[Concerns about adverse effects of inhaled corticosteroids]

Inhaled corticosteroids (ICS) are mainstay in controlling the symptoms of asthma. Previous studies have demonstrated that ICS have minimal systemic effects, at doses of up to 400 micrograms per day for children and up to 1000 micrograms per day for adults. At higher doses some systemic effects can be seen. But to date there is no convincing evidence that this gives rise to any of the well known clinical sequelae of corticosteroid excess. To determine the dosage of ICS, it is important to weigh up the potential benefits and risks in each patient. The use of spacer devices and mouth rinsing may reduce local and systemic adverse effects.