Side Effects of Oral and Injected Steroids

Get to Know the Short- and Long-term Effects of Systemic Steroids

Long term steroid use can cause severe side effects. Retales Botijero/Moment/Getty Images

Oral and injected corticosteroids (or simply “steroids”) are medications used to treat inflammation in the body. When taken in oral or injected forms, the route of administration is termed “systemic.” These medicines are used to treat a wide variety of diseases, such as systemic lupus erythematosus, rheumatoid arthritis and many other autoimmune diseases. Systemic steroids are also used to treat asthma attacks, and on occasion, severe allergic rhinitis symptoms.

Examples include prednisone, methylprednisolone (Medrol dose pack), and injectable triamcinolone (Kenalog).

When people think about the side effects of steroids, they usually mean the side effects of systemic steroids. While systemic steroids are often necessary and life-saving medicines needed to treat inflammation, they don’t come without side effects. Most side effects occur from short-term use. Long-term use can lead to additional side effects.

Short-Term Side Effects of Systemic Steroids

Most people receive systemic steroids for only a few days at a time and experience only temporary side effects. These may include an increase in appetite, difficulty sleeping (insomnia), changes in mood and behavior, flushing (redness) of the face, and short-term weight gain due to increased water retention. These side effects usually resolve after a few days once the steroids have been stopped.

People with underlying medical conditions might also notice other side effects.

Those with diabetes mellitus may see an increase in their blood sugar readings; those with high blood pressure may see their blood pressure readings rise. People with glaucoma could have an increase of the pressures within their eyes; people with congestive heart failure may retain water and have worsening of this condition.

For this reason, a person with any chronic underlying disease should be closely followed by their physician while taking systemic steroids.

Long-Term Side Effects of Systemic Steroids

When systemic steroids are used for long periods of time, or when steroids are taken on multiple occasions, more serious side effects may occur. It is for these reasons that the dose and duration of systemic steroids should be minimized whenever possible. Some side effects can be decreased by taking systemic steroids every other day instead of daily, even if the total dose is the same. Many of the side effects are reversible if the steroids are stopped while other side effects may be permanent.

Side effects of long-term steroid use include:

People taking long-term systemic steroids should be closely monitored for the above diseases and should take medicines to prevent osteoporosis. These medicines may include supplemental calcium and vitamin D, along with medicines to prevent bone loss called bisphosphonates. Examples of bisphosphonates include alendronate (Fosamax), risedronate (Actonel), and ibandronate (Boniva).

Frequent measuring of bone-mineral density should also be performed in people taking long-term systemic steroids.

Learn about the side effects of inhaled steroids and nasal steroids.


Saag KG, Furst DE: Up To Date 2012. Major side effects of systemic glucocorticoids, 2013.

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