Common Questions About Corticosteroids
Q: What is a corticosteroid?
A: A corticosteroid is a type of drug that reduces inflammation of the airways. These medications are inhaled to prevent symptoms rather than treat flare-ups. When used in this way, they are called long-term-control medicines. People take them every day, even when they feel fine. For the drug to work, you need to take it exactly as your health care provider tells you to.
In some cases, this type of drug may be given by mouth as a tablet or liquid for flare-ups, or occasionally as an intravenous medication or intramuscular injection when symptoms are more severe. This strategy is to get asthma under control quickly and stop flare-ups from happening again.
Q: Will inhaled corticosteroids stop an asthma attack that is under way?
A: No. It is important that anyone with asthma have a short-term bronchodilator inhaler ("reliever") available to provide immediate relief of flare-ups.
Q: Is it unusual for a provider to change my dose?
A: No. In fact, the National Asthma Education and Prevention Program’s Guidelines for the Diagnosis and Management of Asthma recommend a “stepwise” approach to asthma care. This means that your provider should adjust your medicine, stepping it up or down, depending on how you are feeling. The goal is to find the lowest dose that you need to control your asthma. Never adjust your dose without talking with your provider.
Q: Do corticosteroids have side effects?
A: As is the case with many medicines, corticosteroids can cause side effects in some people. Serious side effects are rare. Inhaled corticosteroids can cause thrush, a superficial yeast infection in the mouth that is easily treated with anti-yeast lozenges or solutions. By mouth, corticosteroids can cause heartburn and should be taken with food. Some people may be instructed to take over-the-counter anti-acid medications with their corticosteroid. People with diabetes will need to watch their blood sugar carefully when on corticosteroids in pill form, because these medications can raise blood sugar levels. Some people may have mood changes on corticosteroids when given in pill or intravenous or intramuscular form. The long-term use of corticosteroids in pill form or by intramuscular injection can affect the bones, increasing the tendency for bone thinning (osteoporosis). Whenever you notice side effects, even if they are mild, always tell your provider. Even though they have side effects, corticosteroids are often the most effective treatment for a significant asthma flare-up. They can nip such flare-ups in the bud, and so prevent prolonged asthma flares.
Q: Is it safe to take corticosteroids during pregnancy?
A: Although there is no absolute proof that any medicine is entirely safe during pregnancy, inhaled corticosteroids are the first drug choice for controlling asthma inflammation while pregnant. Your provider may suggest an oral form if your asthma is severe.
The National Asthma Education and Prevention Program's guidelines for asthma care during pregnancy emphasize how important it is for the mother and baby to get the mother’s asthma under control. The guidelines offer reassurance when it comes to using asthma medicine.
Research shows that the risk of leaving asthma untreated is more dangerous than any proven risk of taking most asthma medicines. In fact, mothers who do not control their asthma while pregnant can put a developing baby at increased risk for serious health problems or even death.