Asthma Treatment How Long Do Steroids Stay in Your System? By Pat Bass, MD twitter linkedin Dr. Bass is a board-certified internist, pediatrician, and a Fellow of the American Academy of Pediatrics and the American College of Physicians. Learn about our editorial process Pat Bass, MD Medically reviewed by Medically reviewed by John Carew, MD on January 06, 2020 twitter linkedin John Carew, MD, is board-certified in otolaryngology-head and neck surgery. He is an adjunct assistant professor at Mount Sinai Medical Center and NYU Medical Center. Learn about our Medical Review Board John Carew, MD on January 06, 2020 Print Table of Contents View All Table of Contents Understanding Half-Life Steroids Used for Asthma Side Effects of Oral Steroids Side Effects of Inhaled Steroids If you are taking steroids for asthma, you may wonder how long steroids stay in your system. This will vary depending on the type of drug, whether you are taking an inhaled medication such as Advair (fluticasone and salmeterol) or oral corticosteroid (e.g., prednisone), and the characteristics of each medication. Specifically, the drug's half-life will determine how long a drug circulates within your body. Hugo Lin / Verywell Understanding Half-Life A major factor in how long any drug affects your body is the drug's half-life. In simple terms, the half-life of a drug is the time it takes for half of the drug's dosage to be eliminated from your body. For example, the half-life of rescue inhalers like albuterol is in the five- to seven-minute range, while the half-life of Advair is five to seven hours. The half-life of a drug affects several things, including how quickly you'll notice it working and how often you'll need to take it. Short Half-Life Drugs More concentrated Work faster May need to be dosed multiple times per day to keep blood levels constant Long Half-Life Drugs Slower to take effect Are actively in circulation for longer periods Longer time between doses A number of different factors can affect the half-life of a drug, including: Age Sex Hydration Liver disease While half-life is mostly related to the properties of the drug, each body is unique, which means how a drug is metabolized by your body may differ from how the same drug at the same dosage affects another person. Steroids Used for Asthma Oral corticosteroids, sometimes referred to as oral steroids or even by a generic name such as prednisone, are a group of powerful anti-inflammatory medications that are prescribed when you have a significant worsening of your asthma symptoms. They may be used over several days to help get your symptoms under control. Inhaled steroids, by contrast, are localized to the lungs, which reduces the risk of broader side effects. Although people with asthma routinely have been advised to use an inhaled steroid daily, according to updated recommendations for asthma management by the National Institutes of Health (NIH) issued in December 2020, this no longer is regarded as necessary for those with mild to moderate persistent asthma. If you use an inhaler daily to manage asthma, talk to your doctor about how the new guidelines might affect your treatment. Half-Lives of Common Asthma Medications Class Medication Half-Life Relievers Short-acting ß2-agonists salbutamol 4 to 6 hours Anticholinergic ipratropium bromide 3 to 5 hours Methylxanthine theophylline 3 to 13 hours Controllers Glucocorticosteroids (inhaled) fluticasone 14 hours budesonide 2 to 3 hours beclomethasone 15 hours Glucocorticosteroids (oral/intravenous) prednisone 3 to 4 hours Long-acting ß2-agonists formoterol 8 to 10 hours salmeterol 5.5 hours Oral corticosteroids are systemic—meaning they reduce inflammation throughout the entire body. Inhaled steroids, on the other hand, act primarily in the lungs. New Asthma Guidelines Lessen Emphasis on Daily Inhaler Use Side Effects of Oral Steroids It is helpful to understand the differences between oral corticosteroids and inhaled steroids. The most important of these are related to potential side effects, which may become more pronounced when drug levels are not stable. This can occur when prescription instructions are not followed exactly as directed. The half-life of oral corticosteroids is significantly longer than inhaled steroids, and therefore oral steroids have a more significant side effect profile, including: Decrease in bone density and possible osteoporosis Cataracts Glaucoma High blood pressure Elevated glucose Aggression and other changes in behavior Increased appetite, fluid retention, and weight gain Increased risk of infection Depression It is key to mention any recent steroid bursts (the use of a short course of oral steroids) to your healthcare provider. Overuse of oral steroids may prevent your adrenal gland, where your body's natural steroids are made, from working correctly. As a result, your body may not make steroids sufficiently during a time of stress and you may require additional supplementation. Side Effects of Inhaled Steroids Inhaled steroids rarely cause these side effects, but do have local side effects that are easily prevented with appropriate steps. Side effects of inhaled steroids are rare but may include: Thrush (oral candidiasis) Hoarseness These symptoms may be avoided by rinsing your mouth and gargling after using an inhaled steroid, as well as using a spacer device that delivers measured doses. A Word From Verywell If your doctor determines you need to take oral corticosteroids more than once per year, it may be time to reexamine your asthma action plan together. Patients and parents of children with asthma often have concerns about the side effects of steroids. Write down any questions and qualms before meeting with your physician or your child's pediatrician to start a discussion of what's right for you or your child. Was this page helpful? Thanks for your feedback! Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Food and Drug Administration. Advair diskus label. Updated March 31. 2006. Cloutier MM, Baptist AP, Blake KV, et al. 2020 focused updates to the asthma management guidelines: A report from the national asthma education and prevention program coordinating committee expert panel working group. Journal of Allergy and Clinical Immunology. 2020;146(6):1217-1270. doi:10.1016/j.jaci.2020.10.003 Sharma, S, Chakraborty, RK. Asthma medications. StatPearls. Health Service Executive. Side effects of corticosteroids. Updated July 13, 2011 Additional Reading Expert Panel Report 3 (EPR3): Guidelines for the diagnosis and management of asthma. National Heart, Lung, and Blood Institute. Promoting Asthma Control In Children. Appendix G: Asthma Medications (Updated 2008). Toronto, Ont.: Registered Nurses' Association of Ontario; 2008.