Viewer Question: What are the possible long and short term side effects from
inhaled corticosteroid drugs taken for asthma? Is it possible to experience
similar side effects on high doses of the inhaled drugs as on the orally
administered drugs (. prednisone )? There are some potent new inhaled drugs,
. Flovent, that are effective in treating asthma but I was wondering if these
drugs are absorbed into the bloodstream.
Doctor's Response: Current maintenance therapy for asthma is directed primarily at airway inflammation. The application of topical inhaled steroids on the air passages is a very effective means of managing the chronic symptoms of asthma. There are a variety of inhaled steroids available by prescription. These steroids all act in a similar fashion to oral steroids but with fewer side effects. As the dose of inhaled steroids increases so does the potential for some of the more serious steroid complications. The fluorinated steroids fluticasone (Flovent) and budesonide (Pulmicort) are the most potent. It is important to use the lowest effective dose that optimizes lung function and minimizes symptoms. Most of the steroid inhalers when prescribed at the usual dose have an immeasurable effect on the body (that is outside of the air passages). Some potential effects include the suppression of the hypothalamus (in the brain) and the adrenals (above the kidneys). These glands are involved in our bodies response to stress. Measurement of their function is a very sensitive way of determining the impact inhaled steroids may have on the body. When the function of these glands is suppressed than the many side effects seen with oral steroids may also occur. The most common side effect of inhaled steroids is oral candidiasis (thrush). This is easily treated and its occurrence minimized by using a spacing device. Exacerbation of glaucoma has also been reported. To summarize, inhaled steroids are an excellent medication for the treatment of asthma. Their safety profile is terrific when used by knowledgeable practitioners. Thank you for your question.
In a small study in healthy volunteers, the slightly less potent CYP3A inhibitor ketoconazole increased the exposure of fluticasone propionate after a single inhalation by 150%. This resulted in a greater reduction of plasma cortisol as compared with fluticasone propionate alone. Co-treatment with other potent CYP3A inhibitors, such as itraconazole and cobicistat-containing products, and moderate CYP3A inhibitors, such as erythromycin, is also expected to increase the systemic fluticasone propionate exposure and the risk of systemic side effects. The combination should be avoided unless the benefit outweighs the increased risk of systemic corticosteroid side-effects, in which case patients should be monitored for systemic corticosteroid side-effects.
Inhaled corticosteroids are medications used to treat asthma. They are taken by using an inhaler. This medication should be taken consistently so that it decreases inflammation in the airways of your lungs and prevents asthma flare-ups. Inhaled corticosteroids are considered the most effective long term usage medication for control and management of asthma. Depending upon the severity of your asthma, your physician may combine an inhaled corticosteroid with a long-acting beta-2 agonist to treat your condition. Oral and intravenous corticosteroids may be required for acute asthma flare-ups or for severe symptoms.