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However, some drugs can interact with steroids, so you should discuss any new medications with your doctor before starting them, and you should tell anyone else treating you what you’re taking. Don’t take over-the-counter preparations or herbal remedies without discussing them first with your doctor, rheumatology nurse or pharmacist. Some of the following drugs may interact with steroids, so let your doctor know if you’re taking any of these drugs: blood thinners or anticoagulants, such as warfarin drugs for epilepsy, such as phenytoin or carbamazepine drugs for diabetes Xofigo, a drug used to treat prostate cancer. If you’re taking steroid tablets you might need to avoid live vaccines, such as yellow fever. Sometimes a live vaccine may be necessary, but if this is the case your doctor will discuss the possible risks and benefits of the vaccination with you, and it could depend on the dose of steroids you’re taking. If you’re using a steroid cream it’s fine to have vaccinations, but you’ll need to tell the person giving you the injection to avoid the area being treated with the cream. If you’re offered shingles vaccination, known as Zostavax, you should speak to your doctor or rheumatology team ‘ you may be able to have the shingles vaccine if you’re on a low dose of steroids. The vaccine against the most common cause of pneumonia and yearly flu vaccines don’t interact with steroid tablets, as they’re not live vaccines. It’s important that you have these vaccinations to reduce your chances of getting these infections. If you’re having an operation, you might need to stop your steroids. Don’t do this without speaking to your doctor or surgeon first though, as in some cases you might be able to carry on taking them, and you may need to have your dose changed before the operation. The decision will depend on how long you’ve taken them for, what dose you’re on, and where on your body you’re having surgery. Both alcohol and steroid tablets could upset your stomach. If you have indigestion or other stomach problems after starting steroids, then alcohol is likely to add to the problem, so you may want to cut back on how much alcohol you drink. You shouldn’t drink any more than the UK guidelines of 14 units a week. You shouldn’t save these units up to drink all in one go, so try to spread your units across the week and have some alcohol-free days. You can find out more about units of alcohol at www. Fertility, pregnancy and breastfeeding. Current guidelines say that some steroid tablets, including prednisolone, can be taken during pregnancy. They’re often used to treat flare-ups in women who are pregnant. If you’re planning a family, you should discuss this with your doctor, as it’s important that a mother stays healthy during pregnancy and that flare-ups are avoided. If you get pregnant while you’re on steroids, don’t stop taking them before you’ve spoken to your doctor. Although small amounts of steroids could pass into breast milk, there’s no research that has shown that it’s harmful to your baby, so guidelines say that people can breastfeed while taking steroid tablets. You should discuss the risks with your doctor if you have any concerns, bio safe steroids. Steroid creams are safe to use during pregnancy, but if you’re breastfeeding you’ll need to make sure any cream is wiped off before feeding.
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