Steroid inhalers

Steroid inhalers are also known as corticosteroid inhalers.

They are used to treat asthma and chronic obstructive pulmonary disease (COPD). They are only available on prescription.

Steroid inhalers are different from the anabolic steroids.

Anabolic steroids are sometimes prescribed by healthcare professionals. They can also be misused by people to increase muscle mass and improve athletic performance.

Read the patient information leaflet that came with the steroid inhaler you were prescribed. It will have specific advice about your medication.

How steroid inhalers work

Steroid inhalers are sometimes called 'preventer inhalers' because they can help prevent your symptoms.

They work by reducing swelling and irritation in the lungs. This helps to gradually ease your breathing problems.

Types of steroid inhalers

Steroid inhalers come as sprays or powders that you breathe in.

Common types include:

  • fluticasone (also called Flixotide or Arquist)
  • beclometasone (also called Beclazone or Becotide)
  • budesonide (also called Pulmicort)

These medicines are sometimes combined with others in a combination inhaler.

Get emergency help

You might have to get emergency help if you're having an asthma attack or an allergic reaction.

If you're having an asthma attack

Do not use a steroid inhaler on its own to relieve an asthma attack, wheezing or breathlessness. Use your reliever (blue) inhaler.

If you or someone else is having an asthma attack you should take immediate action.

Follow the 5 step rule:

  1. Try to stay calm. Sit up straight and do not lie down.
  2. Take slow steady breaths.
  3. Use your reliever inhaler (usually blue) every minute - children aged 6 years and older can take up to 10 puffs in 10 minutes, children under 6 can take up to 6 puffs in 10 minutes.
  4. Call 999 or 112 if your symptoms do not improve after 10 minutes.
  5. Repeat step 3 if an ambulance has not arrived in 10 minutes.

Serious allergic reaction

A serious allergic reaction (anaphylaxis) from steroid inhalers is rare. But you will need to go to an emergency department (ED) if you experience one.

Immediate action required: Call 999 or 112 or go to an ED if:

  • you get a skin rash
  • you're wheezing
  • you get tightness in the chest or throat
  • you have trouble breathing or talking
  • your mouth, face, lips, tongue or throat start swelling

When you start taking steroid inhalers

Always follow the instructions on the medicines label for your steroid inhaler dose.

Normally you will be started on a dose high enough to get your symptoms under control.

If the inhaler is working, talk to your GP about switching to a lower dose that will still control your symptoms.

Keep taking your inhaler even if you feel well.

Talk to your GP if your inhaler does not seem to be working. Do not start using it more often unless you are following a treatment plan that has been approved by your GP.

Immediate action required: Call 999 or 112 or go to an ED if:

  • your breathing suddenly gets worse and your inhaler is not working

This can be life threatening.

Check if you can take steroid inhalers

Most adults and children can take steroid inhalers.

Allergy warning

Do not use a steroid inhaler if you have had an allergic reaction to steroids or other medicines in the past.

Check with a GP that it's safe to use a steroid inhaler if you:

  • have had tuberculosis or other lung infections
  • are taking, or have recently finished steroid tablets
  • have diabetes
  • are pregnant, trying to get pregnant, or breastfeeding

Pregnancy and breastfeeding

Talk to your GP or pharmacist before using a steroid inhaler if you are pregnant or breastfeeding.

Tell your GP about risks of infections

You are more likely to get infections when you're taking any steroid medicine.

Tell your GP if you're exposed to infectious illnesses like chickenpox or shingles.

Steroids makes you more likely to catch infections such as:

Tuberculosis (TB) may also recur.

Keep away from people with an infectious disease, especially chickenpox or shingles. If you have never had these illnesses, they could make you very ill.

How and when to take it

There are several types of inhaler that are used in different ways.

Your GP, nurse or pharmacist will show you how to use your inhaler. Ask them to watch you using it if you’re unsure about doing it correctly.

The Asthma Society of Ireland website has videos explaining how to use the different types of inhaler.

You'll usually need to take 1 or 2 puffs from your inhaler in the morning and 1 or 2 puffs in the evening.

Rinse your mouth out with water and spit it out or brush your teeth after using your inhaler. Rinsing your mouth will reduce the risk of getting oral thrush.

Food and alcohol

You can usually drink alcohol while using a steroid inhaler and you should be able to eat most foods.

Do not smoke as this can make your medicine less effective and your symptoms worse.

If you forget to take a dose

Take your missed dose as soon as you remember, unless it's nearly time for the next dose. In this case, skip the missed dose and take your next dose as normal.

Do not take a double dose to make up for a forgotten dose.

If you often forget doses, it may help to set a reminder alarm.

If you take too much

Taking too many puffs from a steroid inhaler is unlikely to be harmful if it's a one-off.

Using your inhaler too much over a long period is more likely to give you side effects.

Stopping treatment

Do not stop using your inhaler unless your GP tells you to.

This can help avoid unpleasant withdrawal symptoms such as:

Side effects of steroid inhalers

Talk to your GP or pharmacist if these side effects bother you or do not go away:

  • white patches or redness in the mouth
  • a sore mouth or throat
  • a hoarse or croaky voice
  • a cough
  • nosebleeds

If you're taking a high dose or using an inhaler for a long time, you may get similar side effects to those from steroid tablets.

These include increased appetite, mood changes and difficulty sleeping.

Interactions with other medicines

Some medicines can interfere with the way steroid inhalers work.

Tell your GP if you're taking other medicines:

  • for HIV, such as ritonavir or cobicistat
  • for fungal infections, such as ketoconazole
  • for asthma or COPD, such as bronchodilators or other corticosteroids in tablet form

Also tell a GP or pharmacist if you take any other medicines, including herbal remedies and supplements, before starting to use a steroid inhaler.

Finding your patient information leaflet online

Your patient information leaflet (PIL) is the leaflet that comes in the package of your medicine. 

Information:

To find your PIL online, visit the Health Products Regulatory Authority (HPRA) website

  1. In the ‘Find a medicine’ search box, enter the brand name of your medicine. A list of matching medicines appears.
  2. To the right of your medicine, select ‘PIL’. A PDF of the PIL opens in a new window. 

You can also:

  1. Select the brand name of your medicine.
  2. Scroll down to the Documents section.
  3. From the Package Leaflet line, select PDF version. A PDF of the PIL opens in a new window. 

If your PIL is not on the HPRA website, the European Medicines Agency (EMA) website opens in a new window when you select ‘PIL’.

You can find your PIL on the EMA website.

Finding your PIL on the EMA website

If your PIL is not on the HPRA website, you will be sent to the European Medicines Agency (EMA) website.

To find your PIL on the EMA website:

  1. In the Medicines search box, enter the brand name of your medicine and the word ‘epar’. For example: ‘Zoely epar’. A list of matching medicines appears.
  2. Select the ‘Human medicine European public assessment report (EPAR)’ for your medicine
  3. From the table of contents, select Product information.
  4. Select the EPAR – Product Information link for your medicine. A PDF opens in a new window. The PIL information is in Annex III of the PDF under ‘labelling and package leaflet’

This content was fact checked by a pharmacist, a GP, the National Medication Safety Programme (Safermeds) and the Health Products Regulatory Authority (HPRA).

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This project has received funding from the Government of Ireland’s Sláintecare Integration Fund 2019 under Grant Agreement Number 123.

Page last reviewed: 24 September 2021
Next review due: 24 September 2024

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