Differences Between Inhaled and Oral Corticosteroids for Asthma

A young man is using an asthma inhaler
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Asthma treatment has a number of options that you should discuss with your doctor. Among those are either inhaled or oral corticosteroids. While both can effectively relieve asthma symptoms, you should know how each is different from the other.

Types of Corticosteroids for Asthma Control

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 to your doctor about your asthma action plan and ensure that there are no other reasons your asthma is poorly controlled. Be prepared for the discussion with whether your environment might be worsening your asthma.

Inhaled corticosteroids are often administered via a metered-dose inhaler. Oral corticosteroids are available as both a pill and in a liquid formulation. Most common among these are Prednisone, Prednisolone, and Methylprednisolone.

How Oral Corticosteroids and Inhaled Corticosteroids Differ

The primary difference between these two asthma treatments is the way they are administered:

  • Inhaled steroids are breathed directly into the lungs.
  • Oral steroids are swallowed and digested.

Beyond this obvious difference, there are other significant differences.

1. The parts of the body affected. Oral corticosteroids reduce inflammation throughout the entire body while inhaled steroids act primarily in the lung.

2. The potential side effects. Due to their systemic reach, oral corticosteroids have a greater potential for side effects. These can include loss of bone density, cataracts, and high blood pressure. Inhaled steroids, on the other hand, rarely cause these side effects. Common side effects of inhaled corticosteroids include thrush and cough.

3. Possible drug interactions. There are very few drug interactions with inhaled steroids, but the same cannot be said for oral corticosteroids.

There are many potential interactions of oral corticosteroids with drugs for the treatment of diabetes, high blood pressure (hypertension) and pain.

  • Oral corticosteroids decrease the efficacy of a number of hypertensive drugs, in addition to potentially leading to high blood pressure with long-term use.
  • Oral corticosteroids may increase the risk of bleeding associated with some pain medications, such as ibuprofen.
  • Oral corticosteroids can affect the growth of kids and lead to osteoporosis.
  • 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. However, adults who take high doses of Becloforte, Pulmicort, or Flovent should have their eyeball pressure checked regularly and get a bone density test if they have risk factors for osteoporosis. Children taking high doses of these inhaled steroids should have their height measured regularly and be referred to a specialist.

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