In Sri Lanka, the most commonly used steroids are prednisolone, methylprednisolone, dexamethasone, and deflazacort.
Steroids are used in all autoimmune diseases, such as rheumatoid arthritis, Psoriatic arthritis , SLE, and connective tissue disorders.
All arthritis medicines such as methotrexate, leflunomide, sulfasalazine, and biologics take 2–3 months or more to work.
During this period, the joints are at high risk of permanent damage. Steroids act quickly, and according to international guidelines, they are essential in controlling the disease until the other medicines take effect.
In autoimmune diseases, the immune system wrongly attacks the body’s own joints, skin, and organs.
Steroids act by reducing inflammation rapidly, preventing joint destruction and protecting the body until slower medicines start working.
Steroids are not ‘evil.’ In the right dose, right duration, and for the correct disease indication, they are safe and highly effective.
Oral tablets – most common method.
Intra-articular injections – directly into inflamed joints (usually no more than 3 times per year per joint, as decided by your doctor).
Intravenous (IV) pulses – given in hospital for very severe cases.
Epidural injections – sometimes used in severe back or neck pain with nerve pain spreading to the arms or legs.
Always take steroids exactly as prescribed by your doctor.
Never stop suddenly—this can be harmful. Your doctor will reduce the dose gradually when it is safe to stop.
Take steroids with a proton pump inhibitor (PPI) to protect your stomach and prevent ulcers.
They are safe for the liver and kidneys and do not cause liver or kidney damage.
Blood sugar can rise while on steroids. This can usually be controlled with a proper diet. If you are diabetic, your medication may need adjustment.
Appetite may increase, so maintaining a healthy diet and weight control is very important.
Bone protection: Long-term use may weaken bones. Your doctor may recommend calcium, vitamin D, and sometimes bisphosphonates to protect bone strength.
There is a rare risk of infection. If you develop fever, rashes, or unusual symptoms, contact your doctor immediately.
This information has been prepared with reference to the Australian Rheumatology Association (ARA) Patient Information Leaflet on Prednisolone and international guidelines.
