Steroids, Inhaled

What does this drug do?

Inhaled steroids are one of the most important long-term control medicines, also called controllers. They reduce swelling, inflammation and mucus in the airways. This helps control and prevent asthma symptoms. Inhaled steroids can also help keep the airways from being too irritable.

Inhaled steroids help with long-term asthma control. They do not immediately open the airways. They do not provide quick relief of wheezing in acute asthma attacks. For acute asthma attacks, your child will need a quick-relief medicine, also called a reliever.

What are other names for this medicine?

Several inhaled steroid medicines are available in the US. Each of these delivers a different amount of medicine per puff.

• beclomethasone (Qvar)
• fluticasone propionate (Flovent HFA). ADVAIR Diskus and ADVAIR HFA combine a steroid (fluticasone) with a beta 2-agonist (salmeterol)
• budesonide (Pulmicort Flexhaler, Pulmicort Respules). Symbicort combines a steroid (budesonide) with a long-acting beta 2-agonist (formoterol).
• mometasone (Asmanex Twisthaler). Dulera combines a steroid (mometasone) with a long-acting beta 2-agonist (formoterol).
• ciclesonide (Alvesco)

How is this medicine taken?

Inhaled steroids can be taken with a metered-dose inhaler (MDI), a dry powder device, or a nebulizer. Medicines taken using an MDI should always be used with a spacer. Some medicines are also available as dry powders. Dry powders are delivered by a device that does not need a spacer. Pulmicort Respules are delivered with a nebulizer using either a mouthpiece or a fitted mask to avoid getting the medicine in the eyes.

If this medicine is being used along with a short-acting bronchodilator, use the short-acting medicine first, and then the steroid.

What side effects can this drug cause?

Side effects are more common in children who take high doses of inhaled steroids. Common side effects include:

• hoarse voice
• thrush (a yeast infection of the mouth and throat)

Large doses taken for a long time may affect the bones, eyes, adrenal gland, and muscles.

What special instructions should be followed?

Give your child the medicine every day as prescribed by your healthcare provider. Do this even when your child is free of asthma symptoms. Do not suddenly stop giving your child this medicine unless told to do so by your child's healthcare provider.

Rinse the mouth and spit after each dose. Use a spacer with your MDI to decrease the chance of side effects. Pulmicort Respules should be given with a jet nebulizer and NOT with an ultrasonic nebulizer. When using a nebulizer, use a face mask that fits snugly. It should completely cover your child's nose and mouth to avoid getting the medicine into your child's eyes. After the treatment, rinse your child's mouth with water and wash your child's face. This helps prevent oral thrush and skin irritation.