Corticosteroids

Reviewed by: HU Medical Review Board | Last reviewed: May 2023

Corticosteroids are a type of medicine commonly used as part of a treatment plan for chronic obstructive pulmonary disease (COPD). Corticosteroids are also called steroids or glucocorticosteroids.1,2

Steroids are similar to hormones produced naturally in the adrenal glands, which sit on top of the kidneys. Corticosteroids are not the same as anabolic steroids, which are substances sometimes used by bodybuilders that can have dangerous side effects.1,2

How do steroids work for COPD?

People with COPD have airways that are irritated and swollen, which can make it hard to breathe. Steroids reduce inflammation, so they can help to reduce the amount of swelling in the airways and make breathing easier.2

Not everyone with COPD needs treatment with steroids because other types of medicines can control their symptoms. But some people need steroids as well as other medicines, especially if their symptoms are more severe. These people may need to use steroids as part of long-term maintenance therapy for COPD. This means that they take them on a daily basis to manage their everyday symptoms.1,2

Acute exacerbations, or flare-ups, happen when COPD symptoms suddenly get worse. People who have a moderate or severe COPD flare-up may need steroid treatment to help bring the attack under control and keep it from getting worse.1,2

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Examples

Steroids for COPD may be taken by inhalation or by mouth in pill, tablet, or liquid form.1,2

Inhaled steroids for COPD

Steroids for treating COPD are usually inhaled, if possible. This allows most of the medicine to go directly into the lungs, where it is most needed. It also avoids some serious side effects that can happen from taking steroids by mouth.1,2

Inhaled steroids can be taken by breathing the medicine in through an inhaler or nebulizer. Examples of inhaled steroids include:

  • Qvar® (beclomethasone dipropionate HFA)
  • Beclovent® (beclomethasone dipropionate)
  • Pulmicort® (budesonide)
  • AeroBid® (flunisolide)
  • Flovent® (fluticasone propionate)
  • Azmacort® (triamcinolone acetonide)

For people with a more advanced stage of COPD, inhaled steroids can help:1,2

  • Manage COPD symptoms
  • Improve lung function
  • Improve quality of life
  • Reduce the number of COPD flare-ups

However, treatment with steroids will not keep the disease from getting worse over time.

Oral steroids for COPD

It can take days or weeks of treatment for inhaled steroids to start working at full strength in a person's body. Some people need treatment that takes effect more quickly than that. For this reason, some people need to take steroids by mouth, in pill, tablet, or liquid form.1,2

Oral steroids also come in higher doses. This is sometimes needed for people whose lungs need a larger amount of steroid treatment right away.1,2

Oral steroids used to treat people with COPD include:1,2

  • Prelone® (prednisolone)
  • Deltasone® (prednisone)
  • Medrol® (methylprednisolone)

Bronchodilator-corticosteroid combination medicines

Bronchodilators are medicines commonly used to treat COPD symptoms. Because of the swelling in the airways, the band of muscles surrounding the airways can tighten up. This causes the airway to become too narrow for enough air to pass through to the lungs. Bronchodilators work by relaxing the band of muscles and widening the airways.1,2

Bronchodilator-corticosteroid combination medicines contain a long-lasting bronchodilator plus a steroid in each inhaled dose. For some people in the later stages of the disease, this can be an easy and effective way to manage COPD symptoms.1,2

Examples of these combination therapies include:1,2

  • Advair® Diskus (salmeterol + fluticasone propionate)
  • Breo Ellipta® (vilanterol + fluticasone furoate)
  • Dulera® (mometasone furoate + formoterol fumarate)
  • Symbicort® (budesonide + formoterol fumarate)

What are the possible side effects?

Side effects of steroids usually depend on:2

  • The dose you are taking
  • The length of time you are taking them
  • Whether you are taking steroids through an inhaler or orally in a pill, tablet, or liquid

Common side effects of inhaled steroids are:2

  • Sore mouth
  • Hoarse voice
  • Throat and mouth infections
  • Slightly higher risk of getting pneumonia

Most of these side effects can be reduced or even prevented by rinsing your mouth after each use of the inhaler.2

Side effects from oral steroids are more common and can be more serious. The side effects linked to oral steroids occur more frequently when the steroids are taken in high doses or in smaller doses over a longer period of time. These side effects can include:2

  • Insomnia
  • Stomach irritation
  • Skin bruising
  • Weight gain
  • Osteoporosis
  • High blood sugar/diabetes
  • Cataracts
  • Swelling of the ankles or feet
  • Muscle weakness

These are not all the possible side effects of steroids. Talk to your doctor about what to expect when taking steroids. You also should call your doctor if you have any changes that concern you when taking steroids.

Other things to know

Before beginning treatment for COPD, tell your doctor about all your health conditions and any other drugs, vitamins, or supplements you take. This includes over-the-counter drugs