If your asthma symptoms become severe, your doctor or asthma nurse may give you a short course (3-14 days) of steroid tablets. Steroid tablets work quickly and powerfully to help to calm your inflamed airways. Short courses of steroid tablets are also used to treat acute asthma attacks and are used for essential emergency treatment of asthma attacks.

If you finish a short course of steroids but are not back to normal, you should visit your doctor. You may need to continue the course for more days to get your asthma
back under control.

A small number of people with severe asthma find that their preventer medicine and short courses of steroid tablets are not enough to control their asthma. They need to take steroid tablets for a longer period.

Why do I need to keep taking preventer medicine when I am taking steroid tablets?

The main reason why you should continue taking preventer medicines is because that means your steroid tablet dose can be as low as possible.
Stopping regular steroid tablets: A warning

When you are taking regular tablet steroids your adrenal gland becomes lazy, and makes less of its own natural steroids. This means you have less ability to cope with infections or deal with physical stress.

Long courses of steroid tablets (three weeks or more) can be stopped only by gradual reduction and under the guidance of your doctor or asthma nurse. If they are stopped suddenly you will be very vulnerable to infection and less able to cope with any crisis such as an operation. For this reason the doses should be reduced slowly over weeks or months.

Side effects of steroid tablets

Short term use

For a small number of people, a short-term course of steroid tablets, can lower the body's resistance to chickenpox, so you should contact your doctor if you or your child are taking steroid tablets and you/they come into contact with chickenpox. If your doctor thinks you are at risk they can give you an injection to protect you.

Other possible side effects from taking a short course of steroid tablets are mood swings (especially in children) and increased hunger.

There are very few other side effects from taking occasional (three to four) short courses of steroids per year. However it is important to keep the number of courses to a minimum by making sure you are using enough of your other regular inhaled medicines.

Long term use

A small minority of people with severe asthma need to take steroid tablets for a longer period. However, taking steroid tablets regularly, for long periods of time (months or years) can have serious side effects for some people.

For these reasons your doctor and asthma nurse will always try to prescribe the smallest possible dose of daily steroid tablets. It is very important that you continue to take your other asthma treatments regularly to keep the need for steroid tablets to a minimum.

If you have severe asthma and you have been prescribed long-term steroid tablets your doctor and asthma nurse should discuss and consult with you about the risk of side effects against the benefits of controlling your asthma symptoms (if untreated, severe asthma can lead to permanent lung damage).

The possible side effects of long-term use of steroid tablets are:

• Fattened face (moon face)
• Feeling hungry and wanting to eat more (this extra eating can lead to weight gain)
• Feeling 'hyped up' and over active with difficulty sleeping
• Feeling depressed or having sudden mood swings
• Heartburn and indigestion
• Bruising easily
• Brittle bones (osteoporosis)
• Altering diabetic control or uncovering a tendency to diabetes
• Chickenpox may be more serious
• Risk of cataract increases