Inhaled Corticosteroids for Long-Term Control of Asthma

What To Think About

One of the best tools for managing asthma is a controller medicine that has a corticosteroid (sometimes called a "steroid"). But some people worry about using corticosteroid medicines because of the myths they've heard about them. If you're making a decision about a corticosteroid inhaler, it helps to weigh the facts against the myths.

Most doctors recommend that everyone who uses a metered-dose inhaler (MDI) also use a spacer, which is attached to the MDI. A spacer may deliver the medicine to the lungs better than an inhaler alone. And for many people a spacer is easier to use than an MDI alone. Using a spacer with inhaled corticosteroids can help reduce their side effects and result in less use of oral corticosteroids.

Taking medicine

Medicine is one of the many tools your doctor has to treat a health problem. Taking medicine as your doctor suggests will improve your health and may prevent future problems. If you don't take your medicines properly, you may be putting your health (and perhaps your life) at risk.

There are many reasons why people have trouble taking their medicine. But in most cases, there is something you can do. For suggestions on how to work around common problems, see the topic Taking Medicines as Prescribed.

Advice for women

If you are pregnant, breastfeeding, or planning to get pregnant, do not use any medicines unless your doctor tells you to. Some medicines can harm your baby. This includes prescription and over-the-counter medicines, vitamins, herbs, and supplements. And make sure that all your doctors know that you are pregnant, breastfeeding, or planning to get pregnant.

It is not known whether inhaled beclomethasone, flunisolide, or fluticasone may be harmful to the fetus of a pregnant woman who has asthma. Budesonide is not expected to harm a fetus. A review of the animal and human studies on the effects of asthma medicines taken during pregnancy found few risks to the woman or her fetus. It is safer for a pregnant woman with asthma to be treated with asthma medicines than for her to have asthma symptoms and asthma attacks.^{footnote 2} Poor control of asthma is a greater risk to the fetus than asthma medicines are.^{footnote 2} If you are pregnant, talk with your doctor but do not immediately stop using your asthma medicine.

It is not known whether inhaled beclomethasone, budesonide, flunisolide, or fluticasone passes into breast milk. Talk to your doctor if you have asthma and are breastfeeding a baby.

Concerns for children

Some parents worry that children who use inhaled corticosteroids may not grow as tall as other children. A very small difference in height and growth was found in children who were using inhaled corticosteroids compared to children not using them.^{footnote 3} And one study showed a very small difference in height [about 0.5 in. (1.3 cm)] in adults who used inhaled corticosteroids as children compared to adults who did not use inhaled corticosteroids.^{footnote 4} But the use of inhaled corticosteroids has important health benefits for children who have asthma. If you are worried about the effects of asthma medicines on your child, talk with your doctor.

One study noted that children who use inhaled corticosteroids do not have an increased risk for broken bones (fractures) compared to those who are not using the medicine. ^{footnote 5}

Try to avoid giving your child an inhaled medicine when he or she is crying, because not as much medicine is delivered to the lungs.

Checkups

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

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