How Long Do Steroids Stay in Your System?

If you are taking steroids for asthma, you may wonder how long steroids stay in your system. This will vary depending on the type of drug, whether you are taking an inhaled steroid (e.g., Advair) or oral corticosteroid (e.g., prednisone), and the characteristics of each medication. Specifically, the drug's half-life will determine how long a drug circulates within your body.

A major factor in how long any drug affects your body is the drug's half-life. In very simple terms, the half-life of a drug is the time it takes for half of the drug's dosage to be eliminated from your body.

For example, the half-life of rescue inhalers like albuterol is in the five- to seven-minute range, while the half-life of Advair is five to seven hours.

The half-life of a drug affects several things, including how quickly you'll notice it working and how often you'll need to take it.

A number of different factors can affect the half-life of a drug, including:

• Age
• Gender
• Hydration
• Liver disease

While half-life is mostly related to the properties of the drug, each body is unique, which means that how a drug is metabolized in your body may differ from how the same drug at the same dosage affects another person.

Oral corticosteroids, sometimes referred to as oral steroids or even by a brand name such as prednisone, are a group of powerful anti-inflammatory medications that are prescribed when you have a significant worsening of your asthma symptoms. They may be used over several days to help get your symptoms under control.

Inhaled steroids, in contrast, are localized to the lungs. Their direct action reduces broader side effects, but inhaled steroids need to be used daily for best results.

Oral corticosteroids are systemic—meaning they reduce inflammation throughout the entire body. Inhaled steroids, on the other hand, act primarily in the lungs.

It is helpful to understand the differences between oral corticosteroids and inhaled steroids. The most important differences are related to potential side effects. It's important to note that these become more pronounced when drug levels are not stable, which occurs when prescription instructions are not followed exactly as directed.

The half-life of oral corticosteroids is significantly longer than inhaled steroids, and therefore oral steroids have a more significant side effect profile, including:

• Loss of bone density and possible osteoporosis
• Cataracts
• Glaucoma
• High blood pressure
• Elevated glucose
• Aggression and behavior changes
• Increased appetite, fluid retention, and weight gain
• Increased risk of infection
• Depression

It is key to mention any recent steroid bursts (the use of a short course of oral steroids) to your healthcare provider. Overuse of oral steroids may prevent your adrenal gland, where your body's natural steroids are made, from working correctly. As a result, your body may not make steroids sufficiently during a time of stress and you may require additional supplementation.

Inhaled steroids rarely cause these side effects, but do have local side effects that are easily prevented with appropriate steps. Side effects of inhaled steroids are rare but may include:

• Thrush
• Hoarseness

These symptoms may be avoided by rinsing the mouth and gargling after use of an inhaled steroid, plus utilizing a spacer device that delivers measured doses.

If your doctor needs to prescribe oral corticosteroids more than once per year, your asthma control may be suboptimal and it may be time to reexamine your asthma action plan together. Patients and parents of children with asthma often have concerns about the side effects of steroids. Write down any questions and qualms before meeting with your physician or your child's pediatrician to start a discussion of what's right for you.