Do not abruptly stop chronic corticosteroids. The prescriber should provide a taper or conversion plan and written sick-day/stress-dose instructions because adrenal crisis can occur.
What this means in real life
Chronic corticosteroids suppress the body’s normal cortisol response. Abruptly stopping, sharply reducing or repeatedly skipping doses can cause adrenal insufficiency or adrenal crisis, especially during fever, vomiting, injury, surgery or severe illness. A person may look unusually weak, sleepy, dizzy, nauseated or dehydrated; low blood pressure and collapse are emergencies.
Any planned change requires a written prescriber-directed taper or conversion. The safe pace depends on the drug, dose, schedule, duration and reason for changing. Even after tapering, adrenal suppression can persist, so the team may provide stress-dose instructions or endocrinology testing. Never assume that a child who cannot keep an oral dose down can simply wait until the next day.
Families, schools and emergency clinicians should know the daily steroid, dose, last dose and stress-dose plan. Carry an emergency card or letter and prescribed injectable hydrocortisone when the clinical team recommends it.
A practical checklist
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Do not stop or convert a chronic steroid without the prescriber.
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Obtain written daily, sick-day, vomiting and surgery instructions.
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Keep the medication and emergency plan current at school and during travel.
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Know when and how to use emergency hydrocortisone if prescribed.
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Tell every emergency, dental and surgical team about chronic steroid use.
Questions to bring with you
Use these at the clinic, school meeting, equipment evaluation, program interview or benefits call. Write down the answers and who owns the next step.
- How suppressed is the adrenal system likely to be?
- What exact dose should be given for fever, vomiting, injury or surgery?
- When should we use an injection and call emergency services?
- How long do precautions continue after tapering?
- Who updates the plan as weight or medication changes?
Important safety note
This topic can involve serious or immediate risk. Do not start, stop or change treatment from an online answer. Contact the Duchenne care team; use emergency services for urgent symptoms or danger.
Sources used for this guide
Direct links are included so families can check the original guidance and bring it to qualified professionals.
Content review: July 18, 2026. Medical labels, trials, benefits and programs can change after publication.
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