Corticosteroids for cystic fibrosis

Examples

Oral

Generic Name	Brand Name
methylprednisolone	Medrol
prednisolone	Prelone
	prednisone

Inhaled

Generic Name	Brand Name
beclomethasone dipropionate	QVAR
budesonide	Pulmicort, Rhinocort
flunisolide	AeroBid
fluticasone propionate	Flovent
triamcinolone acetonide	Azmacort

How It Works

Corticosteroids reduce inflammation in the lungs. They also decrease mucus and make it easier for the person to breathe. Corticosteroids can be given as a pill or liquid, as an injection, or with an inhaler. The kind of corticosteroid that will be prescribed depends on what symptoms are being treated.

Why It Is Used

Corticosteroids are widely used to treat many different types of inflammation. They have been tested for use in treating lung inflammation in cystic fibrosis. At this time, they are recommended only for people who have significant shortness of breath and wheezing or an infection caused by a fungus (allergic bronchopulmonary aspergillosis).

Oral corticosteroids are usually used only for short periods of time because of the side effects. Inhaled forms may be used for longer periods of time.

How Well It Works

Corticosteroids are the most powerful medicines for reducing inflammation in the lungs. More research is needed to find out the specific benefits and potential harmful side effects for people who have cystic fibrosis.

Side Effects

Side effects of long-term treatment with steroids given by mouth (pills and liquid) include:

• Problems with the body's ability to use glucose (glucose metabolism).
• Bone weakening (osteoporosis) and bone death from changes in blood supply.
• High blood pressure.
• Repeated infections, bruising, and skin thinning.
• Clouding of the lens of the eye (cataract).
• Growth delay.

Side effects of inhaled corticosteroids are uncommon if the usual amount is taken. Side effects (many of which occur only with high doses) may include:

• Sore mouth, sore throat, or hoarseness.
• Cough and spasms of the large airways.
• Fungus infection in the mouth (thrush).
• Delayed growth in children.
• Decreased bone thickness in adults.
• Clouding of the lens of the eye (cataract).
• High blood pressure in the eye or fluid buildup in the eye (glaucoma).

Using a spacer can help you avoid the side effects of inhaled steroids. After using an inhaler, it is also important to rinse your mouth out with water and then to spit out the water. Swallowing the water will increase the chance that the medicine will get into your bloodstream, which may increase the side effects of the medicine.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

For people who need long-term corticosteroid therapy, inhaled corticosteroids will probably be prescribed because they have fewer side effects. But very few people are able to take any form of corticosteroid for a long time.

Pregnant women who use steroids by mouth or by injection may have babies with low birth weights. Inhaled steroids do not affect the fetus and can be used during pregnancy.

It is always important to weigh the potential benefits against the side effects of corticosteroids.

You can help reduce or prevent side effects of corticosteroids if:

• You use a spacer with your corticosteroid inhaler, you rinse your mouth with water after using your inhaler, and you spit out the water.
• You keep the dose of corticosteroids as low as possible.

If you still have trouble breathing while using inhaled steroids, you may need to increase your dose. Before doing that, check with your doctor to make sure you are using the medicine correctly.

Complete the new medication information form (PDF) (What is a PDF document?) to help you understand this medication.

Author:	Debby Golonka, MPH	Last Updated June 26, 2007
Medical Review:	Michael J. Sexton, MD - Pediatrics Susanna McColley, MD - Pediatric Pulmonology
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