Steroids

• Long term oral use for respiratory disease is rarely indicated
  • Withdraw gradually if: use >3 weeks, >40 mg prednisolone/d
  • When stepping down use of steroid inhalers: Reduce dose slowly (by 50% every 3 months)
• CAUTION: Osteoporotic fractures: Consider bone protection if long term treatment necessary
• Ensure use of steroids aligned with COPD GOLD guideline

Rarely indicated for long term use. Consider dose reduction/withdrawal where possible