Corticostéroïdes
Revu par Dr Colin Tidy, MRCGPDernière mise à jour par Dr Toni Hazell, MRCGPLast updated 26 mars 2023
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Dans cette série :Injections de stéroïdesCorticostéroïdes orauxStéroïdes topiquesUnités de bout de doigt pour les stéroïdes topiquesSprays nasaux stéroïdiens
Les médicaments stéroïdiens sont utilisés pour de nombreuses conditions médicales différentes. Les stéroïdes peuvent être administrés sous forme de crèmes/pommades (par exemple, pour l'eczéma ou la dermatite), sous forme de spray nasal (par exemple, pour le rhume des foins ou la rhinite allergique), sous forme d'inhalateurs (par exemple, pour l'asthme), sous forme de comprimés (par exemple, pour les maladies inflammatoires de l'intestin) ou sous forme d'injection (par exemple, pour l'arthrite).

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What are steroids?
Steroids are hormones that occur naturally in the body. Steroid medicines are man-made and are similar to the natural hormones made in the body. The type of steroids used to treat disease are called corticosteroids. They are different to the anabolic steroids which some athletes and bodybuilders use. Anabolic steroids have very different effects.
Types of steroids
Retour au sommaireSteroids come in many different forms. The main types of steroids are:
Corticostéroïdes oraux
Oral steroids reduce inflammation and are used for treating many different conditions, including:
Arthritis.
As part of the treatment for various cancers.
See also the separate leaflet called Oral Steroids.
Stéroïdes topiques
Topical steroids are used on the skin. See also the separate leaflet called Topical Steroids (excluding Inhaled Steroids).
Topical steroids used for the skin are available as creams, ointments or lotions. Topical steroids are used for various skin conditions. The amount of topical steroid that you should apply is commonly measured by fingertip units. For more information see the separate leaflets called Topical Steroids for Eczema et Fingertip Units for Topical Steroids.
Steroids can also be given as:
Eye drops to reduce inflammation on the surface of the eye such as caused by uvéite. These should only ever be started by a specialist eye doctor (ophthalmologist) who will usually have used a machine called a slit lamp to look into the back of your eye first.
Rectal foam or suppositories to treat ulcerative colitis (proctitis) or for maladie de Crohn affecting the rectum.
Sprays nasaux stéroïdiens
Steroid nasal sprays are medicines that are commonly used to treat symptoms of stuffiness or congestion in the nose. They are used most often for allergies of the nose, such as hay fever. They can be bought over the counter at a pharmacy - in general, treatment of rhume des foins should usually be bought over the counter rather than asking your GP for a prescription. See also the separate leaflet called Steroid Nasal Sprays.
Steroid inhalers
Steroid inhalers are steroids that are breathed in and down into your lungs. Inhaled steroids are mainly used to treat asthma and chronic obstructive pulmonary disease (COPD). For more information see the separate leaflets called Inhalers for Asthma (including Inhaled Steroids) et Inhalers for COPD (including Inhaled Steroids).
Injections de stéroïdes
Steroid injections can be used for joint problems and rheumatoid arthritis. They can also be used for some conditions affecting soft tissues, like tendon inflammation or tennis elbow. They can sometimes be given at the GP practice, if there is a doctor, nurse or physio there who has had special training to do this. In more complicated situations they may be given in a hospital, using ultrasound guidance. For more information see the separate leaflet called Steroid Injections.
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How do steroids work?
Retour au sommaireSteroids are a man-made version of hormones normally produced by the adrenal glands, which are just above each kidney. When taken in doses higher than the amount your body normally produces, steroids:
Reduce inflammation
Inflammation occurs when the body's immune system responds to injury or infection. When this affects the skin and tissues under the skin then the area can become painful, hot, red and swollen. Inflammation usually helps to protect you but sometimes inflammation can cause harm to your body. Steroids can help to treat inflammatory conditions such as asthme et eczéma - they are a type of anti-inflammatory drug.
Reduce the activity of the immune system
The immune system is the body's natural defence against illness and infection. This can help treat autoimmune conditions, such as polyarthrite rhumatoïde, hépatite auto-immune ou lupus érythémateux systémique (LES), which are caused by the immune system mistakenly attacking the body.
Side-effects of steroids
Retour au sommaireSteroids don't tend to cause significant side-effects if they're taken for a short period of time or at a low dose. Side-effects are much more common with oral steroids or if you take them for a long time.Side-effects can include:
Increased appetite, which may cause weight gain.
Difficulty sleeping (insomnie).
Increased risk of infections, especially viral infections such as zona ou rougeole.
Syndrome de Cushing due to excessive steroid in the body, which can lead to various effects on the body, including thinning of the skin, easy bruising and stretch marks.
Eye conditions, such as le glaucome et les cataractes.
Mental health problems, including:
Changes in mood (mood swings) and behaviour - eg, feeling irritable or anxious.
A short course of steroids can be taken and then stopped, but if using them for a long time, they must be slowly tapered off rather than stopping suddenly. Speak to your doctor if you are unclear about whether you need to taper your steroids - generally speaking if you have been taking them for more than a week or two, this might be necessary.
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Traitement et médicaments
Médicaments et traitements pour la démence
Les objectifs du traitement pour les personnes atteintes de démence sont de ralentir l'aggravation des symptômes, de maintenir les fonctions et ainsi de promouvoir l'indépendance. Les médicaments pour la démence sont utilisés pour aider avec les symptômes qui affectent la pensée et la mémoire, ainsi que les symptômes qui affectent l'humeur et le comportement. Mais il existe également de nombreux traitements non médicamenteux qui peuvent aider à soutenir une personne atteinte de démence.
par Dr Toni Hazell, MRCGP

Traitement et médicaments
Médicaments à garder à la maison
Minor illness and mild aches or pains are common. It is useful to keep a few medicines at home in case you need something when you can't get to a pharmacy, or they are closed. Always read the labels carefully and follow the instructions, and store the medicines out of the reach of children. Your pharmacist is a good person to give you more information about over-the-counter medicines which do not need a prescription from your doctor. See your doctor if your symptoms get worse or do not go away.
by Dr Hayley Willacy, FRCGP

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Vérifiez les interactions possibles entre les médicaments, les compléments et les aliments avant de les prendre ensemble.
Lectures complémentaires et références
- Formulaire National Britannique (BNF); Services de Preuves NICE (accès réservé au Royaume-Uni)
- Corticostéroïdes - inhalés; NICE CKS, mai 2020 (accès réservé au Royaume-Uni)
- Corticosteroids - oral; NICE CKS, janvier 2024 (accès réservé au Royaume-Uni)
- Guide clinique pour la prévention et le traitement de l'ostéoporose; Groupe de Lignes Directrices sur l'Ostéoporose (mis à jour en septembre 2021)
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Historique de l'article
Les informations sur cette page sont rédigées et examinées par des cliniciens qualifiés.
Prochaine révision prévue : 24 mars 2028
26 mars 2023 | Dernière version
7 Mar 2018 | Publié à l'origine
Écrit par :
Dr Colin Tidy, MRCGP

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