Facts About Asthma and Steroids

What you need to know about oral corticosteroids

OCS are liquid or pill-form medications that suppress the immune system to reduce and prevent inflammation and swelling from acute asthma attacks or flare-ups and for some cases of severe asthma.

OCS are usually prescribed for five to seven days, which is also called a round or a steroid burst. And while OCS are effective in reducing symptoms, they can lead to side effects and serious health problems.

Side effects of taking oral corticosteroids short-term can include:

• Weight gain in the abdomen, face or neck
• Weak muscles
• Insomnia
• High blood sugar levels
• High blood pressure
• Swelling in lower legs
• Heartburn
• Nausea
• Irritability and mood changes
• Depression
• Anxiety

Side effects of long-term OCS use can include:

• High blood sugar levels/pre-diabetes
• Increased risk of cardiovascular disease
• High blood pressure
• Cataracts
• Glaucoma
• Thin skin
• Increased risk of infection
• Bone loss and osteoporosis
• Hormone imbalance

There are several asthma medications available to help decrease inflammation in the airways. OCS are different from other options because they affect the whole body and can lead to serious health problems.

Read: Why Asthma Gets Worse in Cold Weather >>

Potential overuse of oral corticosteroids

Despite the health risks associated with OCS, research shows the medication can be overused and over-prescribed. One poll found nearly 8 out of 10 people with an asthma specialist received a prescription for oral corticosteroids from another HCP who wasn’t their specialist.

Although oral corticosteroids are effective and can help with severe or acute symptoms when necessary, excessive use of OCS may be a red flag that your treatment plan needs an upgrade.

So, how do you know if you’re possibly overusing steroid medications? According to newly released Global Initiative for Asthma (GINA) guidelines, two or more rounds of OCS in one year is a sign that your maintenance medications are not working well enough.

You should talk to your HCP about your treatment plan if you have any of these signs that your asthma is not well controlled:

• Using any amount of OCS to control your asthma, especially if you use two or more rounds in one year
• Taking a rescue inhaler more than twice a week
• Waking up at night because of asthma symptoms more than twice a month
• Refilling your rescue inhaler more than twice a year
• Experiencing changes in peak flow readings of more than 20%

Alternative options to OCS

GINA guidelines recommend reducing the use of OCS with safer alternatives. Alternative treatments to OCS for asthma can include:

• Inhaled corticosteroids (ICS): Corticosteroids delivered via inhaler or nebulizer device. ICS are not systemic and focus on the airways, which makes them safer to use than OCS and safe to use long term.
• Quick-relief medicines: Inhalable short-acting beta-agonists (SABAs) work fast to relax the muscles around your airways so you can breathe better. They provide relief within minutes but are not recommended for long-term use.
• Biologics: Biologics for asthma target specific cells or block specific molecules to prevent swelling inside the airways. The medication is given via injection or infusion.
• Controller medications: These daily preventives help control asthma symptoms by correcting underlying problems like excess mucus production and swelling. ICS are the most common type of controller medication, which can be combined with long-acting beta-agonists to help keep airways clear. Leukotriene receptor antagonist tablets are also controller medications and can help reduce the effects of inflammatory chemicals in the body.

Speak up about your increased symptoms

If you’ve taken OCS for an asthma flare-up, attack or for increased symptoms more than twice in a year, talk to your HCP about your treatment plan. It’s also a good idea to make an appointment to see an asthma specialist if you don’t already have one. Then take a deep breath — you’ve got this.