Asthma side effects

Questions

Answers to your questions


Can asthma itself cause “side effects”?
Many people focus on the side effects of treatment so much that they forget that poorly treated asthma can also cause ‘side effects’. Apart from the (fortunately low) risk of dying from asthma, there is also a risk that lung function will deteriorate over the years and that you will become disabled by chronic asthma as you age. Children with poorly treated asthma do not grow properly and pregnant women with poorly controlled asthma have a higher risk of complications, for example poor growth or death of the unborn baby.


Can tiredness and forgetfulness be caused by my asthma medication?
No, but if you are not sleeping well because you have poorly treated asthma, you can become tired and forgetful.

Theophylline and related medications can also adversely affect your sleep and may therefore make you feel tired indirectly. If you suspect something like this, discuss it with the doctor who treats your asthma.

The older antihistamines can make you feel drowsy. If you use these medications for hay fever or other allergies and feel tired, you should talk to your doctor about possible alternative medications. If you are allergic to pollen, it is also possible that this causes you to feel tired during the pollen season.


Do inhaled corticosteroids cause any long-term side effects?
As with most medications, inhaled corticosteroids may have side effects in some people.

The most common side effect is a fungal infection in the mouth (oral candidiasis). This is easily treated, and can be prevented by rinsing the mouth after inhalation or sometimes by changing your inhalation technique. Inhaled corticosteroids do not cause fungal (or other) infections in the lungs.

Some people find that their voices become husky after using an inhaled corticosteroid. This usually passes when the dose is lowered, but the hoarseness can sometimes prevent further treatment.

Side effects of inhaled corticosteroids elsewhere in the body are very rare, in contrast to the known risks of corticosteroids given by mouth. Occasionally bruising can occur. There is no evidence that the most commonly prescribed doses of inhaled corticosteroids can lead to osteoporosis or to cataracts in the eyes, for example – although these are recognised complications of corticosteroid tablets.

Inhaled corticosteroids are a very effective way of treating asthma, and in most people the benefit of this effective treatment is much greater than any risk of side-effects. You should discuss any worries you may have about this with your doctor.


Is it good for me to always use inhaled corticosteroids?
Yes, absolutely! These anti-inflammatory medications are currently the most effective treatment for asthma, because they treat the causes of asthma instead of just relieving the symptoms. With long-term treatment, the mucus membranes lining the airways return to normal without any harmful effects on the lungs.

Early treatment with inhaled corticosteroids seems to help prevent asthma from getting worse. This may make it less likely that you will have severe attacks and the treatment these require.


Can I become addicted to the corticosteroids in asthma medications?
No.


Why can I use inhaled corticosteroids for many years, but corticosteroid cream on my skin for only a short period?
The skin and the blood vessels just below the surface of the skin are very sensitive to the effects of corticosteroids. If you apply a corticosteroid cream to the same area of skin for a long time, the skin and the walls of the blood vessels become fragile and break easily, which makes bruising common. Because of this, doctors and scientists have looked very carefully to see whether this could happen in the airways of people treated with corticosteroids over a long period of time. However, no signs of damage to the airways have been seen and it seems that the lining of the airways reacts to corticosteroids in a different way from the skin.


Do I need to rinse out my mouth after using an inhaled corticosteroid?
There is a slight risk of fungal infection in the mouth when using inhaled corticosteroids. Although this affects very few people, it does not hurt to rinse out your mouth after inhaling a corticosteroid, whenever convenient (e.g. at home in the morning or evening). If you are out during the day and it is inconvenient to rinse, this is not a problem, as the risk is very small.


If I can't remember whether I actually took my daily maintenance dose of inhaled corticosteriod, is it better to risk taking a double dose or none at all?
There is no risk in taking a double dose on a single occasion, but try not to make a habit of this!


What can I do to prevent osteoporosis?
There is no evidence that inhaled corticosteroids in commonly prescribed doses can cause osteoporosis, but it is reasonable for all patients with asthma (especially older women) to take steps to avoid this, as it is a recognized consequence of increasing age and physical inactivity (and of corticosteroid tablets used in the long-term).

Physical activity will help your skeleton grow stronger and is probably the most important factor in preventing osteoporosis. Inactivity, for example due to very poor lung function or fear of getting an asthma attack, makes osteoporosis worse. Effective asthma treatment that makes it possible to lead an active life is therefore very important. Calcium supplements for middle-aged and older women who are unlikely to get sufficient calcium in their ordinary food may also reduce the risk of osteoporosis, and specific treatments are available for those at special risk. Research in this field will probably lead to further developments in the future.