The growth of children and adolescents receiving orally inhaled corticosteroids, including QVAR, should be monitored routinely (., via stadiometry). If a child or adolescent on any corticosteroid appears to have growth suppression, the possibility that he/she is particularly sensitive to this effect should be considered. The potential growth effects of prolonged treatment should be weighed against clinical benefits obtained and the risks associated with alternative therapies. To minimize the systemic effects of orally inhaled corticosteroids, including QVAR, each patient should be titrated to his/her lowest effective dose [see Dosage and Administration ( )] .
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.