Inhaledcorticosteroids(ICS), also known as inhaled steroids, are the most potent anti-inflammatory controller medications available today for asthma control and are used to decrease the frequency and severity of asthma symptoms. They are the current mainstay of treatment once a person with asthma needs a higher level of care than arescue inhaler(bronchodilator).
Inhaled corticosteroids help prevent chronic asthma symptoms such as:
You and your physician may want to consider inhaled corticosteroids if any of the following apply:
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Types
Commonly inhaled corticosteroids or combination drugs that contain a steroid include the following. Which may be best for you depends on several factors, including the severity of your asthma and your overall health.
*Indicates corticosteroid component
These medications can be delivered via three different devices:
How They Work
Efficacy
Generally, inhaled corticosteroids are used for long-term treatment of asthma in people of all ages who require daily management. They are effective in preventing asthma attacks butrequire daily use in regularly spaced dosesin order to be effective.
While not all people respond similarly to inhaled corticosteroids, they have been found to improve a number of important asthma outcomes such as:
Side Effects
Overall, the risks associated with inhaled corticosteroids are very low, but there are several things you can do to mitigate them.
Local Side Effects
Thrush (oral candidiasis)is one of the most common side effects of ICS, affecting up to a third of people using them. It almost always seems to occur as a result of ICS being delivered to the side of the mouth and throat, making proper administration technique very important.
Lowering the dosage, using a spacer (a chamber inserted between the inhaler and your mouth), and appropriately rinsing your mouth following inhalation all help lower your risk of thrush. Thrush can also be treated with topical or oral antifungals, such as nystatin.
Other local side effects can include:
Systemic Side Effects
While uncommon, a number of systemic (body-wide) effects can occur with inhaled corticosteroids. Generally, there is a higher risk with higher doses. Potential side effects include:
A Word From Verywell
While inhaled corticosteroids improve asthma control more effectively than any other agent used as a single treatment, it is important to note that these drugs cannot relieve an asthma attack already in progress. A rescue inhaler is still needed for those situations.
9 Sources
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Shroff S, Thomas RK, D’souza G, Nithyanandan S.The effect of inhaled steroids on the intraocular pressure.Digit J Ophthalmol. 2018;24(3):6-9. doi:10.5693/djo.01.2018.04.001
National Heart, Lung, and Blood Institute.Expert Panel Report 3 (EPR3): Guidelines for the Diagnosis and Management of Asthma.
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