Hematologist
CION Cancer Clinics
Steroids for ITP and their side effects | CION Cancer Clinics
Steroids are usually the first medicine for ITP when it needs treating, and they often lift the platelet count within days to a couple of weeks. The common side effects are hunger, weight gain, poor sleep, mood swings and higher blood sugar. Most ease after the course. Longer use brings bone, eye and infection risks, so courses are kept short and reduced slowly by your team. At CION Cancer Clinics, our haematologist cares for anaemia, bleeding, clotting and inherited blood disorders, with ArogyaSri, CGHS and cashless insurance accepted.
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Medically reviewed by Dr. Basudev PokhrelConsultant Haematologist · last reviewed September 2026, next review due September 2027
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On this page
- Why are steroids given for ITP, and what do they cause?
- Which side effects are common, and which need a call?
- What does a course of steroids for ITP usually look like?
- What do families get wrong about steroids for ITP?
- What do the words on the prescription and report mean?
- Who are steroids not right for, and what can this page not tell you?
- Common questions about steroids for ITP
The short answer
Why are steroids given for ITP, and what do they cause?
Steroids are usually the first medicine used when ITP needs treating. They calm the immune system so it stops destroying your platelets as fast. The common side effects are a bigger appetite, weight gain, poor sleep, mood changes and higher blood sugar. Most of these ease once the course is over.
What ITP is doing to your platelets
In ITP, immune thrombocytopenia, your immune system marks your own platelets as foreign and clears them from the blood. Thrombocytopenia simply means a low platelet count. Platelets are the cells that plug small leaks in blood vessels, so a low count shows up as bruises, tiny red dots on the skin or bleeding gums.
What steroids do and do not do
Steroids slow that attack. In many people the count starts rising within days to a couple of weeks. They do not fix the cause, and in adults the count often drifts down again once the course ends. That is why doctors use them as a short bridge, not a long-term plan.
The medicines you may hear named
The ones used most are prednisolone, dexamethasone and, in hospital, methylprednisolone through a drip. Your haematologist chooses the medicine and the schedule. This page gives no doses, because the right amount depends on your weight, your bleeding and your other health conditions.
What you may notice
Which side effects are common, and which need a call?
Not everyone gets all of these. Most are linked to how long the course runs, so a short course usually causes fewer problems than a long one.
Appetite, weight and face
Hunger rises quickly, and weight often follows. With longer use the face can look rounder. This fades slowly after the course ends.
What helps
- Regular meals with less fried food and sweets
- Salt kept low to limit puffiness
Sleep and mood
Many people feel wide awake at night, restless or irritable. Some feel unusually cheerful, others low or tearful. Family members often notice this before the patient does.
Tell the team about any dark thoughts or confusion the same day.Blood sugar and blood pressure
Steroids push sugar and pressure up. If you have diabetes, your readings can rise sharply and your diabetes medicines may need adjusting by your doctor.
Watch for
- Strong thirst and passing urine often
- Headache or blurred vision
Stomach, infection and bones
Steroids can irritate the stomach lining and make infections easier to catch. Longer or repeated courses thin the bones and can affect the eyes. These are the main reasons doctors keep courses short.
Not sure whether this applies to you?
Ask an oncologistStart to finish
What does a course of steroids for ITP usually look like?
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The decision to treat
Your haematologist looks at bleeding first and the platelet number second. Someone with a low count and no bleeding may be watched instead. Tell the doctor about diabetes, high blood pressure, stomach ulcers, tuberculosis in the past, or pregnancy before anything starts.
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Starting the medicine
Tablets are usually taken in the morning with food, which can make sleep a little easier. You may be given a stomach-protecting tablet alongside. If you are admitted with bleeding, the steroid may go into a vein instead.
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Checking the count
Blood tests are repeated to see whether the platelets are climbing. Your blood sugar and blood pressure are checked too. One result on its own means little. The trend over several tests tells the team more.
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Bringing the dose down slowly
After a longer course, steroids are reduced step by step rather than stopped at once. Your body makes its own steroid hormone, and it needs time to take over again. Only your team should set this pace.
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Deciding what comes next
If the count stays safe, you are followed up. If it falls again, the team discusses other options rather than repeating long steroid courses.
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When not to wait
Go to the nearest emergency department or call 108 if there is a severe headache, a head injury, vomiting blood, black stools, bleeding that will not stop, or sudden confusion. Go the same day for a fever with shivering while on steroids, because steroids can hide how serious an infection is. Say that the person has ITP and is taking steroids.
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Commonly believed
What do families get wrong about steroids for ITP?
"The count is normal now, so the tablets can stop today."
Stopping suddenly after a longer course can make you dizzy, weak and seriously unwell, because your own hormone has not caught up yet. It can also let the count fall. Ask the team how and when to reduce, and follow their plan.
"Steroids for ITP are the same as the ones bodybuilders use."
They are a different family of medicines. The steroids used in ITP act on the immune system. They do not build muscle, and with long use they can actually weaken it.
"If steroids did not work, nothing will."
Steroids are only the first step. Other medicines, such as IVIG, eltrombopag, romiplostim and rituximab, work in different ways, and spleen removal is an option for some adults. A poor response to steroids does not close those doors.
"The weight and the round face are permanent."
For most people these settle gradually after the course ends. It takes time, often longer than the course itself, and regular meals with less oil and sugar help it along.
On your prescription
What do the words on the prescription and report mean?
- Corticosteroid
- The full name for the steroids used in ITP. They copy a hormone your adrenal glands make every day.
- Tapering
- Lowering the dose in planned steps instead of stopping at once. Your team writes out the steps for you.
- Response
- The platelet count has risen to a safer level and bleeding has settled. It says nothing about whether the rise will last.
- Steroid-dependent
- The count stays up only while steroids continue. This usually leads the team to look at a different medicine.
- Platelet count
- The number of platelets in a sample of blood. Normal ranges differ between laboratories, so read it against the range printed on your own report.
Being straight with you
Who are steroids not right for, and what can this page not tell you?
Steroids are not the right first choice for everyone. People with poorly controlled diabetes, an active infection, a recent stomach ulcer, severe mood illness or thin bones may be steered towards another option, or watched more closely. Many children with ITP need no medicine at all, because the condition often settles on its own.
Pregnancy and older age
Steroids can be used in pregnancy, but the plan is shared between the haematologist and the obstetrician. Older adults are more likely to get high sugar, confusion and bone thinning, so the team weighs those risks carefully.
What this page cannot tell you
It cannot tell you whether your own count will respond, how long any rise will last, or which side effects you will get. It cannot tell you what dose is right. A single platelet result is always read alongside your symptoms and repeat tests. At CION, Dr. Basudev Pokhrel and the haematology team go through the report with you and explain what the choices are.
Never start, stop or change a steroid on your own. Call the team first, even if you feel well.Questions we are asked
Common questions about steroids for ITP
How quickly do steroids raise the platelet count?
Many people see a rise within days to a couple of weeks, though it varies. Some do not respond at all. Your team repeats the blood test to follow the trend rather than judging on one result. If there is no useful rise, that is information too, and it helps the team choose what to try next.
Can I take steroids if I have diabetes?
Often yes, but your sugar will need closer watching. Steroids can raise readings sharply, especially in the afternoon and evening. Check your sugar more often if your doctor asks, and tell them about high readings or strong thirst. Do not change your diabetes medicines on your own. The team will adjust them with you.
Why can I not sleep since starting the tablets?
Steroids make the body alert, and poor sleep is one of the most common complaints. Taking the tablet in the morning, if your doctor agrees, often helps. Avoid tea and coffee late in the day. If sleep loss is making you anxious, low or confused, tell your team rather than pushing through it.
Will the weight I gained go away?
For most people it comes down slowly after the course ends, as appetite settles. It often takes longer than the course itself. Regular meals, less fried food, fewer sweets and gentle daily walking help. Avoid crash diets while your count is low, and keep eating enough protein to protect your muscles.
Can steroids be given to my child with ITP?
Sometimes, when there is bleeding beyond bruises and tiny red spots. Many children with ITP need no medicine and are watched instead, because the condition often clears on its own. If steroids are used, courses are kept short. Children may become irritable, hungry and restless for a while, and this settles.
Do steroids lower my immunity?
Yes, to some degree, and more so with longer courses. Infections may be easier to catch and harder to spot, because steroids can dampen a fever. Wash hands often, avoid people who are clearly unwell, and get any fever, burning urine or cough with phlegm checked the same day. Ask your team before any vaccine.
What happens if the count falls again after steroids?
This is common in adults and is not your fault. The team looks at whether you are bleeding and how low the count is. Options include watching, IVIG for a quick lift, medicines that help the body make more platelets, rituximab, or spleen removal for some adults. Repeated long steroid courses are generally avoided.
Is treatment for ITP covered by Aarogyasri or insurance?
Steroid tablets are low in cost, but tests, admissions and later medicines add up. Coverage under Aarogyasri, CGHS, ECHS, EHS, PM-JAY and cashless insurance depends on the scheme and the treatment involved, and the rules change. Call the helpline with your card details and the team will help you check your current cover.
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Meet CION's haematologist. One specialist for your blood report and your plan.
Dr. Basudev Pokhrel reviews blood counts, transfusion needs and blood disorders, and works with the CION tumour board on blood cancers.
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Sources
- NHS — Immune thrombocytopenia (ITP)
- NHS — Steroids
- National Heart, Lung, and Blood Institute — Immune Thrombocytopenia (ITP)
- American Society of Hematology — Immune Thrombocytopenia (ITP)
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
ITP Explained: Low Platelets Without CancerWhat ITP is, in plain wordsPlatelet Thresholds: When Treatment StartsWhen doctors decide to treat at allIVIG in ITP: When It Is UsedThe faster option when bleeding needs a quick liftTPO Receptor Agonists: Eltrombopag and RomiplostimWhat comes next if steroids do not hold the countITP and Low PlateletsThe full guide to ITP and low platelets
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Started steroids and worried about the side effects?
Share your blood report and prescription with us. CION's haematology team will go through them with you and explain the next step. One helpline serves every CION centre.