Side Effects of High Dose Steroids and Minimization Strategies

Common Side Effects of High Dose Steroids

Hyperglycemia and worsening of diabetes can occur in patients on high-dose steroid therapy, particularly with prednisone, according to the American Academy of Otolaryngology-Head and Neck Surgery 1, 2
Osteoporosis and increased fracture risk are potential side effects of long-term high-dose steroid use, as reported by the American Academy of Otolaryngology-Head and Neck Surgery and Arthritis Care & Research 1, 2, 3
Cataracts and glaucoma can develop in patients on prolonged high-dose steroid therapy, as noted by the American Academy of Otolaryngology-Head and Neck Surgery 1, 2
Striae (stretch marks) can occur in patients on high-dose steroid therapy, according to the British Journal of Dermatology 4
Insomnia, mood swings, and nervousness/restlessness are potential neuropsychiatric effects of high-dose steroid therapy, as reported by the American Academy of Otolaryngology-Head and Neck Surgery 1, 2

To prevent osteoporosis, calcium and vitamin D supplementation, as well as bone mineral density monitoring with DEXA scans, are recommended by Arthritis Care & Research 3
For patients on high-dose steroid therapy, particularly those with diabetes, regular monitoring of blood glucose is crucial, as recommended by Gut 6
Blood pressure monitoring is also essential for patients on high-dose steroid therapy, as noted by Gut 6
In pregnant patients, high-dose steroid therapy should be used only if benefits outweigh risks, and monitoring for premature delivery is necessary, as reported by Hepatology 7
For surgical patients on long-term steroids, stress-dose steroids may be needed, according to Gut 6

Regular clinical assessment for side effects, including blood pressure and blood glucose monitoring, is recommended by the American Academy of Otolaryngology-Head and Neck Surgery 1
Bone mineral density assessment is necessary for patients on long-term high-dose steroid therapy, as reported by Arthritis Care & Research 3
Ophthalmologic evaluation for cataracts and glaucoma is recommended for patients on prolonged high-dose steroid therapy, according to the American Academy of Otolaryngology-Head and Neck Surgery 1