Hi, The most common medications to cause vocal cord damage are inhaled cortico-steroid like Alvesco inhaler which contains ciclesonide. Alvesco inhaler is used to treat bronchial asthma and chronic obstructive pulmonary disease (COPD). This inhaler may leave small amounts of medicine on vocal cords or cause dryness, irritation or swelling of the vocal cords. This medicine can change the sound of one s voice and cause hoarseness, a breathy voice, a croaking voice or complete loss of the voice. Throat bleeding or pain when taking is possible. In rare cases, the vocal cord may not open or close properly or not open properly, becoming paralyzed. These vocal cords effects can occur within hours of taking medication or after several months of taking the medication. After the medicine is stopped, the effects usually go away within a few hours or may take a few months. Ava-mys nasal spray contains fluticasone furoate which also may cause clinical features like Alvesco inhaler. Ventolin contains salbutamol which may cause irritation of throat, laryngitis etc. Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Zubayer Alam, General And Family Physician