Medicines containing steroids should be used based on dose and duration and under a doctor’s supervision.
STEROIDS are compounds, which are naturally produced by the human body and play an important role in many physiological processes.
Steroids can also refer to man-made substances (synthetic substances) that are used in the treatment of certain diseases.
In Malaysia, steroids are classified as controlled substances and medicines containing steroids can only be prescribed by a doctor, while certain creams and ointments with low-dose steroids may be obtained through pharmacists.
STEROID USE IN MEDICINE
There are two types of steroids used in medicine, namely anabolic steroids and corticosteroids.
Anabolic steroids are synthetic substances that act the same way as the male sex hormone testosterone.
Anabolic steroids are often used to treat hormonal problems among males and can also be used to build lean muscle in patients who have muscle-wasting diseases such as AIDS (Autoimmune Deficiency Syndrome).
Medicines containing anabolic steroids can only be prescribed by a doctor and obtained from hospitals, clinics and community pharmacies.
Corticosteroids, on the other hand, act as anti-inflammatory medicines and are usually prescribed for patients with asthma, eczema and arthritis.
Corticosteroids also suppress the body’s immune system and are, therefore, widely used in the treatment of auto-immune diseases as well as to prevent organ rejection in patients who receive organ transplants.
Some examples of commonly used corticosteroids are prednisolone, hydrocortisone, betamethasone and dexamethasone.
Medicines containing corticosteroids come in various forms such as creams, ointments, inhalers, eye/ear/nose drops, tablets and injections.
DOSAGE
The dose and duration of treatment with corticosteroids will differ for each individual depending on the disease condition and their health status. A patient must always take steroids according to the dose and duration as prescribed by the doctor.
If steroids are taken for a prolonged period of time, the dose may be reduced over time in order to avoid side effects which may occur due to sudden discontinuation in treatment.
Patients are advised to consult their doctors or pharmacists if they encounter any problems while taking steroids so that the doctor can modify the dose to fit the patient’s needs.
ARE CORTICOSTEROIDS DANGEROUS?
As with any other medicine, there are risks associated with prolonged use of corticosteroids, but the benefits outweigh the risks.
Individuals on steroid medications will have regular follow-ups with the prescribing doctor who will continuously assess and monitor them for development of any side effects and act on this should there be any.
Oral steroids should be taken after food in order to reduce gastric irritation. Short-term side effects commonly experienced include weight gain and fluid retention.
Facial swelling (oedema) commonly known as “moon face” can also occur as a result of prolonged use of oral corticosteroids.
Topical corticosteroids in the form of creams and ointments can cause skin thinning with prolonged use and thus increase the risk of sustaining injuries such as bruises and cuts.
Individuals who use topical steroids are advised to use it sparingly and only for a short period of time unless directed by a doctor.
Using corticosteroids over a long period of time can cause bones to become brittle and may also disrupt growth in young children.
As long- term use of corticosteroid increases the risk of developing eye problems such as cataracts, it is advisable to go for eye check-ups regularly in order to maintain good eye health
STEROID ABUSE
Steroid abuse and misuse has been associated with a myriad of diseases such as high blood pressure, heart disease, kidney damage and liver damage among others.
Taking steroids without a doctor or pharmacist’s supervision is dangerous.
There are athletes who misuse steroids, especially anabolic steroids, for the purpose of gaining strength and a competitive edge in sports, which is known in the sports industry as “doping”.
Once an athlete is caught doping, he/she will be removed from the sport or will face a lengthy ban from the sport as doping is considered cheating.
The community is also advised not to use unregistered health products that promise fast cures, miraculous outcomes and are supported with unrealistic testimonies.
Often, these products have been adulterated with large amounts of steroids. Use of such products pose a great health risk.
Always choose health products that are registered with the Ministry of Health as their quality, efficacy and safety have been evaluated.
If there are any inquiries regarding medicines, please call the National Pharmacy Call Centre (NPCC) at the toll-free line 1800-88-6722 during weekdays from 8am to 5pm.
Article prepared by Heygaajivan Kernas, pharmacist, Ministry of Health Malaysia.
