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Inhaled Corticosteroid Treatment

If you have chronic asthma, you may benefit from long term use of inhaled corticosteroids such as Pulmicort Turbuhaler®, Advair®, Azmacort®, QVAR®, Flovent®, Aerobid® and others. A recent expert panel report by the National Heart, Lung, and Blood Institute supported the long term use of inhaled corticosteroids for asthma because of their potent anti-inflammatory effects and ability to reduce airway hyper-responsiveness. Increasing evidence also shows that corticosteroids may prevent or slow down permanent remodeling of the airway. This may be particularly true in young children with asthma. Because inhaled corticosteroids are directly applied to the inflamed bronchial tubes, only small amounts are usually needed to achieve the desired anti-asthmatic effect. In addition, inhaled corticosteroids are rapidly metabolized into inactive substances and therefore are usually safer than oral corticosteroids. However if these inhaled corticosteroids are used at doses greater than recommended, you could experience significant side effects. Inhaled corticosteroids work slowly and therefore are not an appropriate form of treatment for acute asthma when there is immediate need to relieve airway obstruction. Many individuals with chronic asthma may be controlled on inhaled corticosteroids without the need to use oral corticosteroids. Inhaled treatment, if used properly, offers the anti-inflammatory benefit of corticosteroids with minimal risks of significant systemic side effects.

Inhaled Corticosteroids
Brand Name Active Ingredient
Advair Diskus® 100/50 
fluticasone 100mcg
salmeterol 50mcg
Advair Diskus® 250/50 fluticasone 250mcg
salmeterol 50mcg
Advair Diskus® 500/50 fluticasone 500mcg
salmeterol 50mcg
Aerobid® Inhaler System flunisolide 250mcg
Aerobid-M® Inhaler System flunisolide 250mcg
Asmanex® Twisthaler mometasone
Azmacort® Inhalation Aerosol triamcinolone 100mcg
Flovent® 44mcg fluticasone 44mcg
Flovent® 110mcg fluticasone 110mcg
Flovent® 220mcg fluticasone 220mcg
Flovent® Diskus® (not yet released in US) fluticasone
Flovent® Rotadisk® fluticasone 50mcg,
100mcg, or 250mcg
Pulmicort Turbuhaler® Inhalation Powder budesonide 200mcg
Pulmicort Respules® Nebulizer Solution budesonide 0.25mg/2mL
Pulmicort Respules® Nebulizer Solution budesonide 0.5mg/2mL
Nebulizer Solution  
Symbicort® Turbuhaler®*  (not yet released) budesonide/formoterol
QVAR® 40 beclomethasone 40mcg
QVAR® 80 beclomethasone 80mcg
* Combination medication - includes corticosteroid plus long acting sympathomimetic bronchodilator.

The Asthma Center specialists recommend rinsing your throat (gargling with water) after using inhaled corticosteroids to avoid sore throats, yeast infections and hoarseness. One of the most annoying side effects of inhaled corticosteroids is the development of a yeast infection in the back of the throat or on the tonsils, referred to as "thrush" (monilia or candida - a fungal infection). Yeast often looks like a white creamy or cheesy coating on the back of the throat or tonsils. Using a spacer device or just rinsing your throat with water after using corticosteroid inhalers may be effective in preventing this problem. However once thrush has been diagnosed, treatment with anti-fungal agents is usually effective in controlling this side effect.

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