Inhaled and intranasal corticosteroids

Taking high doses for a long time can slow down the normal growth of children and teenagers. Your child’s doctor will monitor their height and weight carefully for as long as they’re taking steroid medicine. This will help them spot any slowing down of your child’s growth and change their treatment if needed.

  • Your dose of diabetes medication may then need to be adjusted.
  • However, it can occasionally happen if they’re used at high doses and for a long time.
  • NHS data for 2013–2014 suggests that, in England, of the 242 million ICS-containing inhalers dispensed at a cost of almost £355m, 39% were for high-dose inhalers.
  • You can report any suspected side effect using the Yellow Card safety scheme.

The second analysis included 8,065 people and compared the combination inhaler with treatment as prescribed. That is, regular inhaled steroid with reliever medication as required. Therefore all patients taking an oral corticosteroid for more than three weeks or ‘prolonged high dose inhaled steroids’ should have the dose tapered gradually.

Side effects of steroid inhalers

Rinsing your mouth out with water after using your medication can help to prevent oral thrush. Using a device called a spacer with your medication can help to prevent legal injectable steroids for sale many of the other problems. The recommended course of treatment largely depends on weighing up the benefits of corticosteroids against the side effects.

  • It might help to remember that asthma is very common and lots of people use inhalers.
  • Extra steroids are usually only prescribed short term until you’ve fully recovered from a flare up of your asthma symptoms.
  • This work shows that simplifying the treatments and empowering patients to decide for themselves when they need to use their inhaler will improve their condition.
  • They include a sore throat, hoarse voice and opportunistic oral candidiasis infection.

The guidelines have moved away from recommending relievers as the first step in asthma management. Inhaled steroids (either in combination with reliever medication, or in separate inhalers) are convincingly superior to reliever medication alone. [17] Kew KM & Seniukovich A. Do inhaled steroids increase the risk of pneumonia in people with chronic obstructive pulmonary disease (COPD)? Spacer devices can also be used to reduce oropharyngeal deposition of drug particles, and should be recommended for all ICS multi-dose inhalers[12] .


Adults taking high doses (either using an inhaler or nebuliser) have an increased risk of getting adrenal gland problems or weak bones (osteoporosis) over time. Accidentally taking too many puffs from a steroid inhaler is unlikely to be harmful if it’s a one-off. Current or previous smokers may have poor responses to ICS as steroids are prevented from switching off the inflammatory genes responsible for airway inflammation. Patients who smoke  may require higher doses of ICS compared with non-smokers for the same therapeutic effect.

Corticosteroids are mainly used to reduce inflammation and suppress the immune system. They’re a man-made version of hormones, normally produced by the adrenal glands (2 small glands that sit on top of the kidneys). GPs could prescribe new weight loss drugs to patients, including semaglutide (Wegovy),…

Diabetes medication

Inhaled corticosteroids (ICSs) are indicated in the management of most patients with asthma and some patients with chronic obstructive pulmonary disease (COPD) [1],[2] . NHS data for 2013–2014 suggests that, in England, of the 242 million ICS-containing inhalers dispensed at a cost of almost £355m, 39% were for high-dose inhalers. There’s some evidence that steroid inhalers used by people with chronic obstructive pulmonary disease (COPD) can increase the risk of chest infections like pneumonia.

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Your dose may need to be reduced slowly over a few weeks or months. If you’ve been taking corticosteroids for a while, you may also need tests before you stop taking them. These will make sure that your adrenal glands are still working properly. A high dose of inhaled steroids can sometimes cause more serious side effects but this is rare.

In asthma, inflammation is primarily caused by eosinophils, while in stable COPD neutrophils are predominant[8] . Corticosteroids are more effective in reducing eosinophilic inflammation, which may explain this difference in clinical response. Patients with asthma who do not use an ICS regularly have poorer outcomes. A national review of asthma deaths in the UK in 2014 found that patients with asthma who did not use an ICS were at significantly greater risk of death[4] .

People with asthma often say they get a hoarse voice, sore mouth, or oral thrush from using their steroid preventer inhaler. So these are listed as common side effects in the patient information leaflet. Your GP or healthcare professional should give you a steroid card if you’re taking high doses of steroid medicine, either in your inhaler, or as tablets. If you’re on high doses of steroid medicine for a long time, one of the possible side effects is an increase in appetite, which could mean you put on weight.

There’s generally no reason why someone shouldn’t be able to use a steroid inhaler or steroid spray. However, these should be used with caution in people with ongoing infections, like tuberculosis (TB). In these situations, you will only be prescribed oral corticosteroids if the benefits of treatment outweigh any potential risks.

It can help you stay well and reduce your risk of an asthma attack. It is important to take your reliever inhaler when you need to, to deal quickly with symptoms getting worse, or an asthma attack. See your GP, asthma nurse, or pharmacist if you’re worried about any side effects. Dry powder inhalers have a lower impact on the environment than breath-actuated or pressurised metered dose inhalers.