2015 issue 1


Volume 31, issue 1

Review article

Adverse effects of glucocorticosteroids due to management of relapses of multiple sclerosis

Łukasz Smoliński1, Dagmara Mirowska-Guzel1,2, Anna Członkowska1,2
1. Institute of Psychiatry and Neurology in Warsaw, 2nd Department of Neurology
2. Medical University of Warsaw, Department of Experimental and Clinical Pharmacology
Farmakoterapia w Psychiatrii i Neurologii 2015, 31 (1), 29–44
DOI: http://dx.medra.org/10.17393/fpn.2015.06.004
Keywords: multiple sclerosis, adverse effects of glucocorticosteroids, glucocorticosteroids


In the vast majority of cases, multiple sclerosis commences with its relapsing – remitting form and therefore the management of relapses continues to be an important aspect of the clinical care despite the emergence of efficacious disease modifying drugs. Current evidence indicates, that glucocorticoid therapy for multiple sclerosis relapses improves functional status within several weeks from administration with no effect on the long-term prognosis. The safety profile of glucocorticosteroids used for the management of multiple sclerosis relapses is considered favourable. The most common adverse effects of glucocorticosteroids are benign and include mainly gastrointestinal symptoms, mood disturbances and insomnia. The remaining adverse effects such as hyperglycaemia, infections, hypertension, oedema, arrhythmias, venous thrombosis occur rarely. While using glucocorticoid therapy, adequate care should be given to patients with co-morbidities, which can increase the risk of adverse effects. These are patients using non-steroidal anti-inflammatory drugs, warfarin, anti-epileptic drugs, other medications metabolized by the cytochrome P450, patients diagnosed with diabetes, hypertension, glaucoma, and pregnant women. It was noted that the occurrence of adverse reactions depends on glucocorticosteroid formulation.

Address for correspondence:
Dagmara Mirowska-Guzel
Warszawski Uniwersytet Medyczny
Katedra i Zakład Farmakologii Doświadczalnej i Klinicznej
ul. Banacha 1b, 02-097 Warszawa, Poland
phone: +48 22 11 66 160
e-mail: dmirowska@wum.edu.pl