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Glucocorticoids

Written on Aug 15, 2018 by C. Fookes, BPharm

What are Glucocorticoids?

Glucocorticoids are a type of corticosteroid hormone that is very effective at reducing inflammation and suppressing the immune system. Inflammation is the way our immune system responds to harmful substances and trauma and is part of our healing process. However, if the usual control mechanisms that turn the process of inflammation off aren’t functioning properly and it continues unabated, our tissues can become damaged. Continued inflammation is associated with many chronic conditions including diabetes, obesity, cancer, depression and heart disease.

Glucocorticoids are secreted naturally by our adrenal gland in response to stress and have numerous effects on our bodies that are essential for life. Glucocorticoid drugs are synthetic versions of these hormones.

What are glucocorticoids used for?

Glucocorticoids are used to treat conditions that have inflammation as a symptom, such as:

What are the differences between glucocorticoids?

Glucocorticoids all have a similar structure and clinical effect. Their main differences lie in their potency (dose), the time they last for in the body, and their propensity for fluid retention.

Prednisone 5mg is considered equivalent to methylprednisolone 4mg, triamcinolone 4mg, dexamethasone 0.75mg, and betamethasone 0.75mg. High doses of prednisone are more likely to cause salt and water retention and increased potassium excretion than high doses of triamcinolone, dexamethasone, or betamethasone.

Standard formulations of prednisone, methylprednisolone, and triamcinolone last for around 12 to 36 hours in the body whereas dexamethasone and betamethasone last for 32 to 72 hours.

Some glucocorticoids are formulated in a way that extends their duration of action (for example, depot preparations of methylprednisolone provide anti-inflammatory effects for one to four weeks). 

Prednisone is one of the most commonly used glucocorticoids, because of its low cost. It is converted into prednisolone by the liver and is only available orally.

Generic name Brand name examples
betamethasone Celestone Soluspan
budesonide Entocort EC, Uceris
dexamethasone DexPak 10 day
hydrocortisone rectal Anucort HC
methylprednisolone Medrol Dose-Pack
prednisone Sterapred
prednisolone Millipred
triamcinolone Kenalog-40

Are glucocorticoids considered safe?

When given at recommended dosages for short durations of time, glucocorticoids are considered safe. One-off doses of glucocorticoids, even if they are large, or short-course therapies of less than one-week have few harmful effects. However, more regular or extended dosing has been associated with a number of severe side effects.

If glucocorticoids are given on a daily basis (at a dose equivalent to prednisone 15mg/day for more than three weeks), the adrenal glands stop producing glucocorticoids and tissue in the adrenal cortex begins to atrophy (die off). This is of concern if the glucocorticoid is suddenly stopped because the adrenal tissues will not immediately begin producing glucocorticoids again. This is called acute adrenal insufficiency and symptoms include irritability, nausea, joint pains, dizziness and low blood pressure. To avoid this happening, steroid medication should be withdrawn slowly, over several weeks or months, to allow the adrenal cortex to resume its full functioning capacity again.

For people who are taking glucocorticoids long-term, extra doses of glucocorticoids should be given during times of acute stress, such as severe infection or surgery, to mimic the cortisol surge that is normally produced by the body during particularly stressful events, otherwise healing may be delayed or incomplete.

Evening dosages of glucocorticoids should be discouraged as they can cause insomnia. Instead, glucocorticoids are normally taken just once a day, or if taken twice a day, they should be dosed in the morning and again at noon.

Because glucocorticoids suppress the immune system, they increase the risk of infection. Certain viral infections, such as chickenpox or measles may have a more severe course in people taking glucocorticoids.

Long-term use of glucocorticoids can also cause Cushing’s syndrome. Symptoms include a fatty hump between the shoulders, a round face, weight gain, irregular menstrual cycles, fatigue, and depression.

For a complete list of severe side effects, please refer to the individual drug monographs.

What are the side effects of glucocorticoids?

Glucocorticoids have been associated with a number of side effects including:

For a complete list of side effects, please refer to the individual drug monographs.

List of Glucocorticoids:

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Drug Name Reviews Avg. Ratings
Cortifoam
generic name: hydrocortisone
0 reviews
   
10
Dexpak Taperpak (Pro)
generic name: dexamethasone
2 reviews
   
10
Millipred (Pro)
generic name: prednisolone
0 reviews
   
10
Millipred DP
generic name: prednisolone
0 reviews
   
10
Sterapred DS
generic name: prednisone
2 reviews
   
10
Aristocort (Pro)
generic name: triamcinolone
3 reviews
   
9.7
Aristospan (Pro)
generic name: triamcinolone
1 review
   
9.5
Rayos (Pro)
generic name: prednisone
2 reviews
   
9.5
Cortef (Pro)
generic name: hydrocortisone
3 reviews
   
9.3
Orapred (Pro)
generic name: prednisolone
2 reviews
   
9.0
Sterapred (Pro)
generic name: prednisone
1 review
   
9.0
MethylPREDNISolone Dose Pack
generic name: methylprednisolone
26 reviews
   
8.8
Medrol Dosepak
generic name: methylprednisolone
18 reviews
   
8.4
Solu-Medrol (Pro)
generic name: methylprednisolone
12 reviews
   
8.3
Celestone (Pro)
generic name: betamethasone
1 review
   
8.0
Hydrocortone
generic name: hydrocortisone
2 reviews
   
8.0
Entocort EC (Pro)
generic name: budesonide
22 reviews
   
7.9
Kenalog-10 (Pro)
generic name: triamcinolone
14 reviews
   
7.9
Kenalog-40 (Pro)
generic name: triamcinolone
25 reviews
   
7.7
Zilretta (Pro)
generic name: triamcinolone
3 reviews
   
7.7
Depo-Medrol (Pro)
generic name: methylprednisolone
13 reviews
   
7.1
Medrol (Pro)
generic name: methylprednisolone
9 reviews
   
6.8
Dexamethasone Intensol
generic name: dexamethasone
3 reviews
   
6.3
Deltasone (Pro)
generic name: prednisone
8 reviews
   
6.2
Decadron (Pro)
generic name: dexamethasone
14 reviews
   
5.8
Uceris (Pro)
generic name: budesonide
17 reviews
   
5.6
Dexasone
generic name: dexamethasone
1 review
   
5.5
Azmacort (Pro)
generic name: triamcinolone
1 review
   
5.3
Prednicot
generic name: prednisone
1 review
   
4.7
Cortenema (Pro)
generic name: hydrocortisone
1 review
   
4.0
A-Hydrocort (Pro)
generic name: hydrocortisone
0 reviewsAdd rating
A-Methapred (Pro)
generic name: methylprednisolone
0 reviewsAdd rating
Aristocort For Injection
generic name: triamcinolone
0 reviewsAdd rating
Baycadron (Pro)
generic name: dexamethasone
0 reviewsAdd rating
Bubbli-Pred
generic name: prednisolone
0 reviewsAdd rating
Celestone Soluspan (Pro)
generic name: betamethasone
0 reviewsAdd rating
Clinacort
generic name: triamcinolone
0 reviewsAdd rating
Colocort (Pro)
generic name: hydrocortisone
0 reviewsAdd rating
Cortone Acetate
generic name: cortisone
0 reviewsAdd rating
Cotolone
generic name: prednisolone
0 reviewsAdd rating
De-Sone LA
generic name: dexamethasone
0 reviewsAdd rating
Dexacen-4
generic name: dexamethasone
0 reviewsAdd rating
Dexasone LA
generic name: dexamethasone
0 reviewsAdd rating
Emflaza (Pro)
generic name: deflazacort
0 reviewsAdd rating
Flo-Pred (Pro)
generic name: prednisolone
0 reviewsAdd rating
LoCort
generic name: dexamethasone
0 reviewsAdd rating
Methylpred DP
generic name: methylprednisolone
0 reviewsAdd rating
Orapred ODT (Pro)
generic name: prednisolone
0 reviewsAdd rating
PediaPred (Pro)
generic name: prednisolone
0 reviewsAdd rating
Prelone
generic name: prednisolone
0 reviewsAdd rating
Solu-Cortef (Pro)
generic name: hydrocortisone
0 reviewsAdd rating
Solurex
generic name: dexamethasone
0 reviewsAdd rating
Solurex LA
generic name: dexamethasone
0 reviewsAdd rating
Triam-Forte
generic name: triamcinolone
0 reviewsAdd rating
Triamcot
generic name: triamcinolone
0 reviewsAdd rating
Veripred 20 (Pro)
generic name: prednisolone
0 reviewsAdd rating
Zema Pak (Pro)
generic name: dexamethasone
0 reviewsAdd rating
ZoDex (Pro)
generic name: dexamethasone
0 reviewsAdd rating
Zonacort
generic name: dexamethasone
0 reviewsAdd rating

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

See Also

Medical conditions associated with glucocorticoids:

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