Side effects of reliever medicines
Relievers are a safe and effective medicine and have very few side effects. Some relievers can temporarily increase your heartbeat or give you mild muscle shakes. These effects are more common when taking high doses. However they generally wear off within a few minutes or a few hours at most.
Side effects of preventer medicines
Side effects of steroid tablets
The possibility of side effects from taking your inhaled preventer medicine is very low. Because the inhaled medicine goes straight down to the airways where it is needed, very little is absorbed into the rest of the body.
If you use preventer medicine there is a small risk of having a sore tongue, sore throat, hoarseness of the voice and a mouth infection called thrush. To help prevent these side effects, rinse your mouth out and brush your teeth after using your preventer inhaler. Using a spacer will also help reduce the possibility of thrush.
Children should be monitored closely if they are taking preventer medicines - especially for growth.
It is possible that long-term and high-dose use of preventer medicines (inhaled steroids) may cause some other side effects (See 'Side effects of long-term use of steroid tablets', below). That is why your doctor and asthma nurse will try to keep you on the lowest dose to control your symptoms.
Several studies have suggested the possibility of a very slight increased risk of the development of cataracts in elderly people who have used inhaled steroids. As with use of all medicines, careful attention needs to be paid to the risk versus benefit argument and it's as likely that any risk can be reduced by always using the lowest possible dose of medication to control the condition.
Short term use
For a small number of people, a short-term course of steroid tablets, can lower the body's resistance to chickenpox, so you should contact your doctor if you or your child are taking steroid tablets and you/they come into contact with chickenpox. If your doctor thinks you are at risk they can give you an injection to protect you.
Other possible side effects from taking a short course of steroid tablets are mood swings (especially in children) and increased hunger.
Long term use
There are very few other side effects from taking occasional (three to four) short courses of steroids per year. However it is important to keep the number of courses to a minimum by making sure you are using enough of your other regular inhaled medicines.
A small minority of people with severe asthma need to take steroid tablets for a longer period. However, taking steroid tablets regularly, for long periods of time (months or years) can have serious side effects for some people.
For these reasons your doctor and asthma nurse will always try to prescribe the smallest possible dose of daily steroid tablets. It is very important that you continue to take your other asthma treatments regularly to keep the need for steroid tablets to a minimum.
If you have severe asthma and you have been prescribed long-term steroid tablets your doctor and asthma nurse should discuss and consult with you about the risk of side effects against the benefits of controlling your asthma symptoms (if untreated, severe asthma can lead to permanent lung damage).
The possible side effects of long-term use of steroid tablets are:
- Fattened face (moon face)
- Feeling hungry and wanting to eat more (this extra eating can lead to weight gain)
- Feeling 'hyped up' and over active with difficulty sleeping
- Feeling depressed or having sudden mood swings
- Heartburn and indigestion
- Brittle bones (osteoporosis)
- Altering diabetic control or uncovering a tendency to diabetes
- Chickenpox may be more serious
- Risk of cataract increases
Steroid tablets do not have any side effects that damage the heart.
What can I do about side effects of steroid tablets?
- Most importantly, don't smoke. If you smoke, bone thinning side effects are worse. Your general asthma control will also be helped if no one in your household smokes. If your partner gives up smoking, it may mean you can cut down on your dose of steroid tablet.
- Taking steroid tablets first thing in the morning may have some benefit in decreasing side effects.
- People who need to take regular steroid tablets can use daily calcium supplements, although there is no clear scientific evidence to prove that these are useful.
- Weight-bearing exercise, such as walking for 20 minutes each day will help protect against the bone thinning effect of long-term steroids.