The aim of this article is to bring less well recognised adverse effects of inhaled corticosteroids to the attention of prescribers. Whilst inhaled steroids have a more favourable side effect profile than systemic steroids, they are not free from adverse effects. The dose of inhaled steroids used should be carefully monitored, and kept at the lowest dose necessary to maintain adequate control of the patient’s disease process. Be particularly aware of the cumulative effect of co-prescribing various dose forms of corticosteroids (inhaled, intranasal, oral and topical preparations).
Oral and injectable systemic corticosterois are steroid hormones prescribed to decrease inflammation in diseases and conditions such as arthritis (rheumatoid arthritis, for example), ulcerative colitis, Crohn's disease, asthma, bronchitis, some skin rashes, and allergic or inflammatory conditions that involve the nose and eyes. Examples of systemic corticosteroids include hydrocortisone (Cortef), cortisone, prednisone (Prednisone Intensol), prednisolone (Orapred, Prelone), and methylprednisolone (Medrol, Depo-Medrol, Solu-Medrol). Some of the side effects of systemic corticosteroids are swelling of the legs, hypertension, headache, easy bruising, facial hair growth, diabetes, cataracts, and puffiness of the face.
Feeling Fine – I had a young track runner tell me “I feel fine, I don’t wan’t to take medicines unnecessarily”. I asked him how often he took his albuterol rescue inhaler. His reply was that he took two puffs before every practice or competition. This is poorly managed asthma. This young man is walking around with inflamed lungs every day, and only providing himself short-term relief without addressing the cause. If he would adhere to his doctor’s prescription of inhaled corticosteroids, his lungs would function normally with little or no need for the rescue inhaler. Inhaled corticosteroids are a safe and effective class of medication that are the cornerstone of most asthma treatment plans. Their use has benefitted millions of asthmatics and has prevented many millions of emergency room visits and hospitalizations. If your doctor has recommended an inhaled corticosteroid for you, please adhere to the plan as prescribed. It will improve your life as it did mine.