Steroid inhalers are anti-inflammatory sprays or powders that you breathe in. They are also called corticosteroid inhalers.
They are used to treat asthma and chronic obstructive pulmonary disease (COPD). They are only available on prescription.
Common types include:
- fluticasone (also called Flixotide)
- beclometasone (also called Beclazone or Becotide)
- budesonide (also called Pulmicort)
Steroids also come in a mixed inhaler with other medicines such as bronchodilators. Mixed or combination inhalers are only available on prescription.
Read the patient information leaflet that came with the steroid inhaler you were prescribed. It will have specific advice about your medication.
Non-urgent advice: Find your patient information leaflet
Your patient information leaflet is the leaflet that comes with your medicine. You can find a digital version of the leaflet online.
Steroid inhalers are different from anabolic steroids.
Anabolic steroids are sometimes prescribed for a limited number of medical conditions. They can also be misused by people to increase muscle mass and improve athletic performance.
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 ease your breathing problems.
Check if you can take steroid inhalers
Most adults and children can take steroid inhalers.
They may not be suitable for you if you:
- have or have ever had tuberculosis (TB) or have a lung infection
- are taking, or have recently finished taking steroid tablets
- have diabetes
- are pregnant, trying to get pregnant or are breastfeeding
Important
Do not use a steroid inhaler if you have had an allergic reaction to steroids or other medicines in the past.
When you start taking steroid inhalers
Always follow the instructions on the medicine 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. It will only stop your symptoms if it's used every day.
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.
How and when to take steroid inhalers
There are several types of inhaler that are used in different ways.
Your breathing may improve within 2 days. But it can take up to 4 weeks for the steroid inhaler to have its full effect.
You'll usually need to take 1 or 2 puffs from your inhaler in the morning and 1 or 2 puffs in the evening.
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.
Rinse your mouth out with water or brush your teeth after every use of your inhaler. Rinsing your mouth will reduce the risk of getting oral thrush.
Techniques for using inhalers - asthma.ie
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 not likely to be harmful if it's a one-off. Speak to your GP or a pharmacist if you're worried.
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. When you stop your treatment, you may need to reduce your dose gradually.
This can help avoid withdrawal symptoms such as:
- severe tiredness
- joint pain
- vomiting
- dizziness
- losing your appetite
- mood changes
- difficulty sleepingSide effects of steroid inhalers
Steroid inhalers usually cause few or no side effects if used correctly and at low doses.
Common side effects of taking steroid inhalers include:
Oral thrush
Oral thrush is a fungal infection that causes white patches, redness and soreness in your mouth.
Try rinsing your mouth with water or brushing your teeth immediately after using your inhaler to stop this happening.
Ask a pharmacist to recommend a suitable treatment such as an antifungal mouth gel. They may suggest that you see your GP to discuss the best treatment.
Keep using your steroid inhaler while using any antifungal treatment.
Dry or sore throat, or hoarse voice
Try rinsing your mouth with water or brushing your teeth after using your inhaler to stop this happening.
Keep taking your steroid inhaler but talk to your GP or pharmacist if these side effects bother you or do not go away.
If you are taking a higher dose of a steroid inhaler for a long time (more than a few months), you may get similar side effects to those from steroid tablets.
These include increased appetite, mood changes and difficulty sleeping.
If you have a serious allergic reaction
A serious allergic reaction from steroid inhalers is rare.
Emergency action required: Call 999 or 112 or go to an emergency department (ED) if:
- you get a rash
- you're wheezing
- you get tightness in your chest or throat
- you have trouble breathing or talking
- your mouth, face, lips, tongue or throat start swelling
Emergency action required: Call 999 or 112 or go to an emergency department (ED) if:
- your breathing suddenly gets worse and your inhaler is not working
This can be life threatening.
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 or bronchodilator inhaler (usually blue) like salbutamol.
What to do if you have an asthma attack
See the patient information leaflet that comes with your medicine for a full list of side effects.
Non-urgent advice: Find your patient information leaflet
Your patient information leaflet is the leaflet that comes with your medicine. You can find a digital version of the leaflet online.
Report side effects
You can report any suspected side effects to the Health Products Regulatory Authority (HPRA): report an issue - hpra.ie
Steroid inhalers and other medicines
Tell your GP or pharmacist if you are taking any other medicines.
This includes:
- herbal remedies or supplements
- medicines for HIV, such as ritonavir or cobicistat
- medicines for fungal infections, such as ketoconazole
- medicines for asthma or COPD, such as bronchodilators or corticosteroid tablets
Some medicines can affect the way steroid inhalers work.
Food, alcohol and smoking
You can usually drink alcohol and eat most foods while using a steroid inhaler.
Do not smoke as this can make your medicine less effective and your symptoms worse.
Fact check
This content was fact checked by a pharmacist, a GP, the National Medication Safety Programme (Safermeds) and the Health Products Regulatory Authority (HPRA).
