Inhaled corticosteroids (ICS) are one of the most effective medicines used to treat recurrent or chronic asthma. They are designed to reduce inflammation in the bronchial tubes of individuals with asthma. ICS work by turning off the lung’s production of mediators that cause inflammation, swelling, mucous production, and eventual constriction or blockage of the medium to small airways in the lungs.
When taken regularly, they will even decrease bronchial “hyper-reactivity”, or the tendency for the bronchial tubes of asthmatic patients to spasm or constrict when exposed to allergens or irritants.
Inhaled corticosteroids are available in a meter dose inhaler (MDI or “puffer”) form, a dry powder inhaler, or as a nebulized medication.
Because inhaled corticosteroids are preventative, or prophylactic, they should be taken daily and over long periods of time, exactly as prescribed by your physician. Most inhaled corticosteroids are dosed once or twice daily. Patients can usually expect to see results from ICS within one to two weeks. These medications should not be used for acute or sudden onset of asthma symptoms.
Your physician or nurse will direct you or your child in proper inhaler on nebulizer technique. For young children, a spacer device (aerochamber or Inspirease) may be recommended to help facilitate delivery of medication to the lungs. All patients should rinse their mouth and throat out with water or mouthwash after using these medications in order to prevent minor side effects, such as oral thrush.
In general, inhaled corticosteroids are considered quite safe. Because the medicine is inhaled directly into the lungs, resulting in minimal systemic absorption, and the fact that the dose delivered is so small, steroid side effects are minimized. The most common adverse effects include sore throat, hoarse or husky voice, and thrush (yeast infection of the throat). Rinsing thoroughly after each use will minimize the likelihood of these side effects.
High dose and long term use of medications in the steroid family may affect bone growth, the density or strength of bones, and promote the growth of cataracts. Patients on high doses of inhaled corticosteroids should have their growth monitored (for children), as well as bone density testing eye exams periodically.
For the overwhelming majority of children who are on inhaled corticosteroids for asthma and/or nasal steroids for rhinitis, or nasal disease, height will not be affected. There is some evidence that children on inhaled corticosteroids may actually have some decrease in growth velocity in the first year of treatment. However, other studies of large numbers of children have shown that with years of inhaled corticosteroid use, expected final adult height was attained.