3 Corticosteroids for Respiratory Conditions
Understand how inhaled and systemic corticosteroids are used for asthma and COPD, how their benefits and risks differ, and what safe use and follow-up involve.
How inhaled corticosteroids support control
Corticosteroids reduce airway inflammation. , including budesonide, fluticasone, and beclomethasone, deliver medicine mainly to the lungs and are used for long-term asthma control. They help prevent symptoms and exacerbations, so prescribed daily use remains important even when a person feels well or symptoms are controlled.
An ICS used alone generally does not provide immediate relief during an attack and is not a rapid-relief bronchodilator. Some prescribed ICS–formoterol combination inhalers can also be used as relievers; patients should follow their specific treatment plan.
In COPD, ICSs are maintenance treatment for selected patients, typically as part of combination therapy. They are not a universal treatment for everyone with COPD.
Using inhaled corticosteroids safely
Rinsing the mouth with water and spitting it out after an inhaled dose helps reduce medicine remaining in the mouth and throat. A spacer can also reduce local deposition when it is appropriate for the inhaler device.
Possible local effects include (thrush) and hoarseness. If these symptoms occur, patients should seek advice rather than stopping prescribed treatment on their own.
During ongoing treatment in children, monitor growth as directed by the healthcare provider. Correct inhaler technique, following the prescribed plan, and using the lowest dose that maintains control help balance benefit and risk. High doses or prolonged use of inhaled corticosteroids can also have systemic effects.
When are used
, such as oral prednisone, act throughout the body. They may be prescribed for significant asthma flare-ups and moderate-to-severe COPD exacerbations. For moderate or severe COPD exacerbations, the cited GOLD guidance recommends for up to five days.
are usually used for a limited course because risks increase with greater dose and duration. They can raise blood glucose, increase infection risk, suppress adrenal function, and contribute to bone loss, among other effects. Osteoporosis and elevated blood glucose are concerns with prolonged or repeated systemic treatment compared with usual low-dose inhaled corticosteroid use.
do not replace ongoing maintenance treatment after an exacerbation unless the prescriber changes the plan.
Avoiding abrupt withdrawal
Prolonged systemic corticosteroid use can suppress the body's own steroid production. Abruptly stopping long-term treatment may cause , even if breathing has improved. Patients should follow the prescriber's plan and should not stop prolonged treatment abruptly without medical advice; a clinician should direct dose reduction or transition to another treatment.