Definition

Corticosteroids are a type of anti-inflammatory medicine. Corticosteroid overdose occurs when someone accidentally or intentionally takes more than the normal or recommended amount of this medication.

Corticosteroids come in many forms, including:

Creams and ointments that are applied to the skin
Inhaled forms that are breathed into the nose or lungs
Pills or liquids that are swallowed
Injected formulas delivered to the skin, joints, muscles, or veins

Most corticosteroid overdoses occur with pills and liquids.

This is for information only and not for use in the treatment or management of an actual poison exposure. If you have an exposure, you should call your local emergency number (such as 911) or the National Poison Control Center at 1-800-222-1222.

Poisonous Ingredient

Alclometasone dipropionate
Amcinonide
Augmented betamethasone dipropionate
Beclomethasone dipropionate
Betamethasone
Betamethasone benzoate
Betamethasone dipropionate
Betamethasone sodium phosphate
Betamethasone valerate
Clobetasol propionate
Clocortolone pivalate
Cortisone
Desonide
Desoximetasone
Dexamethasone
Dexamethasone acetate
Dexamethasone sodium phosphate
Diflorasone acetonide
Diflorasone diacetate
Flunisolide
Fluocinolone acetonide
Fluocinonide
Fluocinolone acetonide
Flurandrenolide
Fluticasone propionate
Halcinonide
Halobetasol propionate
Hydrocortisone
Hydrocortisone acetate
Hydrocortisone butyrate
Hydrocortisone sodium phosphate
Hydrocortisone valerate
Methylprednisolone
Methylprednisolone acetate
Methylprednisolone sodium succinate
Mometasone furoate
Prednisolone acetate
Prednisolone sodium phosphate
Prednisolone tebutate
Prednisone
Triamcinolone
Triamcinolone acetonide
Triamcinolone diacetate
Triamcinolone hexacetonide

Note: This list may not be all inclusive.

Where Found

Alclometasone dipropionate (Delonal)
Augmented betamethasone dipropionate (Deprolene)
Beclomethasone dipropionate (Diprosone)
Betamethasone sodium phosphate (Celestone)
Betamethasone valerate (Valisone)
Clobetasol propionate (Temovate)
Clocortolone pivalate (Cloderm)
Desonide (DesOwen, Tridesilon)
Desoximetasone (Topicort)
Dexamethasone (Decadron)
Fluocinonide (Lidex)
Flunisolide (AeroBid)
Fluocinolone acetonide (Synalar)
Flurandrenolide (Cordran)
Fluticasone propionate (Cutivate)
Halcinonide (Halog)
Hydrocortisone (Cortef)
Hydrocortisone sodium phosphate (Solu-Cortef)
Hydrocortisone valerate (Westcort)
Methylprednisolone (Medrol)
Methylprednisolone sodium succinate (Solu-Medrol)
Mometasone furoate (Elocon)
Prednisolone sodium phosphate (Pred Fonte)
Prednisone (Deltasone)
Triamcinolone acetonide (Aristocort)

Note: This list may not be all inclusive.

Symptoms

Symptoms of corticosteroid overdose can include:

Burning or itching skin
Convulsions
Deafness
Depression
Dry skin
High blood pressure
Muscle weakness
Nervousness
Psychosis
Sleepiness
Stopping of menstrual cycle
Swelling in lower legs, ankles, or feet
Weakness
Worsening of health conditions such as ulcers, diabetes

Before Calling Emergency

Determine the following information:

Patient's age, weight, and condition (for example, is the person awake or alert?)
Name of the product (ingredients and strengths, if known)
Time it was swallowed
Amount swallowed

However, DO NOT delay calling for help if this information is not immediately available.

Poison Control, or a local emergency number

The National Poison Control Center (1-800-222-1222) can be called from anywhere in the United States. This national hotline number will let you talk to experts in poisoning. They will give you further instructions.

This is a free and confidential service. All local poison control centers in the United States use this national number. You should call if you have any questions about poisoning or poison prevention. It does NOT need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week.

See: Poison control center - emergency number

What to expect at the emergency room

The health care provider will measure and monitor the patient's vital signs, including temperature, pulse, breathing rate, and blood pressure. Symptoms will be treated as appropriate. The patient may receive:

Activated charcoal
EKG
Fluids through a vein (by IV)
Laxative
Medications to treat fluid and electrolyte changes
Tube through the mouth into the stomach to wash out the stomach (gastric lavage)

Expectations (prognosis)

Most cases of corticosteroid overdose result in relatively minor fluid and electrolyte changes. If the problem is severe enough to cause heart rhythm disturbances, the outlook may be more grave.

References

Nikkanen HE, Shannon MW. Endocrine toxicology. In: Shannon MW, Borron SW, Burns MJ, eds. Haddad and Winchester's Clinical Management of Poisoning and Drug Overdose. 4th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 16.

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