Medications

Steroids Before Surgery

Long-term steroid tablets need careful handling around surgery — stopping them suddenly is the real danger.

Medically reviewed by Dr. Saurabh Shukla, MBBS, DNB Anesthesiology · Last updated June 2026

Quick answer

Keep taking your steroids — do not stop them suddenly. People on regular steroid tablets (such as prednisolone) may need an extra 'stress dose' around surgery, because their body can't ramp up its own steroid response.

Why it matters

Taking steroids for weeks or longer tells your adrenal glands to slow their own production. If you stop suddenly, your body can't make the extra steroid that the stress of surgery demands — leading to a dangerous drop in blood pressure called an adrenal crisis.

To prevent this, anesthesia teams often give extra steroid cover around the operation and continue your usual dose.

Do not stop without instruction

Never stop long-term steroids abruptly before surgery. Tell your team you take them so they can arrange stress-dose cover.

What to ask your doctor

  • Should I take my steroid as usual on the morning of surgery?
  • Do I need an extra 'stress dose' for this surgery?
  • How long have I been on steroids — does that change the plan?
  • What are the warning signs of adrenal crisis to watch for?

Red flags — call your team

Red flags — call your team

  • You've taken regular steroids for several weeks or more
  • Feeling very weak, dizzy, faint, or nauseated
  • You recently stopped steroids suddenly

References

  • American Society of Anesthesiologists (ASA) — perioperative steroid management. asahq.org
  • Endocrine peri-operative (stress-dose steroid) guidance.

Frequently asked questions

Do I stop steroids before surgery?

No. Long-term steroids should not be stopped abruptly. Continue them and tell your team, as you may need an extra stress dose around surgery.

What is a stress dose of steroids?

Extra steroid given around surgery to replace what your body would normally make under stress, preventing a dangerous drop in blood pressure (adrenal crisis).

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