Daily steroid inhalers

Hello all,

I am a newbie to this forum, but was hoping that you might be able to help me.

I registered at a new doctors yesterday, as I have recently moved. It was a bad experience. She didn't ask me any questions as a new patient registering that has asthma, but instead lectured me on taking my becotide every day. I am on becotide & severvent twice daily. She told me that continually taking the inhaled steroid is going to weaken my bones.

My asthma has been really up and down since diagnosis and at the end of last year I was really poorly was put on Beclaforte 250 - 2 puffs three times a day. I am really worried now because she has said that taking my becotide is detrimental to my long term health, but I really don't think that I can stop it.

Any one able to offer some words of wisdom?

16 Replies

  • Gosh, how unsupportive - doesn't sound like the sort of doctor you want to see for your asthma.

    Does the surgery do an asthma clinic with an asthma nurse? Our asthma nurse is wonderful - always on my side, always willing to modify medication or try new options to help.

    It's bad enough having to cope with asthma, without being made to feel guilty / anxious about it. And what's her ""prescription"" - stopping all medication and dying young? <lol> Knowledge is power - maybe the best thing you can do is find out heaps about asthma, your medication and go prepared to stand your ground next time.

    hope this helps, pamela

  • thank you Pamela

    She didn't offer any other solutions.

    I felt really positive when I went in there, as I am finally learning how to manage my asthma. i left feeling rather deflated.

    I guess she may be of the 'it's all in your head' menatility.

  • sorry to hear about your bad experience. I agree with Pamela try and find out if the surgery does an asthma clinic. It is very rare for them not to have a specialist asthma nurse these days. Is it a group practice or just a single GP practice? If it is a group practice each GP will have there own speciality. Find out which one specialises in chest problems/heart and lung. The surgery should have information somewhere about all the doctors in the practice. If they are really up-to-date you will be able to access this via the surgery website on-line. A group practice means you don't have to see the GP you are registered with but you can ask to see the one most expereinced in asthma.

    Hope you get on better now


  • Can I just add that steroid inhalers have very little if no impact on bone density!

    Most of the steroid stays in your lungs and only if you are on a very high dose does any get absorbed into your system.

    The benefits of taking a steroid preventer inhaler far outweigh the possible side effects and the effects of uncontrolled asthma.

    If you are worried contact asthma UK help line - see red box at top of this screen.

    Your GP sounds very unsupportive. You seem to be doing the right thing by taking your inhalers every day which is good.

    Is there anyone else at your new practice that you can see instead?

    Take care


  • Steroid inhaler side effects

    Hi Amanda, welcome to the forum

    As Kate has said, there is a very low rate of systemic (body wide) side effects with inhaled steroids even at very high doses. Uncontrolled asthma is far far more dangerous than taking your steroid inhaler regularly; indeed, uncontrolled asthma can be life-threatening. Most doctors spend all their time trying to persuade patients that they should take their steroid inhalers regularly despite the patients' fears about side effects - your new doctor seems to have got it the other way round!

    If you want to minimise the (already small) risk of systemic side effects, there are a couple of things you can do:

    - the old 'rinse and spit' routine helps to reduce the amount of steroid swallowed and therefore potentially absorbed, and also minimises mouth and throat side effects;

    - obviously it's important, as with almost any drug, to be on the lowest possible dose that controls your symptoms, and to think about stepping down (with the supervision of your GP/asthma nurse) if you are well controlled;

    - beclomethasone, the drug in becotide/becloforte, is *relatively* more systemically absorbed than some of the newer drugs such as fluticasone (Flixotide) and mometasone (Asmanex) so if you are really worried it might be worth talking to your GP about changing to one of these - but changing your steroid can sometimes produce a deterioration in control so if you are well controlled at the moment you may want to leave well alone!

    Is there a different GP at the practice that you can see, or an asthma nurse, as others have suggested? It does sound like you need to have a good chat to someone who isn't going to scold you for taking your medication properly!

    Hope this helps,

    Em H

  • Thanks Em for the more constructed reply! LOL



  • There is a risk of a serious infection or sometimes worse when taking corticosteriods while fighting a virus like measles or chicken pox. The risk is small as most young children are now vaccinated against these viruses. But when my 19 year old was 5 he had the chicken pox and his Pediatrician took him off his inhaler immediately and checked him over every couple of days and he ended up getting pneumonia and was in the hospital for about 2 weeks before he started to get better. Luckily his Pediatrician was checking for it because it got very bad fast, he had a fever that was hard to control for 10 days and had pneumonia in both lungs which made his asthma very bad. The doctor said that sometimes pneumonia follows the chicken pox but that is was probably because of the Beclovent inhaler he was using at the time. He did go back on it after the chicken pox were completely gone and he was switched to Becloforte when he was about 15 and then symbicort at 17 and now he is on Flovent which seems to be working good so far.

  • Stevie,

    the risk is usually with oral steroids - we in the UK carry a blue warning card if we are on oral steroids such as Prednisolone as you can be more at risk of infections like chicken pox.

    With inhaled steroids, I don't think that there is that much of a risk though unless perhaps you are taking really high inhaled doses???

    Can someone medical clarify this please!



  • Chicken pox

    Kate, that's right, the risk is primarily with oral steroids. If you are on oral steroids and have contact with someone with chicken pox or shingles, particularly if you haven't already had chicken pox yourself, you should contact your doctor to see if you need immunisation with immunoglobulin, as there is increased risk of getting a severe form of the illness. The same applies to measles. As Kate says, if you are on oral steroids you should have a steroid card and the info about chicken pox should be on it.

    As far as inhaled steroids are concerned, I've done a very quick Medline search and it reveals that there are a very few (single figures!) case reports of severe chicken pox infection whilst on inhaled steroids alone, mostly in people on very high doses, ie 2000 mcg daily beclomethasone or 1000 mcg daily fluticasone. So the bottom line, I guess, is that the risk is very very small, but if you are concerned you should see your doctor.

    Please no-one stop oral or inhaled steroids because of contact with chicken pox without talking to your doctor or asthma nurse first!

    I remember last year at work, I was looking after a patient who eventually turned out to have chicken pox meningitis (very nasty!). Before we got the diagnosis I had spent quite some time with my face 5cm away from theirs trying to look at the backs of their eyes with an ophthalmoscope and when we found out what was wrong with them, Occy Health were rather concerned, cos I was on quite a lot of pred at the time! My mum helpfully couldn't remember whether I'd had chicken pox as a child or not, but thankfully a quick blood test proved that I must have done cos my antibody levels were good, so I could stop worrying. Incidentally, that patient was completely healthy in every other way and wasn't on any steroids in any shape or form, we did every test under the sun to try to look for immune dysfunction and they all came back negative. Severe chicken pox or complications such as meningitis or pneumonia can occasionally happen to healthy people for no apparent reason at all, and if you consider that there are a large number of people in the world who are on inhaled steroids, occasionally the two might occur together purely co-incidentally.

    Sorry, Kate, that was perhaps a longer answer than you had in mind! Got a bit of a medical bee in my bonnet tonight, must be missing work!

    None of the above is intended as specific medical advice, consult your own doc if you are worried, blah blah blah. (Sorry, has to be done!)

    Take care all

    Em H

  • In Canada there is still warnings to avoid contact with measles and chicken pox while taking Flovent HFA etc. When my son became sick after the chicken pox it was in the early 1990's soon after there were a couple reported deaths in Canada possibly due to inhaled corticosteroids and chicken pox. Our Pediatrician just didn't want to take any chances so he took him off of it until he was over the viral infection. Canada can be overzealous when it comes to medication warnings. It has only been a few years since we have been able to purchase ibuprofen because of warnings. We had to go to the US to buy it.

  • thank you all for your help.

    I am pleased to announce that I am going to register at a new surgery. I spoke with an asthma nurse through this website and she, along with your advice, have really put my mind to rest.

    I have worked so hard to get my asthma controlled that I feel almost angry at this dr for suggesting I stop my preventer.



  • Good for you Amanda

    The last thing you need is for a doctor who you are supposed to trust to look after you making you feel stressed and wrong about your asthma.

    Good luck with the new docs.

    Welcome to the board.


  • regarding the steroid inhalors and chickenpox - before michael was on oral steroids too, he was taking seritide 250 2 puffs 2x a day, and we were given a steroid treatment card for it. im not sure if the dose itself was higher than normal (he was 2 at the time) but i do know that seritide isnt usually prescribed to his age.

    now though, he was in contact with shingles a few weeks ago and was put onto antibiotics in addition to his other medicines (it was precautionary because it wasnt definate contact!)and we have a medic alert tag to say that he is on steroids (plus his allergies etc) aswell as the blue card

  • I am taking fluticasone inhaler for past 1 year and frankly even I wonder at times what will be the long term side effects .

    But on the other hand do we have a choice ?

  • I use the becloforte 4 puffs twice daily, the only thing i found that was different in me was my lack of apetite was getting worse for some reason.

    any1 else had that?

  • I've never had a lack of apetite problem though always wanted one! I tend to find that my appetite goes up when my steroid dose increases, and that coupled with less excercise is always a disaster! Currently trying to live on salads for 3 weeks to lose at least some weight before a family wedding!

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