Corticosteroids for shingles

Examples

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Generic Name

methylprednisolone

Generic Name

prednisone

How It Works

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Corticosteroids can be taken by mouth (orally) or given by injection.

Corticosteroids reduce inflammation and severe pain, and they control itching. They also suppress the immune system, which may contribute to the development of complications of shingles, such as infections. Corticosteroids are sometimes used together with an antiviral medicine to treat shingles.

Corticosteroid injections may be combined with other treatment, such as an anti-inflammatory drug (for example, ibuprofen), to reduce pain from postherpetic neuralgia.

Corticosteroid injections must be given in a hospital setting by trained health professionals.

Why It Is Used

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Corticosteroids may be helpful for treating shingles in people who:

• Have severe pain.
• Are older than 50.
• Have shingles that affects the eye or face.

Your health professional may not recommend corticosteroids if you have a weak immune system, diabetes, or uncontrolled high blood pressure.

How Well It Works

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Taking corticosteroids can lower the pain from shingles. Adding corticosteroids to antiviral treatment for shingles may speed healing. But corticosteroids are not well studied enough to know if they help reduce the chance of getting postherpetic neuralgia as a result of shingles.¹

One study reports that an injection with methylprednisolone decreased the intensity and area of pain of postherpetic neuralgia better than treatment with topical anesthetics such as lidocaine.² But this appears to be a short-term benefit. Also, corticosteroids may cause shingles to spread in the skin.¹ And there is a risk for serious side effects, such as meningitis.

Side Effects

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Side effects may include:

• Skin rash.
• Blurred vision.
• Increased urination.
• Unusual thirst.
• Mood changes.
• Headache.
• Indigestion.
• Increased appetite and restlessness.
• Insomnia.
• Weight gain.
• Increased risk for infection.

With long-term use, corticosteroids can cause serious complications such as cataracts, osteoporosis, and damage to joints.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

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The earlier corticosteroids are used to help treat shingles, the more likely they will reduce pain and speed healing. Corticosteroids may be used when shingles affects the face or early in the course of the illness in older people and people who have severe pain.

Although corticosteroids offer short-term relief from the pain of postherpetic neuralgia, the pain usually returns. In addition, corticosteroids may trigger the spread of shingles in the skin.¹

It is important that your health professional know about any other health conditions you have before you take corticosteroids or any other medicine.

Complete the new medication information form (PDF) (What is a PDF document?) to help you understand this medication.

References

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Citations

1. Wareham D (2006). Postherpetic neuralgia, search date December 2005. Online version of Clinical Evidence (15): 1–9.

2. Kotani N, et al. (2000). Intrathecal methylprednisolone for intractable postherpetic neuralgia. New England Journal of Medicine, 343(21): 1514–1519.

Credits

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Author	Debby Golonka, MPH
Editor	Susan Van Houten, RN, BSN, MBA
Associate Editor	Pat Truman, MATC
Primary Medical Reviewer	Wajeeh E. Nasser, MD - Family Medicine
Specialist Medical Reviewer	Randall D. Burr, MD - Dermatology
Last Updated	March 21, 2007