Section Under Review

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General Notes

For use of corticosteroids in the treatment of asthma, see Chapter 3 - Corticosteroids.

For use of corticosteroids in the treatment of musculoskeletal and joint disorders see Chapter 10 – Drugs used in rheumatic diseases and gout and Drugs used in neuromuscular disorders.

For use of corticosteroids in dermatology, see Chapter 13 – Topical corticosteroids.

Patients receiving more than 2.5mg of prednisolone (or equivalent; see BNF link below) for longer than 3 months may require osteoporosis prophylaxis. See Chapter 6 – Drugs affecting bone metabolism.

Care should be taken in reducing pharmacological doses of glucocorticoids if the patient has been treated for longer than 3 weeks to avoid cortisol insufficiency due to prolonged suppression of the hypothalamic–pituitary–adrenal (HPA) axis.

Please refer to the BNF for further information on glucocorticoid therapy.

Replacement Therapy

Glucocorticoid Therapy

NHSL Joint Adult Formulary Key

To indicate the category of a formulary medicine, updated sections adopt the following key:

Preferred list (P): First-line formulary choices.

Total list (T): Alternative choices when preferred list options not effective/not tolerated, or not indicated.

Specialist initiation (S1): Specialist initiation, or on the advice of a Consultant or Specialist Practitioner in this therapeutic area. Continuation in primary care is acceptable.

Specialist use only (S2): Supply via hospital, Homecare Service or a hospital based prescription (HBP) for dispensing by community pharmacy. Not prescribed in primary care setting.

Editorial Information

Last reviewed: 31/01/2022

Next review date: 31/01/2025

Author(s): NHSL.

Version: Please refer to the introduction section for an explanation of the review dates above.

Approved By: ADTC

Reviewer name(s): ADTC.