How quickly do steroids work?
Symptoms usually start to improve 2-4 weeks after treatment is started. Maximum benefit is
usually seen after 6-12 months of treatment.
How well do steroids work?
It is thought that for every 10 patients with myasthenia gravis who are treated with steroids,
between 4-8 people will either go into remission or have such good symptom improvement
that they have an almost normal daily life and muscle strength. How well you respond to
steroids depends on how severe your myasthenia gravis is.
When do I take steroids?
Steroids are usually taken every day or every other day in the morning; after or with
breakfast. Your doctor will advise.
What dose should I take?
This is different for every patient and may change throughout your treatment.
Steroids (prednisolone) are usually started at a low dose for example prednisolone 5-10mg
each day and the dose gradually increased. This is because high doses of steroids at the
start of treatment can make the muscles weaker. Therefore the dose is built up slowly. Once
the recommended dose has been reached (prednisolone up to 80-100 mg every other day or
up to 50 mg each day) it is usually held there for several months. After this, the dose is
usually reduced over a number of months to the lowest dose that controls the symptom.
Ideally the dose of steroid should be reduced to prednisolone 5-10 mg every day. This is in
order to lower the risk of side-effects. Unfortunately it is not always possible to lower the
dose of steroid by this much and few patients are able to stop steroid treatment altogether.
Note: when you start treatment with corticosteroids you may find that your symptoms are
worse in the beginning.
What is the length of treatment?
The length of treatment is different for each patient; however treatment is usually long-term
(months or years). Some patient will need steroids permanently. If your symptoms are well
controlled the doctor may decide to gradually lower the dose of your medicine to a dose that
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will still keep the symptoms away. If symptoms return the doctor may decide to increase this
dose again.
Stopping steroids
Never stop taking steroids abruptly. Steroids are very similar to a hormone in that is made in
your body called cortisone. When you start taking steroids your body can stop making its
own. Your body will become used to the steroids level in your body and stopping them
suddenly may cause you to experience withdrawal symptoms. These effects include
weakness, tiredness, feeling sick, vomiting, diarrhoea, abdominal pain, low blood sugar and
low blood pressure which can cause dizziness, fainting or collapse.
Any dose reduction should be supervised by a doctor, undertaken slowly and over a number
of weeks or months. This will allow your body to start making its own corticosteroids and you
should not have any of these effects.
It is important to always tell you doctor or pharmacist if there is any reason you cannot take
you medication (e.g. sickness or diarrhoea)
What should I do if I miss a dose?
If you forget to take your medication in the morning, take it as soon as you remember the
same day.
If you forget to take your medicine, but do not remember until the next day. Take your
medicine as normal the next day. Do not take double the dose the next day.