the test for you so you don’t have to wait until your next neuro appointment.
MS is quite a shock that nobody is really prepared for. It can take a long time to get through the process of grief. You might even want to think about talking to a therapist for a while to help guide you through it. Your family and friends can be supportive but they can’t take your medicine for you and having a therapist help you through the bad early days is kind of like taking your medicine.
The good news is that a lot of people do feel better after they get diagnosed and get their medications and lifestyle in order. Its just that it can take a while for that to happen. So hang in there! It might take some time but you will start to feel better.

Prednisone by Pro Doc

How does this medication work? What will it do for me?

Prednisone belongs to the group of medications called corticosteroids. It is used to treat a number of conditions. It is more commonly used to treat allergic reactions, some skin conditions, severe asthma, and arthritis. It can also be used to treat steroid deficiency in the body, certain blood disorders, certain types of cancer, and ulcerative colitis. It works by reducing swelling, inflammation, and irritation; by suppressing the body’s immune response; or by replacing steroids when production by the body is deficient.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

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What form(s) does this medication come in?

This medication is available as 5 mg and 50 mg tablets.

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How should I use this medication?

The dose of prednisone varies greatly according to the condition being treated and on your circumstances. Take prednisone with food to avoid stomach upset. If this medication has been taken for extended periods, do not stop taking it without talking with your doctor. When this medication is stopped, the dose should be reduced gradually according to your doctor’s instructions.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important to take this medication regularly, exactly as prescribed by your doctor. Do not stop taking this medication without first talking with your doctor. If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Who should NOT take this medication?

Do not take this medication if you:

  • are allergic to prednisone or any ingredients of this medication
  • have an internal fungal infection
  • will be given a live virus vaccine (e.g., measles, mumps, rubella, yellow fever, BCG) and are taking large immunosuppressive doses of prednisone
  • have herpes simplex of the eye, except for short-term or emergency treatment of allergic-type reactions
  • have measles or chickenpox, except for short-term or emergency treatment of allergic-type reactions
  • have peptic ulcers (stomach ulcers)
  • have diverticulitis
  • have undiagnosed inflammation of the digestive system (non-specific colitis)
  • have a viral or bacterial infection that is not controlled by medications (anti-infectives)

What side effects are possible with this medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

  • acne
  • bloating
  • diarrhea
  • changed sense of taste
  • heartburn
  • hiccups
  • increased appetite
  • increased sweating
  • irregular menstrual periods
  • nausea
  • reddish-purple lines on arms, face, groin, legs, or trunk
  • thin, shiny skin
  • thinning hair
  • trouble sleeping
  • unusual increase in hair growth
  • unusual tiredness or weakness
  • vomiting
  • weight gain

Although most of the side effects listed below don’t happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

  • decreased or blurred vision
  • eye pain
  • false sense of well-being
  • filling or rounding out of the face
  • hallucinations
  • increased blood pressure
  • irregular heartbeat
  • mood or behaviour changes (e.g., aggression, rage, anxiety or excitation)
  • muscle weakness
  • pain in arms, back, hips, legs, ribs, or shoulders
  • skin rash
  • slowed growth (for children)
  • fluid retention (e.g., rapid weight gain, swelling of feet or lower legs)
  • symptoms of depression (e.g., poor concentration, changes in weight, changes in sleep, decreased interest in activities, thoughts of suicide)
  • symptoms of high blood sugar (e.g., frequent urination, increased thirst, excessive eating, unexplained weight loss, poor wound healing, infections, fruity breath odour)
  • symptoms of a stomach ulcer (e.g., persistent abdominal or stomach pain or burning, bloody or black, tarry stools)
  • symptoms of tuberculosis reactivation (e.g., coughing blood, chest pain)
  • unusual bruising
  • wounds that heal slowly

Stop taking the medication and seek immediate medical attention if any of the following occur:

  • seizures
  • symptoms of a severe allergic reaction, e.g.:
    • difficulty breathing
    • hives
    • swelling of the face, mouth, tongue, or throat

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there any other precautions or warnings for this medication?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Electrolytes and fluid: If you take large doses of prednisone, you may need to restrict your salt intake and take potassium supplements. Check with your doctor about whether you need any supplements while you are on this medication. You may also retain extra fluid that may cause an increase in your blood pressure. Your doctor will monitor for these effects by checking your blood pressure and doing blood tests to check your electrolyte levels.

Eye problems: Prolonged use of prednisone may cause glaucoma with possible damage to the optic nerves or it may produce cataracts. It may also increase the risk of eye infections due to fungi or viruses. Report any change in vision, eye pain, eye irritation, redness, or discharge to your doctor as soon as possible.

High blood sugar: Prednisone can cause high blood sugar. Your doctor may check your blood sugar levels with blood tests while you are taking this medication. If you have diabetes, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. If you experience increased thirst and urination while taking this medication, contact your doctor.

Infections: This medication may mask some signs of infection, and new infections may appear during their use. Contact your doctor if you notice any symptoms of an infection (e.g., fever, chills, cough, sore throat), or if you are in contact with someone who has measles or chickenpox.

Kidney problems: Prednisone may be used in the treatment of specific kidney problems. It may also cause increased fluid retention and electrolyte changes, affecting the kidney. If you have kidney problems or reduced kidney function, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Liver function: Liver disease or reduced liver function may cause this medication to build up in the body, causing side effects. If you have liver problems, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Medical treatment: Inform all doctors that you go to that you are taking this medication.

Mental health: Prednisone, like other corticosteroids, may cause behaviour and personality changes and mood swings. These reactions are most likely to occur when you first start taking this medication. If you experience these symptoms, or notice them in a family member who is taking this medication, contact your doctor as soon as possible.

Osteoporosis: This medication can increase the risk of osteoporosis (brittle bones). Talk to your doctor about ways to help prevent osteoporosis. Your doctor will monitor your bone density if you take this medication for a long period of time.

Stomach and intestinal problems: If you have or have had a stomach or intestinal ulcer, or have ulcerative colitis, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Stopping medication: Do not stop this medication without consulting your doctor. When this medication is stopped after having taken it for a prolonged period, the dose should be reduced slowly as prescribed by your doctor. Suddenly stopping prednisone following prolonged treatment may result in symptoms of corticosteroid withdrawal syndrome including nausea, fatigue, loss of appetite, fever, muscle and joint pain, and a general feeling of being unwell.

Unusual stress: If you experience any unusual physical stress (e.g., trauma, surgery), your doctor may increase your dose of prednisone during and after the event.

Vaccination: If you are taking this medication, vaccines may not be as effective and you may be more likely to experience certain side effects. Therefore, vaccines are usually not recommended while you are taking prednisone, especially when high doses are used.

Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: This medication passes into breast milk. If you are a breast-feeding mother and are taking prednisone, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding . If you take high doses of prednisone, your doctor may advise you not to breast-feed.

Children: Since prednisone can slow the growth and development of infants and children, it should not be taken for prolonged periods of time if at all possible. Growth and development will be closely monitored by your child’s doctor.

What other drugs could interact with this medication?

There may be an interaction between prednisone and any of the following:

  • aldesleukin
  • amphotericin B
  • androgens (e.g., methyltestosterone, nandrolone, testosterone)
  • antacids (e.g., aluminum hydroxide, calcium carbonate, magnesium hydroxide)
  • anticholinesterase medications (e.g., neostigmine, pyridostigmine)
  • aprepitant
  • aripirazole
  • “azole” antifungals (e.g., itraconazole, ketoconazole, voriconazole)
  • barbiturates (e.g., phenobarbital)
  • BCG
  • boceprevir
  • calcitriol
  • carbamazepine
  • celecoxib
  • ceritinib
  • cholestyramine
  • conivaptan
  • cyclosporine
  • deferasirox
  • delavirdine
  • denosumab
  • diabetes medications (e.g., chlorpropamide, glipizide, glyburide, insulin, metformin, nateglinide, rosiglitazone, saxagliptin)
  • diuretics (water pills; e.g., furosemide, hydrochlorothiazide)
  • donepezil
  • echinacea
  • estrogens (e.g., conjugated estrogen, estradiol, ethinyl estradiol; including estrogen-containing birth control pills)
  • ethacrynic acid
  • galantamine
  • HIV protease inhibitors (atazanavir, darunavir, lopinavir, ritonavir)
  • hyaluronidase
  • hydrocodone
  • indacaterol
  • isoniazid
  • leflunomide
  • macrolide antibiotics (e.g., clarithromycin, erythromycin)
  • mifepristone
  • mitotane
  • natalizumab
  • nefazodone
  • nelfinavir
  • nicardipine
  • nonsteroidal anti-inflammatory medications (NSAIDs; e.g., diclofenac, ibuprofen, ketorolac, naproxen)
  • phenytoin
  • pimecrolimus
  • primidone
  • quinolone antibiotics (e.g., ciprofloxacin, norfloxacin, ofloxacin)
  • rifabutin
  • rifampin
  • rivastigmine
  • roflumilast
  • salicylates (e.g., ASA)
  • sodium phenylbutyrate
  • somatropin
  • tacrolimus
  • telaprevir
  • tofactitinib
  • vaccines or toxoids (e.g., BCG, measles, mumps, rubella, varicella)
  • warfarin

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

  • stop taking one of the medications,
  • change one of the medications to another,
  • change how you are taking one or both of the medications, or
  • leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

All material copyright MediResource Inc. 1996 – 2020. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/drug/getdrug/Prednisone-by-Pro-Doc

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Corticosteroids are a class of medications related to cortisone, a naturally occurring hormone.

The corticosteroids most commonly used for dogs include either prednisone or prednisolone although others are also available. Corticosteroids are prescribed for dogs to treat a variety of issues, including allergies, various skin problems, itching, inflammation and immune system irregularities. Although extremely useful for many canine health problems, they are powerful medications and must be used carefully and as prescribed. Plus, if the dog has taken the medications for a period of time, the dosage must be decreased over time to prevent a withdrawal reaction.

Unfortunately, corticosteroids can have side effects. These can range from relatively minor to more serious effects, both physical and behavioral, or a combination of both. In fact, studies and dog owner anecdotes both have shown that as many as 30 percent of dogs show some kind of behavioral change when taking these medications. If your dog is prescribed a short course of these medications (perhaps just a few days), the side effects will likely be minor to none at all. Longer courses of treatment, however, may cause side effects.

Increased Thirst

An increased thirst is one of the most common side effects of corticosteroids for both short courses of treatment as well as longer ones. Unless the veterinarian recommends otherwise, water should always be available for dogs taking these medications as some dogs get very thirsty. You can also add water to your dog’s meals, increasing the amount of water added to the Honest Kitchen’s food if your dog is eating that, to the point of even making the food soupy. If your dog is eating other foods, perhaps canned or kibble foods, add water to those also so you are suppling more of your dog’s increased water needs in his meals.

This thirst doesn’t generally cause many behavior problems except that if he drinks his water bowl dry, and the increased water added to his food doesn’t satisfy him, he’ll go looking for water. Medium to large sized dogs may drink out of the toilet which means any cleaners in the toilet could cause additional problems as some are toxic. Small dogs who cannot reach the toilet may bark for more water or if no one is available to give them more water, they may chew destructively in frustration.

Increased Urination and Housetraining Accidents

If the dog is drinking more water than normal, it’s obvious that the dog will also be urinating more. The most obvious sign of this is the dog needing to go outside during the night, sometimes two or three times. Don’t ask the dog to hold his bladder; if he asks to go outside, let him out.

Dogs left home alone during the day while everyone is gone will also need to go outside more often so arrangements will need to be made so that can happen. If you can’t come home, perhaps a neighbor can help.

Due to an increased need to urinate, housetraining accidents are common. It’s important not to punish the dog; not only is this not good dog training, but he also has less control during this time. After all, his bladder is refilling more quickly than normal. Instead, just make sure he gets outside twice as often as he normally needs. Once the dog is off the steroids, it doesn’t take long before the thirst decreases and urination habits go back to normal.

Nervousness and Agitation

Some dogs taking corticosteroids become restless. They may pace back and forth or have trouble relaxing. Panting is common. The dog may have trouble falling asleep or staying asleep.

Some dogs become agitated and react to different sights or sounds more quickly than they normally do. Some dogs seem to startle at just about anything, even normal household noises. A few dog owners have said this reaction seems as if the dog’s senses have been amplified.

Again, as with housetraining accidents, don’t get angry with the dog for these changes in his behavior. Instead, if his restlessness or lack of sleep seems to be too much for his comfort, talk to your veterinarian.

Increased Appetite

When one of my previous dogs was on a long course of corticosteroids due to a serious health concern, his appetite increased dramatically. He was really hungry. He acted as if he’d never been fed—ever—and he needed to be fed NOW!

Although my dog didn’t get into trouble over his increased appetite, many dog owners report that their dog began raiding trash cans, ate the cat’s food, opened kitchen cupboard doors or stole food off the kitchen counter. It’s important at this time to make sure any food is well protected from your dog’s efforts to satisfy his hunger because in most cases that hunger will override any training. To make him feel better, offer him several small meals during the day rather than one large meal. You can also give him snacks in a food dispensing toy so that his brain is busy as he works for these bits of food.

Some dogs, because they’re so hungry, will begin guarding the food they’re given. It’s important to avoid these episodes as much as possible as you don’t want your dog to feel that he needs to bite to protect his food.

Aggression

Aggression isn’t the most commonly seen behavioral change due to corticosteroid use, but unfortunately, it does happen. In fact, when I talk to dog owners and I’m told their dog has had a sudden onset of aggressive behavior, one of the first questions I ask is whether the dog has been prescribed a corticosteroid drug.

Sometimes the aggression is mild and the dog is easily startled and reacts with a growl or bark but doesn’t do anything else. Other dogs appear to be downright grumpy. In these instances, you may be able to live with this reactive or grumpy behavior for the time your dog needs to take the medication. However, if you feel uneasy about your dog’s behavior, call your veterinarian. Perhaps another drug might work as well without the behavioral side effects.

A few dogs on corticosteroids will develop what is often called steroid psychosis. These dogs appear to be out of touch with reality and are dangerously aggressive. It’s important to not confront these dogs in any way as they are more likely to accept your challenge or attempt to control them with an attack. Because of the drug’s effect on the dog’s brain, it’s as if the dog has lost his natural inhibition about biting people. Instead, if faced with this, be calm, quiet and simply try to keep everyone, dog and people, safe. Then call your veterinarian right away.

When Your Veterinarian Prescribes a Corticosteroid

This listing of side effects is not to cause you to avoid giving these medications. These powerful drugs can do a great deal of good for your dog in certain situations and if your veterinarian prescribes them, give them to your dog exactly as directed. However, knowing the potential problems of these drugs can help you (and your dog) should a problem develop. You can rearrange your dog’s trip outside to relieve himself, make sure he has more water, adjust his mealtimes and understand where his restlessness is coming from. Plus, if you see signs of any aggressive behavior, call your veterinarian right away. Call before any aggressive behavior accelerates.

Written by: Liz Palika, owner of Kindred Spirits Dog Training

Originally published on “The Honest Kitchen’s Blog”.

In fact, for as long as a year afterward, you may need a “stress dose” of steroids to boost your immune response during extreme physical stress, as can result from surgery, an accident or a new serious illness.

Keep all immunizations up to date. Make sure to get a flu shot every year and, if on prolonged steroids, consider getting the pneumonia vaccine as well. Contact your doctor without delay at the first sign of what may be a serious infection, like high fever, productive cough, pain when urinating or large boils on the skin.

To minimize damage to the digestive tract, take the medication after meals or with an antacid. Let your doctor know if you develop persistent heartburn or black, tarry stools. To counter steroid-induced insomnia, take the drug early in the day.

An adequate intake of calcium and vitamin D through dairy products and supplements and regular weight-bearing exercise are vital to reducing the risk of osteoporosis. If you smoke, quit; and limit alcohol to a drink a day, if that. Reduce the risk of falls by using night lights and eliminating obstacles and scatter rugs.

Steroid-induced fluid retention that causes blood pressure to rise abnormally can be minimized by sticking to a low-sodium diet. Avoid salty foods and salted processed foods and snacks. Have regular blood-pressure checks and, if the rise is serious, ask the doctor about taking a diuretic. Periodic checks for a rise in blood sugar are also important. Reduce your risk of heart disease with a low-fat, low-cholesterol diet rich in vegetables and whole grains and regular aerobic exercise.

If you notice any vision problems while taking steroids, see an ophthalmologist without delay. The condition may be temporary, or it could be sight-threatening, as happened to my asthmatic friend.

Rarely, damage to the hip joint called aseptic necrosis can result from long-term use of high doses of steroids. If you develop pain in the groin, a symptom of this condition, call your doctor.

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