The growth of children and adolescents receiving orally inhaled corticosteroids, including QVAR, should be monitored routinely (., via stadiometry). If a child or adolescent on any corticosteroid appears to have growth suppression, the possibility that he/she is particularly sensitive to this effect should be considered. The potential growth effects of prolonged treatment should be weighed against clinical benefits obtained and the risks associated with alternative therapies. To minimize the systemic effects of orally inhaled corticosteroids, including QVAR, each patient should be titrated to his/her lowest effective dose [see Dosage and Administration ( )] .
Oral and injectable systemic corticosterois are steroid hormones prescribed to decrease inflammation in diseases and conditions such as arthritis (rheumatoid arthritis, for example), ulcerative colitis, Crohn's disease, asthma, bronchitis, some skin rashes, and allergic or inflammatory conditions that involve the nose and eyes. Examples of systemic corticosteroids include hydrocortisone (Cortef), cortisone, prednisone (Prednisone Intensol), prednisolone (Orapred, Prelone), and methylprednisolone (Medrol, Depo-Medrol, Solu-Medrol). Some of the side effects of systemic corticosteroids are swelling of the legs, hypertension, headache, easy bruising, facial hair growth, diabetes, cataracts, and puffiness of the face.
Inhaled steroids do have some side effects, although usually not the side effects that people normally think of with “steroids”. Inhaled steroids can cause thrush (yeast infection in the throat) and hoarseness. Both of these can be minimized by rinsing the mouth after using. Inhaled steroids do have a small effect on bone density and in someone already prone to osteoporosis might be an additional risk factor. Things like weight gain, mood changes, blood sugar elevation and immune system suppression really aren’t an issue with inhaled steroids because the total dose to the body is extremely low. For most patients, the benefits of being on an inhaled steroid FAR FAR FAR outweigh the risk.