Several glucocorticoids are approved by the U.S. Food and Drug Administration to help in the resolution of acute relapses of multiple sclerosis. Glucocorticoids have powerful anti-inflammatory and immunosuppressive properties that can help ease relapse symptoms, but they do not seem to have an impact on overall disease progression. Those most commonly used in MS are prednisone, methylprednisolone, and dexamethasone.
Glucocorticoids in animal studies have been shown to cause harm to a developing fetus. Therefore, patients who are pregnant are advised to discuss the use of glucocorticoids with their healthcare providers so as to carefully weigh the potential benefits and risks in their particular case.
Alcohol consumption can potentially worsen the side effects of glucocorticoid treatment or increase the likelihood that they occur. Patients are therefore recommended to seek medical advice from their healthcare team on the combination of alcohol and corticosteroids.
It is difficult to predict when and if patients will respond favorably to glucocorticoids, both in terms of therapeutic response and tolerability. This response depends, in part, on the type of glucocorticoid given, its dose, regimen, and administration method. Typically those administered intravenously (into the vein) act more quickly in providing symptom relief. In MS, glucocorticoids are prescribed to solve acute relapses; therefore, they tend to be fast-acting. Most patients usually feel an easing of symptoms within a few days of treatment; however, each person may respond differently to treatment, and some may even fail to respond adequately. Patients should follow up with their healthcare team if they have questions about the effects of the prescribed treatment.
Increased appetite and weight gain are listed as common side effects of treatment with glucocorticoids. Some of these medications also may contribute to hair loss — thinning of the scalp hair is listed as a possible side effect on the prescribing information label of several glucocorticoids.
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