An older steroid the body turns into active cortisol
Cortisone
An older steroid tablet used for adrenal hormone replacement and to reduce inflammation.
What is Cortisone?
Cortisone is an older corticosteroid (steroid) tablet. The body converts it into active cortisol, which is why it is used to replace the natural steroid hormone when the adrenal glands are not making enough, and to reduce inflammation. As with all steroids, the main rules are not to stop it suddenly, and to be aware that longer-term use raises the risk of infection, can affect blood sugar and bones, and may cause weight gain and mood changes. People taking it longer term carry a steroid card and may need extra steroid cover when they are unwell.
Education and reference only. This is a plain-language guide to Cortisone — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Cortisone is a corticosteroid, the group of medicines usually just called 'steroids'. It is one of the older members of this group. Once taken, the body changes it into cortisol, the active steroid hormone the adrenal glands normally make. Because of this, cortisone is used both to replace that hormone when the adrenal glands cannot produce enough and to damp down inflammation in various conditions. It is taken by mouth as a tablet. Today other steroids are often chosen instead, but cortisone works in the same general way.
How it works
After it is swallowed, cortisone is converted in the body, mainly in the liver, into the active steroid cortisol. Cortisol then does the work: as replacement therapy it supplies the steroid the body needs to function normally, and at higher levels it calms down the immune system and reduces inflammation, which helps in conditions driven by swelling and overactive immune responses. Because the body normally makes its own cortisol on a daily rhythm, taking steroid tablets can quieten the body's own production, which is why the dose must not be stopped suddenly.
Company & origin
Originated / developed by: Generic (long-established).
An older corticosteroid used in the UK for adrenal hormone replacement and to reduce inflammation, converted in the body to active cortisol.
Practical use
How to take Cortisone
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- Take it by mouth exactly as prescribed, usually in the morning, ideally with food to protect your stomach.
- Never stop it suddenly; the dose must be reduced gradually under medical guidance.
- Carry your steroid card and show it to anyone treating you, including dentists and pharmacists.
- Tell your prescriber if you become unwell, need surgery or are injured, as you may need extra steroid cover.
- Report signs of infection promptly, as steroids can lower your defences and hide the usual warning signs.
Weighing it up
Advantages & disadvantages of Cortisone
Advantages
- An effective way to replace the body's steroid hormone when the adrenal glands cannot make enough.
- Reduces inflammation in a range of conditions.
- Taken by mouth as a long-established, well-understood tablet.
Disadvantages
- Must not be stopped suddenly and needs to be reduced gradually.
- Longer-term use raises the risk of infection and can affect blood sugar, bones, weight and mood.
- Needs a steroid card and extra cover during illness or surgery.
Practical use
Good to know
The single most important rule with cortisone, as with all steroid tablets taken for more than a short time, is never to stop it suddenly: the body's own steroid production may have wound down, and a sudden stop can make you very unwell, so the dose is reduced gradually under guidance. People on longer-term treatment carry a steroid card and may need extra 'steroid cover' during illness, surgery or injury. Longer use raises the risk of infections (and can mask their signs), can raise blood sugar, weaken bones over time, and cause weight gain, thinning skin, mood changes and disturbed sleep. Taking it in the morning can help with sleep. Tell anyone treating you that you take a steroid, and report signs of infection promptly.
Who should not take it / use with caution
- People who have had a serious allergic reaction to cortisone should not take it.
- It is used with great care in people with active infections, as it can make them worse and hide their signs.
- It is used with caution in people with diabetes, high blood pressure, osteoporosis or stomach ulcers, under medical guidance.
Monitoring
- Reviewing the dose so that the lowest effective amount is used.
- Checking blood pressure, blood sugar and weight, especially with longer use.
- Reviewing bone health and watching for signs of infection over time.
Side effects
- Increased appetite, weight gain and fluid retention.
- Raised blood sugar, raised blood pressure and disturbed sleep or mood changes.
- A higher risk of infections, which steroids can also mask.
- With longer use, thinning of the skin and bones (osteoporosis) and other steroid effects.
Key interactions
- Taken with anti-inflammatory painkillers (NSAIDs) it raises the risk of stomach irritation and ulcers.
- It can affect blood sugar, so diabetes treatment may need adjusting.
- Some medicines change steroid levels, and live vaccines are generally avoided, so tell your prescriber what you take.
Available as: Tablets taken by mouth.
Answers
Cortisone: frequently asked questions
What is cortisone used for?
It is a steroid tablet used to replace the body's natural steroid hormone when the adrenal glands cannot make enough, and to reduce inflammation.
Why can't I stop it suddenly?
Steroid tablets can quieten the body's own steroid production, so stopping suddenly can make you very unwell; the dose is reduced gradually under guidance.
Why do I need a steroid card?
It tells anyone treating you that you take a steroid, which matters because you may need extra steroid cover during illness, surgery or injury.
What are the main risks with longer use?
A higher risk of infection, plus effects on blood sugar, blood pressure, bones, weight, skin, sleep and mood, so the lowest effective dose is used.
How is it different from cortisol?
The body converts cortisone into cortisol, the active steroid hormone, so cortisone is essentially a form that becomes active inside the body.
The wider class
About Corticosteroid (oral)
Cortisone belongs to the corticosteroid (oral) class. For how the class as a whole works, its shared safety principles and monitoring, see the full guide.
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Authoritative sources
- BNF
- NICE CKS
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