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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).
Pulmicort (budesonide) can come in solution which for asthma is then inhaled by using a nebulizer machine to aerosolize the medication. Swallowed Pulmicort (budesonide) is combined with other components such as Splenda to create a slurry which is then swallowed. This Swallowed budesonide (Pulmicort) Slurry may be used for those who may have more difficuly with dry swallowing fluticasone from an MDI. For those who are on swallowed steroids it is recommended not to eat or drink anything for 30 minutes after taking this medication so that it can provide optimal coating of the esophagus. Furthermore, anyone on these medications should swish and spit or brush their teeth after each use to remove any residual steroids in the mouth where it may have unwanted side effects.