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Child developed asthma. Prescribed budecort inhaler, montair granules, asthalin, duolin. Do these steroids have side effects?

My daughter is 18 months old. She developed asthama at 12 months age. Before that she never had any complaints. Doctor has advised budecort inhaler 100 mcg (pink coloured) to be given twice 1 day for 6 months and montair granules 4mg (oral) once in a day for 2.5 months. Also, doctor has advised nebulisation with budecort / duolin / budesal / asthalin repsules whenever she feels uneasy / breathe fast. I would like to know what are the side effects of all these steriod being taken by my daugther at so early age? What are the other options available? We are really worried? Please advise. Thanks
Asked On : Fri, 2 Nov 2012
Answers:  4 Views:  1605
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Pediatrician, Cardiology 's  Response

Inhalational steroid has minimal systemic side effects because it mainly acts locally.
You have mentioned that your doctor has advised nebulisation with budecort, duolin, budesal and asthalin. Budecort contains budesonide and budesal contains both budecort and salbutamol, while duolin contains salbutamol and ipratropium and asthalin contains salbutamol.
During acute exacerbation only salbutamol inhalation is prescribed. Some physician also uses ipratropium and budesonide during acute attack. But using all these four drugs at a time is not justified.
According to guidelines there is no substitute of steroid if asthma is diagnosed. You need not to worry as side effects are minimal. Wash her mouth each time after use of steroid inhalation as this decreases the side effects further. Consult your doctor to be clear about the drug used during acute attack.
Answered: Sun, 4 Nov 2012
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Emergency Medicine Specialist Dr. R.A. Singh's  Response
Thanks for writing your query.
Steroids taken through inhaler or nebulizers have no or minimal side effects as they are not absorbed in blood and their action is directly on the airway passage. They are rather helpful in curing and preventing the asthmatic attacks.
You should take care of rinsing her mouth after giving the medicine as they can cause fungal infection in the oral cavity if not rinsed.
I hope this is useful to you. If you have any doubts, I will be happy to help.
Answered: Sat, 3 Nov 2012
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Allergist and Immunologist Dr. Sujoy Khan's  Response
All steroid inhalers have a degree of absorption into the system and therefore they are not given for prolonged lengths of time unless absolutely required.
The montair granules are not steroid pills and rightly prescribed for 10 weeks.
I hope none of these will be required after a few months, and this is most likely viral induced asthma. It is important that lung inflammation is controlled and regular visits to the asthma clinic is recommended.
Answered: Sat, 3 Nov 2012
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General & Family Physician Dr. Debraj Jash's  Response
It is important to know that uncontrolled asthma has a far more deleterious effect on health than side effects of the medicine. At this age budetrol metered dose inhaler via dedicated face mask twice daily is the treatment of choice. If your child remains controlled with these medication, then an attempt to reduce the dose of steroid will be attempted within six months. Side effects of inhalational steroids are hoarseness of voice, oral candidiasis, growth retardation. Children treated with inhalational steroid will have a late peak growth velocity. They will have normal adult height but they will reach it later.After each inhalation, you need to wash your child's mouth with water.Inhalational steroids when taken at larger dose may lead to osteoporosis, glucose intolerance,puffiness of face, hypertension. But the dose at your child is taking, having the chance of this systemic side effects are rare. Childhood asthma have a relatively good prognosis. Make sure your child is having these medications at correct dosage. Hope, I satisfied your queries.
Answered: Sun, 4 Nov 2012
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