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What Is The Difference Between Inhaled & Oral Corticosteroids?

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Updated June 19, 2014

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

Inhaled Corticosteroid

What Is The Difference Between Inhaled & Oral Corticosteroids?

Photo: © GlaxoSmithKline
Question: What Is The Difference Between Inhaled & Oral Corticosteroids?
Answer:

Oral corticosteroids, or oral steroids, are a group of very strong anti-inflammatory medications that help get your asthma under control when you have an asthma attack or significant worsening of your asthma symptoms. It is important to understand the differences between this group of steroids and inhaled steroids.

If you need oral corticosteroids more than once per year, your asthma control is probably not what it should be. Make sure to talk with your doctor about your asthma action plan and ensure that there are not other reasons your asthma is poorly controlled.

How Are Oral Corticosteroids and Inhaled Corticosteroids Different?

In addition to the route of administration (inhaled steroids are breathed directly into the lungs, while oral steroids are swallowed and digested), there are other significant differences.

Oral corticosteroids reduce inflammation throughout the entire body, while inhaled steroids act primarily in the lung. Due to their systemic reach, oral corticosteroids have a greater potential of side effects, which include loss of bone density, cataracts, and high blood pressure. Inhaled steroids, on the other hand, rarely cause these side effects.

There are very few drug interactions with inhaled steroids, while there are many potential interactions of oral corticosteroids with drugs for the treatment of diabetes, high blood pressure (hypertension), and pain. For example, oral corticosteroids decrease the efficacy of a number of hypertensive drugs, in addition to potentially leading to high blood pressure with long-term use. Similarly, oral corticosteroids may increase risk of bleeding associated with some pain medications, such as ibuprofen. Finally, corticosteroids inhibit the effect of some drugs used to treat diabetes.

In general, there are fewer and less severe side effects with inhaled corticosteroids compared to oral corticosteroids. While common side effects of inhaled corticosteroids include thrush and cough, oral corticosteroids can affect the growth of kids and lead to osteoporosis.

Learn More About Oral Corticosteroids

Sources:

National Heart, Lung, and Blood Institute. Accessed: March 25, 2011. Expert Panel Report 3 (EPR3): Guidelines for the Diagnosis and Management of Asthma.

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