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 production in the airways to help control and prevent asthma symptoms. Inhaled steroids can also reduce the "twitchiness" or irritability in the airways.

Inhaled steroids help with long-term asthma control. They do not immediately open the airways. They do not provide immediate 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?

There are currently 6 inhaled steroid medicines available in the U.S. Each of these delivers a different amount of medicine per puff.

  • beclomethasone (Qvar, Vanceril)
  • triamcinolone (Azmacort)
  • flunisolide (AeroBid)
  • fluticasone propionate (Flovent, 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)
  • 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 delivered using a valved holding chamber or spacer device. Budesonide (Pulmicort), fluticasone (Flovent) and mometasone (Asmanex) 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 properly 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 is the usual dose?

The usual dose depends on the type of medicine and whether you are taking a low, medium, or high dose. It is usually given 1 to 2 times a day. Your child's healthcare provider will tell you what dose your child needs.

Your prescribed dose of ____________________ is ______ puffs taken _______ times a day.

What side effects can this drug cause?

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

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

Large doses taken over extended periods of time may cause other side effects involving the bones, eyes, adrenal gland, and muscles.

What special instructions should be followed?

Remember to give your child the medicine every day as prescribed by your healthcare provider 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 valved holding chamber or 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 giving nebulized steroids use a face mask that fits snugly and completely covers 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 to help avoid oral thrush or skin irritation.

Written by the Asthma Task Force at The Children's Hospital, Denver.
Published by RelayHealth.
Last modified: 2009-01-09
Last reviewed: 2008-12-29
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
© 2009 RelayHealth and/or its affiliates. All Rights Reserved.