When used in high doses, a small amount of the medication is absorbed into the bloodstream and some side effects beyond the mouth and throat may develop. The most likely to be encountered are easy bruisability of the skin and suppression of the adrenal glands. The significance of adrenal gland suppression is discussed in further detail in the pamphlet entitled Asthma and Steroids in Tablet Form , prepared by the Partners Asthma Center. The risk from the long-term use of inhaled steroids in terms of hastening thinning of the bones (osteoporosis) is currently being studied. However, it is widely agreed that any risk that may be discovered will be far less than that resulting from use of steroids in tablet form in doses needed to achieve the same control of asthma.
Great question! Unfortunately, there are side effects to taking steroids – inhaled or oral. However, the risk of suppressing the immune system with inhaled corticosteroids is far less than with the use of systemic steroids.
For a person with asthma, inhaled steroids are an important part of treatment. They reduce the airway inflammation that is the hallmark of asthma. So, when prescribing inhaled steroids most doctors weigh carefully the benefits vs. the risks. Most likely you’re on the lowest possible dose for the severity of your asthma – enough to treat the inflammation and avoid exacerbations. One of the benefits of inhaled steroids is that they are being delivered directly to the area needed, which is one of the reasons a much lower dosing can be used with far less side effects. In fact, it takes about a year of inhaled steroids to equal a 5 day course of oral steroids prescribed during an exacerbation .
Discuss whether a change in controller medication or decrease in the dose or strength of the inhalant would be an option. Some health experts have reported a reduction in hoarseness after backing down the dose, but this is not always effective. There is a particular inhaled steroid which is inactive until it reaches the surface of the lung (after inhalation). It seems to be an ideal inhalant for people who have adverse effects which are localized to the throat or tongue. The brand name of this unique inhaled steroid is Alvesco. It is only available by prescription. Unfortunately no currently available steroid based inhaler, (including Alvesco) eliminates the risk of dysphonia. One study referenced below suggested reduced risk with some dry powder inhalers.