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Contents
  • Why Withdraw Glucocorticoids?
  • The Risk of HPA Suppression
  • Tapering Approaches

What Happens When You Stop Taking Glucocorticoids?

What Happens When You Stop Taking Glucocorticoids?

What's This About?

Glucocorticoids are powerful drugs used to treat various inflammatory conditions, but stopping them can be tricky. This article explores what you need to know about withdrawing from glucocorticoids safely.
Contents
  • Why Withdraw Glucocorticoids?
  • The Risk of HPA Suppression
  • Tapering Approaches

Why Withdraw Glucocorticoids?

Glucocorticoids are often withdrawn when maximum benefits are achieved, or when side effects like osteoporosis become too serious. In some cases, immediate cessation is necessary, such as in steroid-induced acute psychosis or herpesvirus-induced corneal ulceration. In these scenarios, using the lowest possible dose until safe withdrawal is crucial.

The Risk of HPA Suppression

Long-term use of glucocorticoids can suppress the hypothalamic-pituitary-adrenal (HPA) axis, making sudden withdrawal risky. Symptoms of adrenal insufficiency may appear if glucocorticoids are stopped too quickly. Patients with suspected HPA suppression should taper gradually and carry emergency medical information.
The process and risks associated with stopping glucocorticoids, including potential HPA axis suppression and adrenal insufficiency.

Tapering Approaches

Tapering glucocorticoids involves reducing doses gradually to prevent disease flare-ups and cortisol deficiency symptoms. A generally safe approach is to decrease the dose by 5-10% every one to four weeks, adjusting based on patient response. In some cases, an alternate-day regimen is used, but this might not suit everyone, especially those with rheumatoid arthritis.

FAQs

Why is glucocorticoid withdrawal necessary?

Withdrawal is needed to prevent side effects and manage conditions effectively.

What is HPA suppression?

HPA suppression occurs when glucocorticoids suppress adrenal gland function.

How can withdrawal symptoms be managed?

Symptoms can be managed by gradually tapering the medication dose.

What is an alternate-day regimen?

It's a method of taking glucocorticoids every other day to reduce side effects.

How fast should glucocorticoids be tapered?

The dose is usually reduced by 5-10% every one to four weeks.

The Bottom Line

Glucocorticoid withdrawal must be managed carefully to avoid complications.
Talk to Doctronic about the best way to taper off glucocorticoids safely.
Additional References
  1. Kirwan JR. Systemic corticosteroids in rheumatology. In: Rheumatology, Hochberg MC, Silman AJ, Smolen JS (Eds), Mosby, St. Louis 2003. p.385.
  2. Joseph RM, Hunter AL, Ray DW, Dixon WG. Systemic glucocorticoid therapy and adrenal insufficiency in adults: A systematic review. Semin Arthritis Rheum 2016; 46:133.
  3. Ueda N, Chihara M, Kawaguchi S, et al. Intermittent versus long-term tapering prednisolone for initial therapy in children with idiopathic nephrotic syndrome. J Pediatr 1988; 112:122.
This article has been reviewed for accuracy by one of the licensed medical doctors working for Doctronic.