Inhaled glucocorticoids (also called inhaled corticosteroids or ICS) have fewer and less severe adverse effects than orally-administered glucocorticoids, and they are widely used to treat asthma and chronic obstructive pulmonary disease (COPD) [ 1 ]. However, there are concerns about the systemic effects of ICS, particularly as they are likely to be used over long periods of time, in infants, children, and older adults [ 2,3 ]. The safety of ICS has been extensively investigated since their introduction for the treatment of asthma 30 years ago [ 4-9 ].
The aim of this article is to bring less well recognised adverse effects of inhaled corticosteroids to the attention of prescribers. Whilst inhaled steroids have a more favourable side effect profile than systemic steroids, they are not free from adverse effects. The dose of inhaled steroids used should be carefully monitored, and kept at the lowest dose necessary to maintain adequate control of the patient’s disease process. Be particularly aware of the cumulative effect of co-prescribing various dose forms of corticosteroids (inhaled, intranasal, oral and topical preparations).