Fluticasone inhaler side effects
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Systemic Side Effects of Fluticasone Inhalers
Fluticasone, an inhaled corticosteroid (ICS), is widely used for asthma and other obstructive lung diseases. While generally considered safe, it can cause systemic side effects, especially at higher doses or with prolonged use. One significant risk is adrenal insufficiency, where the body’s natural steroid production is suppressed. This has been observed in both adults and children, sometimes presenting with symptoms like hypoglycemia or fatigue. The risk may be higher in individuals with genetic differences affecting steroid metabolism or in those with higher body fat, as fluticasone can accumulate in adipose tissue. Awareness of this risk is important, and patients should be maintained on the lowest effective dose to minimize systemic side effects 13.
Local Side Effects: Voice Changes and Throat Issues
Local side effects are common with fluticasone inhalers. These include voice changes, hoarseness, throat irritation, oropharyngeal candidiasis (thrush), and a sensation of fullness in the throat. Studies have shown that these issues, sometimes called steroid inhaler laryngitis, are more frequent and severe with fluticasone compared to other inhaled corticosteroids like ciclesonide. Regular laryngeal examinations are recommended for patients experiencing persistent voice problems, as these side effects can impact quality of life and adherence to therapy. Most local side effects improve or resolve after stopping the medication 24.
Patient-Reported Side Effects Compared to Other Inhaled Steroids
When compared to ciclesonide, patients using fluticasone report more intense side effects, both local (such as throat discomfort and voice changes) and systemic. In multiple studies, ciclesonide was associated with fewer and less severe side effects, suggesting that the choice of inhaled steroid can influence the patient’s experience and tolerability of treatment 24.
Safety Profile in Clinical Trials
In controlled clinical trials, fluticasone inhalers have generally been well tolerated, with no serious side effects reported in short-term use. However, these trials may not always capture rare or long-term complications, highlighting the importance of ongoing monitoring in real-world use .
Conclusion
Fluticasone inhalers are effective for managing asthma and other lung diseases, but they can cause both systemic and local side effects. The most notable risks include adrenal suppression and voice or throat problems, which may be more pronounced than with some other inhaled steroids. Patients should be monitored for these side effects, and the lowest effective dose should be used to reduce risk 1234.
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