The following reporting rates of common adverse experiences are based upon 4 clinical trials in which 1196 patients (671 female and 525 male adults previously treated with as-needed bronchodilators and/or inhaled corticosteroids) were treated with QVAR (doses of 40, 80, 160, or 320 mcg twice daily) or CFC-BDP (doses of 42, 168, or 336 mcg twice daily) or placebo. Table 3 below includes all events reported by patients taking QVAR (whether considered drug related or not) that occurred at a rate over 3% for QVAR. In considering these data, difference in average duration of exposure and clinical trial design should be taken into account.
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 ].
Also, when given in very large doses (many puffs from a high-concentration steroid inhaler), the amount of steroid medicine that spills over into the bloodstream can become significant. Although the effect is small, like a very small dose of prednisone, over the years this small effect can potentially add up to serious harmful effects. High doses of inhaled steroids taken for a long time can probably predispose to cataracts, glaucoma, and thinning of the skin and bones. As a result, your doctor will probably only have you take high doses of inhaled steroids as a means to avoid steroid tablets. And he/she will constantly work with you to attempt to reduce the dose of inhaled steroids to a more conventional and safer range.