Inhaled Steroids and Asthma
Adverse Side Effects from Inhaled Steroids
The Risk of Glaucoma with Inhaled Steroids
Learn more about steroid medications, their uses, and complications.
Inhaled Steroids and Asthma
Inhaled steroids are now considered the cornerstone of asthma
treatment. The National Institutes of Health released its updated
version of the Expert Panel Report on the Guidelines for the Diagnosis
and Treatment of Asthma in 2007. This report strongly supports the
use of inhaled steroids to reduce and prevent asthma symptoms in people
with moderate to severe asthma.
Adverse Side Effects from Inhaled Steroids
The use of high dose inhaled steroids has reduced the need for long
term oral steroids in many asthma patients. Doctors have known for many
years that long term use of oral steroids (available in tablet or
liquid form) has been associated with a greater risk for glaucoma,
cataracts and other side effects and they regularly monitor for these
adverse effects. Because inhaled steroids are given in small doses
directly to the airways and are much less available to the rest of the
body, they have a much lower risk for systemic side effects than oral
steroids. There are a number of preparations available in different
strengths that can be prescribed in a range of low to high doses.
At this time, there is only limited information on adverse side
effects from inhaled steroids, especially with higher doses. However,
as with any medicine, there is a concern for the potential of adverse
effects. Physicians should identify patients who have a greater risk
for side effects and use the lowest dose of medicine needed to control
the disease. In addition, a number of asthma medicines are available
which may be used to reduce the need for high dose inhaled steroids for
many patients.
The Risk of Glaucoma with Inhaled Steroids
There has been a recent report raising concerns about the use of
high dose inhaled steroids and an increased risk of developing ocular
hypertension or glaucoma. Ocular hypertension is high pressure within
the eye that can possibly result in partial or complete loss of vision.
A recent study reviewed patients over 65 years of age who were referred
to an eye specialist and included patients who were taking higher
doses of inhaled steroids, including higher than recommended doses. A
high dose inhaled steroid was defined as a daily dose exceeding 1500
mcg per day. This is calculated by taking the dose per inhalation for
the specific inhaled steroid and multiplying that by the number of
inhalations a person takes per day.
The study showed that patients who were on high dose inhaled
steroids for longer than three months had a higher risk for developing
glaucoma. This study points out that caution should be used with long
term use of high dose inhaled steroids in elderly patients. It is
important to note, however, that the risk for glaucoma overall
increases with age due to the aging process. The study implies that
high dose inhaled steroids should be used cautiously in patients who
already have glaucoma. It is reassuring that this study noted that
people who were taking low to moderate doses of inhaled steroids were
not at greater risk for glaucoma.
It is important to remember that many people require routine inhaled
and occasional oral steroids to control their asthma. Good asthma
control is crucial and inhaled steroids play a major role in asthma
management. If you are taking a high dose of an inhaled steroid for
more than three months, you may benefit by receiving care from or
consulting an asthma specialist. An asthma specialist is experienced
with the current asthma medicines, how to adjust the dose of these
medicines for their best effect and when to monitor for side effects.
Please talk to your doctor about any concerns you may have with your
asthma treatment and possible side effects.
Learn more about steroids medications, their uses and complications.
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