How do corticosteroid inhalants work?
Corticosteroid inhalants are orally inhaled medications for the prevention and maintenance treatment of asthma and chronic obstructive pulmonary disease (COPD). Corticosteroid inhalants are powerful anti-inflammatory agents that prevent inflammation of the airway, relieve symptoms of asthma and COPD, and ease breathing.
Inhaled corticosteroids have an effect on many types of immune cells such as mast cells, eosinophils, basophils, lymphocytes, macrophages, and neutrophils in the airway. Corticosteroids prevent immune cells from releasing pro-inflammatory substances such as histamine, leukotrienes, cytokines, and eicosanoids, which are associated with asthma attacks.
Corticosteroid inhalants may be used as monotherapy or may be combined with other medications when asthma is not adequately controlled with corticosteroids alone. Medications combined with corticosteroid inhalants help:
- Relax bronchial smooth muscles
- Inhibit hypersensitivity reactions in the bronchial passage
- Reduce mucus secretion in the respiratory system
- Improve lung function
Medications combined with corticosteroid inhalants include:
- Long-acting beta2 agonists (LABAs): LABAs enhance the activity of beta-2 adrenergic receptors, protein molecules on cell surfaces that are stimulated by epinephrine, a natural hormone in the body. LABAs relax bronchial muscles and inhibit hypersensitivity reactions from mast cells, a type of immune cells that initiate allergic reactions.
- Long-acting muscarinic antagonists (LAMA): LAMAs block the activity of muscarinic receptors which make muscles contract in response to acetylcholine, a chemical that nerve endings secrete. LAMAs relax bronchial smooth muscles, reduce mucus secretion in the respiratory system and improve lung function.
How are corticosteroid inhalants used?
Corticosteroid inhalants are administered as oral inhalations in the form of powders, aerosolized tiny particles or droplets, or solutions nebulized into a fine mist. Many types of inhalation devices such as metered dose inhalers and nebulizers are available on prescription.
Corticosteroid inhalants are used in the treatment of the following conditions:
FDA-approved:
- Long term maintenance treatment and exacerbations of chronic obstructive pulmonary diseases include:
- Prevention and maintenance treatment of chronic asthma, an inflammatory bronchial condition
Orphan designation:
- Eosinophilic esophagitis, an allergic inflammatory disease of the esophagus
What are side effects of corticosteroid inhalants?
Side effects of corticosteroid inhalants may include the following:
- Headache
- Upper respiratory tract infection/inflammation
- Pharyngitis (throat inflammation)
- Nasopharyngitis (inflammation of nose and throat)
- Rhinitis/allergic rhinitis (inflammation of the nasal passage)
- Epistaxis (nasal bleeding)
- Nasal congestion
- Nasal discharge
- Throat irritation
- Viral upper respiratory tract infection
- Cough
- Sinusitis (inflammation of the sinuses)
- Sinus infection
- Laryngitis (inflammation of the larynx)
- Aphonia (speech difficulty due to damage to the larynx)
- Bronchitis (inflammation of bronchial passage)
- Exacerbation of asthma symptoms
- Dyspnea (shortness of breath)
- Wheezing
- Immediate and paradoxical bronchospasm
- Pneumonia
- Oropharyngeal pain (mouth and throat pain)
- Dysphonia (hoarseness)
- Oral candidiasis (Candida yeast infection)
- Oropharyngeal candidiasis
- Esophageal candidiasis
- Otitis media (middle ear inflammation/infection)
- Ear pain
- Toothache
- Dental caries
- Tooth discoloration
- Fatigue or malaise
- Musculoskeletal pain
- Muscle injury
- Muscle soreness
- Muscle spasms
- Muscle stiffness and rigidity
- Back pain
- Arthralgia (joint pain)
- Pain in extremities
- Pyrexia (fever)
- Influenza
- Dizziness
- Migraine
- Vomiting
- Viral gastroenteritis
- Abdominal pain or discomfort
- Dyspepsia (indigestion)
- Diarrhea
- Constipation
- Procedural pain
- Facial edema
- Urticaria (hives)
- Conjunctivitis (inflammation of the conjunctiva, the membrane on the whites of the eyes and the inner surface of eyelids)
- Dysmenorrhea (painful menstruation)
- Dysgeusia (taste disorder)
- Loss of taste
- Reduced salivation
- Dry mouth
- Blurred vision
- Cataracts
- Glaucoma (an eye condition that damages the optic nerve)
- Central serous chorioretinopathy (fluid buildup under the retina which can lead to retinal detachment and vision loss)
- Urinary tract infection
- Urinary retention
- Anxiety
- Agitation
- Restlessness
- Nervousness
- Aggression
- Depression
- Sleep disorders
- Insomnia
- Behavioral changes such as hyperactivity and irritability primarily in children (rare)
- Suicidal ideation (primarily in children)
- Abnormal behavior
- Tremor
- Palpitations
- Chest pain and tightness
- Angina pectoris (chest pain due to coronary heart disease)
- Tachycardia (rapid heartbeat)
- Cardiac arrhythmias (irregular heartbeats) such as:
- Supraventricular tachycardia (rapid heart rate beginning above the ventricles)
- Supraventricular extrasystoles (extra heartbeats)
- Atrial fibrillation (irregular and rapid heart rate with the atria out of synchronization with the ventricles)
- Allergic reactions such as:
- Rash
- Urticaria (hives)
- Pruritus (itching)
- Angioedema (swelling in the tissue under the skin or mucous membranes)
- Anaphylaxis (severe allergic reaction)
- Hyperglycemia (high blood glucose levels)
- Weight gain
- Immunosuppression and risk of infections
- Viral skin infections
- Ecchymosis (bruising)
- Reduction in bone mineral density (osteoporosis)
- Soft tissue injuries
- Contusions
- Symptoms of systemic glucocorticoid steroid effects such as adrenal suppression and hypercortisolism/Cushing syndrome
- Cushingoid features (facial roundness and fat accumulation in midsection and upper back due to Cushing syndrome)
- Growth velocity reduction in children and adolescents
- Systemic eosinophilic conditions with features of vasculitis (blood vessel inflammation) consistent with Churg-Strauss syndrome (rare)
Information contained herein is not intended to cover all possible side effects, precautions, warnings, drug interactions, allergic reactions, or adverse effects. Check with your doctor or pharmacist to make sure these drugs do not cause any harm when you take them along with other medicines. Never stop taking your medication and never change your dose or frequency without consulting your doctor.
What are names of some corticosteroid inhalant drugs?
Generic and brand names of corticosteroid inhalant drugs include:
- Alvesco
- ArmonAir Digihaler
- Arnuity Ellipta
- Asmanex HFA
- Asmanex Twisthaler
- beclomethasone, inhaled
- Breo Ellipta
- Breztri
- budesonide inhaled
- budesonide/formoterol/glycopyrrolate inhaled
- ciclesonide inhaled
- Flovent Diskus
- Flovent HFA
- fluticasone furoate inhaled
- fluticasone inhaled
- mometasone inhaled
- Pulmicort Flexhaler
- Pulmicort Respules
- Qvar RediHaler
- Trelegy Ellipta
- umeclidinium bromide/vilanterol inhaled/fluticasone furoate inhaled
- vilanterol/fluticasone furoate inhaled
