Doctors generally prescribe inhaled corticosteriods over oral (tablet or liquid) corticosteroids, because the inhaled medication is more targeted. In other words, when it's inhaled, medication goes directly into the lungs where it's needed. Unlike oral medicines, inhaled steroids do not have to pass through other parts of the body where they're not needed, and as a result are less likely to cause unwanted side effects.
If you are using a pressurized MDI (pMDI) inhaled steroid, then doctors recommend the use of a spacer device, especially for children. A spacer slows down the delivery of the aerosol droplets that carry the medicine, making delivery even better targeted to get into the airways. Remember, spacers should not be used with dry-powered devices such as the DISKUS® or Turbuhaler®.
Q: What are steroids?
A: Some athletes misuse anabolic steroids to build muscle. Corticosteroids are the steroids used to treat asthma. Corticosteroids do not build muscle or enhance performance. Corticosteroids are hormones that you body naturally produces. When your doctor prescribes an inhaled corticosteroid, he is giving a very small amount of this same hormone, to reduce the inflammation in the airways.
Q: Will corticosteroids used to treat asthma cause dangerous side effects?
A: The corticosteroids that are inhaled to treat asthma today are considered safe. This is because the medicine, which is breathed in through a puffer, goes directly into the lungs where it reduces inflammation in the airways. A steroid tablet that is swallowed has more side effects because a large amount goes into the blood stream and is carried to other parts of the body. Side effects from inhaled corticosteroids are minor when the proper amount is taken. A few people get a cough, hoarseness or husky voice, sore throat or thrush (a yeast infection). Patients can protect against these discomforts by rinsing their mouth, gargling with water and spitting out, to remove any medicine left in the mouth.
Q: Are inhaled corticosteroids reserved for people with severe asthma?
A: No. Inhaled corticosteroids are used in mild to moderate asthma as well as in more severe cases. Canada's Asthma Control Guidelines, developed by Canada's leading asthma doctors, recommend the use of inhaled corticosteroids to reduce airway inflammation and get symptoms under control.
Q: How do I know that inhaled corticosteroids won't cause health problems in the longer term?
A: As with any medicine, doctors and patients must weigh the possible risks of taking medicine against the effects of not taking the medicine to decide what is best. Low amounts of inhaled steroids are generally considered to be the best option and are used by many people for asthma control.
Q: I do not feel comfortable taking inhaled steroids every day. Can I stop?
A: When your asthma is under control talk to your doctor about adjusting the dose of your medications. Do not stop taking your controller medications. If you do, the airway inflammation may return.