How Steroids Help Asthma & COPD: Benefits & Risks

Inhaled corticosteroids are the cornerstone of treatment for chronic lung diseases like asthma and COPD.¹ But like many medications, these come with benefits and risks. As patients, it is important for us to ask ourselves, how do steroids work in asthma and COPD?

To understand how they work, we should first learn what a steroid is exactly.

Steroids, or corticosteroids are medications that look like cortisone, a hormone we naturally produce in our body.¹ Cortisone is essential in fighting off infection, diseases, and other injuries.¹ Because corticosteroids are similar to cortisone, they can also fight off inflammation and help control inflammatory diseases like arthritis (inflammation in the joints), dermatitis (inflammation in the skin), and colitis (inflammation in the large intestines).¹

Asthma and COPD are both lung diseases where there is chronic inflammation in the lungs, causing swelling and narrowing of the airways.¹ Corticosteroids help reduce inflammation, and by doing so, reduce symptoms of cough, wheezing, and difficulty breathing, and prevent flare-ups.¹

How do I take corticosteroids?

Corticosteroids can be taken by mouth, by injection, or by inhalation through inhalers and nebulizers.¹

Inhaled corticosteroids (ICS) are the most effective form of medications for controlling asthma and COPD.¹ Examples include budesonide, fluticasone, and mometasone. They can be given via inhalers or nebulizers. Inhalers are small devices that you can carry in your bag or purse. There are different types of inhalers for asthma and COPD, and each type is used differently. Learn more about how to use inhalers in this article.

Inhaled corticosteroids can also be given through nebulizers, but these are less convenient since you need to use a bigger machine.¹

Corticosteroids taken by mouth as tablets are called oral corticosteroids. They are often used in severe asthma treatment and COPD flare-ups. Most commonly used oral corticosteroids is prednisolone.²

Are corticosteroids safe for everyone?

Inhaled corticosteroids (ICS) are the first-line therapy for all patients with asthma and COPD, including children. While these drugs have side effects that can cause growth stunting for children, uncontrolled asthma has an even greater effect on suppressing growth.³ The benefits of using ICS outweighs the risks in children.³ By controlling asthma in children, we ensure good lung health and overall development.

While there may be concerns about the use of drugs during pregnancy, managing asthma with inhaled corticosteroids is more beneficial than the potential risks associated with the medications. With these, the chance of asthma attacks occurring during the pregnancy decreases.⁵ Always consult your doctor before taking any medications.

On the other hand, inhaled corticosteroids cannot be used by those with an allergy to steroids and milk.⁴ Lactose, a protein in milk, is used to preserve the corticosteroids in dry powder inhalers, which can cause allergic reactions when used by sensitive individuals.³ Inhaled corticosteroids are also not used in patients with untreated fungal, bacterial, and tubercular infections of the lungs and respiratory tract.⁴

Oral corticosteroids are used by patients with severe persistent asthma and COPD flare-ups.² However, they are not given to persons with allergies, infections, and other immunosuppressive diseases.² As they have greater side effects, they are not prescribed freely. Always ask your doctor for proper instructions when taking these.

What are the side effects of using corticosteroids?

The side effects depend on the type of corticosteroid you are using and how long you have been taking them.⁴

Inhaled corticosteroids (ICS) pass through the nose and upper airways. The dose required for this method is much lower than oral corticosteroids since the medication is delivered straight to the lungs.^4,6 Because they are given directly, there are fewer side effects which are potentially reversible. Side effects include hoarseness of the voice, sore throat, sinusitis, headache, toothache, cough, and oral candidiasis, an overgrowth of fungi in the mouth.⁶

On the other hand, oral corticosteroids are taken by the mouth and digested in the bowel. Because they pass through the entire body, they have more side effects that are more serious as well. Long-term use of oral corticosteroids can lead to various side effects in the different systems of the body, including osteoporosis, muscle inflammation, impaired glucose tolerance, weight gain, infections, hypertension, acne, dermatitis, and stomach ulcers.²

But it is important to note that development of side effects depends on several factors such as dose, duration, age, comorbid conditions and nutritional status.²

Despite these side effects, the benefits of inhaled corticosteroids outweigh the risk, especially in asthma and COPD, which is why they are the primary medications used in these diseases.¹

What can I do to prevent these side effects?

There are several ways you can prevent side effects.

• Use your inhalers correctly.¹
  • By using your inhalers properly, you can guarantee that you get the proper dosage of your medications.
• When using inhaled corticosteroids, make sure to wash and gargle your mouth with water after puffs.⁴
  • This is to wash away the remaining corticosteroids in the mouth and reduce risk of oral candidiasis.
• Follow your doctor’s medication instructions.
  • Corticosteroids are given for a specific amount of time. Make sure you are following what is written in your prescription and the inhaler’s product information, so that you get the prescribed dosage.
• Visit your doctor regularly.
  • It is important to follow up with your doctor regularly so they can monitor your progress and response, adjust medications when necessary, and ensure you are taking your inhalers and pills properly.

Monitoring yourself and your loved ones closely is essential. If any symptoms appear, consult with your doctor promptly so your condition can be managed well.

Stay on top of your asthma and COPD. Learn how to Breathe Better through these articles.

Approval ID: PH-12380