Corticosteroids (Inhalation)

Before Using This Medicine

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For inhalation corticosteroids, the following should be considered:

Allergies - Tell your doctor if you have ever had any unusual or allergic reaction to corticosteroids. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy - Although studies in animals have shown that inhaled corticosteroids cause birth defects and other problems, in humans these medicines, when used in regular daily doses during pregnancy to keep the mother's asthma under control, have not been reported to cause breathing problems or birth defects in the newborn. Also, corticosteroids may prevent the effects of poorly controlled asthma, which are known to be harmful to the baby. Before taking an inhaled corticosteroid, make sure your doctor knows if you are pregnant or if you may become pregnant.

Breast-feeding - It is not known whether inhaled corticosteroids pass into breast milk. Although most medicines pass into breast milk in small amounts, many of them may be used safely while breast-feeding. Mothers who are using this medicine and who wish to breast-feed should discuss this with their doctor.

Children - Inhalation corticosteroids have been tested in children and, except for the possibility of slowed growth, in low effective doses, have not been shown to cause different side effects or problems than they do in adults.

Studies have shown that slowed growth or reduced adrenal gland function may occur in some children using inhaled corticosteroids in recommended doses. However, poorly controlled asthma may cause slowed growth, especially when corticosteroids taken by mouth are needed often. Your doctor will want you to use the lowest possible dose of an inhaled corticosteroid that controls asthma. This will lessen the chance of an effect on growth or adrenal gland function. It is also important that children taking inhaled corticosteroids visit their doctors regularly so that their growth rates may be monitored.

Regular use of inhaled corticosteroids may allow some children to stop using or decrease the amount of corticosteroids taken by mouth. This also will reduce the risk of slowed growth or reduced adrenal function.

Children who are using inhaled corticosteroids in large doses should avoid exposure to chickenpox or measles. When a child is exposed or the disease develops, the doctor should be contacted and his or her directions should be followed carefully.

Before this medicine is given to a child, you and your child's doctor should talk about the good this medicine will do as well as the risks of using it. Follow the doctor's directions very carefully to lessen the chance that unwanted effects will occur.

Older adults - Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults. Although there is no specific information comparing use of inhaled corticosteroids in the elderly with use in other age groups, this medicine is not expected to cause different side effects or problems in older people than it does in younger adults.

Other medicines - Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your health care professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine.

Other medical problems - The presence of other medical problems may affect the use of inhaled corticosteroids. Make sure you tell your doctor if you have any other medical problems, especially:

• Cirrhosis (liver disease) - The effect of inhaled corticosteroids may be stronger in patients with this disease
• Glaucoma - Use of this medicine may cause the pressure in the eye to be increased
• Hypothyroidism (decreased production of thyroid hormone) - The effect of inhaled corticosteroids may be stronger in patients with this condition
• Infections, untreated - Using this medicine while an infection is present and is not being treated may cause the infection to get worse.
• Osteoporosis (bone disease) - Inhaled corticosteroids in high doses may make this condition worse in women who are past menopause and who are not receiving an estrogen replacement

• Tuberculosis (history of) - Use of this medicine may cause a tuberculosis infection to occur again