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Medical Forum / Diseases and Disorders / Asthma / January 2007Do Corticosteroid inhalation drugs contain any prednisone?
My question is based on the experience of a hexagenarian female who is taking Asmanex and who has experienced what is considered to be a rare side effect, specifically, she is experiencing significant swelling like one would experiecne with prednisone. So, I have tried, yet unsuccessfully so far to determine if Asmanex or any of the corticosteroid inhalation drugs used to prevent asthma attacks have any portion of prednisone in them. All of the pharmacological studies I have read to date for these drugs seem to indicate reduced usage of prednisone from use of the corticosteroid inhalation drugs. Thank you, Gerald Gerald, although most people don't experience "systemic" side effects on inhaled steroids, there are reported cases, so you can't rule it out. Are you seeing a nice round face? > My question is based on the experience of a hexagenarian female who is taking > Asmanex and who has experienced what is considered to be a rare side effect, [quoted text clipped - 8 lines] > > Gerald > Gerald, although most people don't experience "systemic" side effects on > inhaled steroids, there are reported cases, so you can't rule it out. Are > you seeing a nice round face? Oh oh. Is it possible to get that while only chewing? The first diagnosis said sinus infection but I was on antis for several weeks and I don't have any pain. Second said infected saliva gland, ditto on the antis and I KNOW my glands are working. Third said I was under stress and I had strained the jaw muscle so when I chew it swells up. It hasn't been painful or anything and swelling goes down in a minute or so. I am trying to de-stress, unfortunately just had a bad incident today so... Anyway, is it possible that is from corticosteroids? ~Melanie Look up Cushing's. It can happen to people who take steroids, most likely the oral kind but others as well. You would find that they have pretty consistent symptoms - a nice round face the whole time they are on the meds and for a period after they discontinue. Muscle cramping is another of the clues that a patient has this problem on steroids. > > Gerald, although most people don't experience "systemic" side effects on > > inhaled steroids, there are reported cases, so you can't rule it out. Are [quoted text clipped - 15 lines] > > ~Melanie > Look up Cushing's. It can happen to people who take steroids, most likely > the oral kind but others as well. You would find that they have pretty [quoted text clipped - 6 lines] > Are > > > you seeing a nice round face? I don't think it's what I have but will ask my other doctor when I go in two weeks. I really hope next year is better. Are we all on the same page? ~Melanie > My question is based on the experience of a hexagenarian female who is > taking [quoted text clipped - 8 lines] > reduced usage of prednisone from use of the corticosteroid inhalation > drugs. They don't have prednisone exactly - but prednisone is a corticosteroid in the same class as the "steroid" inhalers such as asmanex. They all can have similar side effects. With inhaled steroids the dose to the whole body is much less than with oral prednisone (micrograms rather than milligrams) but there can be systemic effects.  Signature00doc Thank you all for your responses. The hexagenarian female to which I referred has had a significant sensitivity to prednisone, mainly with the side effect of swelling in the abdominal area. She has not taken prednisone in several years, but was recently diagnosed as being asthamtic (at age 67, which I understand is not rare, but is not very common for her age) since she showed no signs of asthma prior to this. She is take Asmanex as a corticosterioid inhaler, and to date it has been effective with regard to preventing her astham-specific symptoms, but she is having similar abdominal swelling apparently from the Asmanex, albeit not as significant as she had with prednisone (note: the prednisone was taken many years ago for health issues not related to asthma). I think that she is very likely just very sensitive to this entire class of steroids. She is consider switching to Flovent, Pulmicort, or QVAR for cost mainly as the Asmanex is very expensive (approximately $175 per month even with insurance) and to see if possibly one of the other corticosteroids might be less symptomatic w.r.t. the abdominal swelling. Thank you all, Gerald >> My question is based on the experience of a hexagenarian female who is >> taking [quoted text clipped - 7 lines] >much less than with oral prednisone (micrograms rather than milligrams) but >there can be systemic effects. > I think that she is very likely just very sensitive to this entire class > of > steroids. That is quite possible. She could try using Advair or a leukotriende blocker like SIngulair or Accolate to spare the steroid. Of course these would add to the expense. > She is consider switching to Flovent, Pulmicort, or QVAR for cost > mainly as the Asmanex is very expensive (approximately $175 per month even > with insurance) and to see if possibly one of the other corticosteroids > might > be less symptomatic w.r.t. the abdominal swelling. Of the newer steroids Pulmicort is the least expensive (at least in the U.S.). One unit is still expensive but it has 200 doses. This will last over 3 or 6 months depending on if she takes it once or twice daily. Signature00doc Thank you sincerely for this information, "00doc". Do you happen to know if there are any specific pharmacological advantages for Asmanex in relation to Pulmicort, without respect to cost and assuming that no other steriods/corticosteroids besides Asmanex or Pulmicort are taken? >> I think that she is very likely just very sensitive to this entire class >> of [quoted text clipped - 13 lines] >U.S.). One unit is still expensive but it has 200 doses. This will last over >3 or 6 months depending on if she takes it once or twice daily. > Thank you sincerely for this information, "00doc". > > Do you happen to know if there are any specific pharmacological advantages > for Asmanex in relation to Pulmicort, without respect to cost and assuming > that no other steriods/corticosteroids besides Asmanex or Pulmicort are > taken? Since most of the information comes from the drug companies it is always hard to know what to believe. Mometasone (Asthmanex) tends to have very little systemic absorption. Budesonide (Pulmicort) has more but it is cleared from the circulation much more quickly by the liver so what does get absorbed doesn't stay in circulation as long. In fact, other formulations of budesonide are given orally for inflammatory bowel disease and seem to have a fairly low systemic effect in that setting due to the rapid metabolism. Asthmanex claims superior drug depositition but I'm not sure I buy it. Of course, which is better is always really two questions: 1) It is any better? 2) Is the improvement worth the additional price? I'm scheptical about #1. For most people I very much doubt #2. Signature00doc Thank you so much, "00doc". This has been very helpful. I think this will provide good points to discussion with this woman's doctor. >> Thank you sincerely for this information, "00doc". >> [quoted text clipped - 19 lines] > >I'm scheptical about #1. For most people I very much doubt #2. I have been plagued with asthma for over 50 years. Every doctor has told me (and my daughter, who also has asthma) to use Albuterol. We just kept puffing all day year after year. I was in Brazil to have some plastic surgery, but the surgeon said I must see a cardiologist before he started cutting. I would guess he did not want me to die on his watch. The cardiologist said my heart was fine, but said I hear lots of noise in your lungs. He asked what I have been using. I said Albuterol, which even on their label mentions arrhythmia. Since I discontinued the Albuterol, I have not had a single tachycardia attack. I had been plagued with this as well as asthma for all those years. He gave me a better puffer prescription, however I never had to use it, He asked why I do not prevent it in the first place. He gave me a prescription that prevented the wheezing This is FLUIR (fumarato de formoterol) which is a small capsule of powder that is inhaled twice a day. This was in Nine years ago, and I nor my daughter have not had even a hint of a wheeze since. Thought you should look into this....... My cost per day is $ 2.00 for the combination. medication is cheap in Brazil. Schering-Plough makes the FLUIR, They do not make this here for the American Market. I telephoned my local pulmonary man and told him this and he feverishly wrote down this information as he is constantly prescribing Albuterol as the only method he knows. The Brazilian Cardiologist who gave me this information said "What kind of doctors do you have in the US"? I told him my opinion which is that they are only interested in making money and have no interest in helping their patients. He has heard that before from Many Americans. I have sent the above the American Lung Association before, but they would rather just raise money and give it to their officers...................... lou@angelic.com The inhaled version of the med you mention is sold in the US as Symbicort. Giving it in oral form would not be as safe due to the side-effects of oral steroids. If you had been taking multiple doses of albuterol daily it is not surpirsing that your heart was racing. The concept of giving a steroid to prevent wheezing in anyone who is taking albuteorl several time a day should not be news. It is standard. Signature00doc > I have been plagued with asthma for over 50 years. > [quoted text clipped - 53 lines] > > lou@angelic.com |
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