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Medical Author:

George Schiffman, MD, FCCP

George Schiffman, MD, FCCP

Dr. Schiffman received his B.S. degree with High Honors in biology from Hobart College in 1976. He then moved to Chicago where he studied biochemistry at the University of Illinois, Chicago Circle. He attended Rush Medical College where he received his M.D. degree in 1982 and was elected to the Alpha Omega Alpha Medical Honor Society. He completed his Internal Medicine internship and residency at the University of California, Irvine.

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Medical Editor:

William C. Shiel Jr., MD, FACP, FACR

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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Beclomethasone (Qvar), budesonide (Pulmicort), flunisolide (AeroBid), fluticasone (Flovent), and triamcinolone (Azmacort, which was discontinued at the end of 2009) are used as first-line medications to control asthma. A small amount of inhaled corticosteroids is swallowed with each dose, but it's much less than that contained in oral corticosteroids. Therefore, inhaled corticosteroids decrease the likelihood of adverse effects from long-term use.

How corticosteroid inhalers work

Inhaled corticosteroids are often the first type of medication prescribed to control asthma. By inhaling the medication, these drugs act locally to decrease inflammation within the breathing passages, thereby avoiding the side effects associated with long-term use of oral corticosteroids.

Who should not use these medications

• Individuals allergic to corticosteroids or any of the inhaler contents should not use these drugs.



• Individuals with status asthmaticus or acute asthma attacks should not use these drugs.

Use

Corticosteroids for asthma are typically available as handheld inhalers containing liquid or powder. Many inhaled products have specific devices, and you should be thoroughly informed on how to use the inhaler prescribed for you. Frequency of administration (how often you use the inhaler) depends on the specific product.

Drug or food interactions

Since the drug is localized to the airway, no drug interactions have been reported.

Side effects

Do not use for an acute asthma attack. Inhaled corticosteroids may decrease growth in children, so use the lowest dose possible. Inhaled corticosteroids may also increase the risk of serious or fatal infection in individuals exposed to serious viral infections like chickenpox or measles. Long-term use may cause cataracts or glaucoma (increased pressure within the eyes).

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