Powerful, fast and genuinely useful — with rules about stopping that matter more than most people are told.
Explained by a GMC-registered GP, not a leaflet
Honest about what we can and cannot prescribe remotely
Side effects given the same weight as benefits
Your NHS records in the room, with your consent
Care led personally by Dr Khan
Attentive, unhurried care that listens properly
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Registered with the Care Quality Commission
Prednisolone is a corticosteroid — a synthetic version of cortisol, the body's own steroid hormone — which suppresses inflammation and immune activity powerfully and quickly.
It is not an anabolic steroid. Anabolic steroids build muscle; corticosteroids break it down over time. The shared word causes real and unnecessary anxiety.
It treats inflammation rather than its cause, which is why it is so often a bridge to something else rather than the whole answer.
In polymyalgia rheumatica the response is so rapid and dramatic that it is almost diagnostic — which is precisely why steroids should not be started before the diagnosis is made, since they remove the evidence.
If you take steroids long term and become unwell with fever, vomiting or injury, the dose usually needs increasing rather than stopping. Your body cannot produce its own extra cortisol under stress, and it needs the extra.
Vomiting and unable to keep tablets down means urgent medical attention — this can become an adrenal crisis.
Anyone on long-term steroids should carry one. It tells anyone treating you that your dose must not be interrupted. Ask your pharmacist.
There are few absolute barriers, because steroids are sometimes essential. Considerable caution applies with diabetes, osteoporosis, peptic ulcer, glaucoma, heart failure, mental health conditions and recent live vaccines.
Live vaccines must be avoided during significant steroid treatment.
Steroids are used in pregnancy where needed, and prednisolone crosses the placenta poorly.
Yes in some situations, and deliberately not in others.
We will consider a short course for a flare of a condition already diagnosed and previously treated this way — gout, a known inflammatory condition, or a well-established asthma or COPD rescue pack used according to an existing plan.
We will not prescribe steroids remotely for undiagnosed symptoms. Steroids are powerfully anti-inflammatory, which means they mask illness effectively — including infection and, occasionally, cancer. A short course that makes someone feel better while an undiagnosed problem progresses is a real harm.
We also will not manage long-term steroid treatment remotely, which needs monitoring of bone density, blood pressure, glucose and much else.
Prednisolone is a very cheap generic. A short course costs little.
Enteric-coated tablets cost more and reduce stomach irritation. Soluble tablets are available where swallowing is difficult.
Steroid emergency cards are free from pharmacies and should be carried by anyone on long-term treatment.
Do not stop steroids abruptly after more than about three weeks of treatment. Your adrenal glands stop producing cortisol during treatment and take time to restart. Stopping suddenly can cause an adrenal crisis — collapse, low blood pressure, and it can be fatal.
Reduction is gradual and supervised, slower the longer you have been on treatment and the lower the dose gets.
Fatigue, aching, low mood, nausea and dizziness during reduction are common and usually mean the taper is too fast rather than that the underlying condition has returned.
For conditions needing long-term control, the aim is always to find something that reduces or replaces the steroid — methotrexate, azathioprine, biologics and others, all under specialist supervision.
Where inflammation is localised, injected, inhaled or topical steroids achieve local effect with far less systemic exposure.
Because after a few weeks your body has stopped making its own cortisol. Short courses are fine to stop; longer ones must be tapered, and this is genuinely dangerous to get wrong.
No. Those are anabolic steroids, which build muscle. Corticosteroids do the opposite. Entirely different drugs.
A very common effect. Taking the whole dose first thing in the morning helps considerably. It settles after the course.
Expected — steroids raise blood glucose. If you have diabetes, monitor more closely; diabetes medication often needs temporary adjustment.
A card confirming you take long-term steroids and that your dose must not be interrupted. Free from pharmacies, and it matters in an emergency when you may not be able to explain.
No — the opposite. The dose usually needs increasing during illness. If you cannot keep tablets down, seek urgent medical help.
Clinically reviewed by Dr Mohammad Zubair Khan, GMC 7563469
Last reviewed
August 30, 2026
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Same-day access is usually available, from 6am to 10pm, seven days a week. You choose a time that suits you rather than waiting on hold at 8am.
Yes. Care is led personally by Dr Mohammad Khan, so you are not passed between clinicians. Continuity is the point of a small practice: someone who knows your history and is listening attentively rather than working through a checklist.
Yes, with your consent. We can access your Summary Care Record during the consultation, so your current medications, allergies and significant history are in the room. That means fewer questions you have already answered elsewhere, and safer prescribing.
No. We are not here to replace GPs, only to support them. Your NHS practice remains responsible for your ongoing care, and with your consent we write to them after the consultation. We are useful when you need to be seen sooner, or want more time than a standard appointment allows.
Twenty unhurried minutes and a comprehensive assessment. A written treatment plan is included, along with any prescription, sick note or referral letter arising from the consultation, at no extra charge.
£40 for 20 minutes, self-pay. Membership is optional and never required. Priced for fairness, because we are not here to charge extortionate amounts for access to a doctor.
It means the diagnosis can usually be made from your history and photographs, and that treatment can be arranged safely without examining you. Where a condition is not marked treatable online, it is because examination is the diagnosis — listening to a chest, feeling an abdomen, examining an ear or a joint — or because a procedure or device is needed.
Yes, where there is a genuine bacterial infection — cellulitis, impetigo, bacterial urine infections, confirmed strep throat. We will also frequently tell you that you do not need one. Most sore throats, coughs, colds and earaches are viral, and an antibiotic gives you the side effects with none of the benefit.
If your problem turns out to be genuinely outside what we can do remotely, the doctor will tell you straight away, point you to the right service, and refund your fee in full. We would rather do that than fill twenty minutes to justify the charge.
Call 999 or go to A&E — do not book an online appointment and do not wait for a reply to an email. For urgent problems that are not emergencies, NHS 111 is available 24 hours a day, online or by phone, and can direct you to the right service.
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