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Inhaled Corticosteroids

Also indexed as: AeroBid® Inhaled, Azmacort® Inhaled, Beclomethasone Inhaled, Beclovent® Inhaled, Beconase AQ® Inhaled, Beconase® Inhaled, Budesonide Inhaled, Cutivate® Inhaled, Decadron® Phosphate Turbinaire or Respihaler, Dexamethasone Inhaled, Flonase® Inhaled, Flovent® Inhaled, Flunisolide Inhaled, Fluticasone Inhaled, Levalbuterol Inhaled, Mometasone Inhaled, Nasacort AQ® Inhaled, Nasacort® Inhaled, Nasalide® Inhaled, Nasonex® Inhaled, Proventil® Inhaled, Pulmicort® Inhaled, Rhinocort® Inhaled, Triamcinolone Inhaled, Vancenase AQ® Inhaled, Vancenase® Inhaled, Vanceril® Inhaled, Ventolin® Inhaled, Volmax® Inhaled, Xopenex™

Combination drug: Viskaldix®

Corticosteroids are inhaled by mouth to treat and prevent asthma, as well as other inflammatory conditions of the lungs that restrict breathing. They are inhaled into the nose to treat and prevent symptoms of hay fever and other allergies. In addition, some agents may be used to prevent recurrence of nasal polyps following surgical removal.

The information in this article pertains to inhaled corticosteroids in general. The interactions reported here may not apply to all the Also Indexed As terms. Talk to your doctor or pharmacist if you are taking any of these drugs.

Interactions with Dietary Supplements

Calcium
Most of an inhaled dose of beclomethasone is actually swallowed, which may lead to reduced absorption of calcium.1 Health practitioners may recommend calcium supplementation to individuals using beclomethasone inhalers.

Dehydroepiandrosterone (DHEA)
A group of women with asthma who had been taking inhaled beclomethasone were shown to have low levels of DHEA compared to women with asthma who were not taking beclomethasone.2 The authors speculated that this effect may partially explain how corticosteroids can cause osteoporosis. However, more research is needed to confirm these suspicions and to evaluate whether supplemental DHEA is beneficial to patients taking inhaled corticosteroids.

Summary of Interactions for Inhaled Corticosteroids

Depletion or interference Calcium
Dehydroepiandrosterone (DHEA)*
Adverse interaction None known
Side effect reduction/prevention None known
Supportive interaction None known
Reduced drug absorption/bioavailability None known

For the convenience of the reader, the information in the summary is categorized as follows: “Depletion or interference” indicates the drug may deplete or interfere with the absorption or function of the supplement or herb. “Adverse interaction” indicates that the supplement or herb used together with the drug may result in undesirable effects. “Side effect reduction/prevention” indicates the supplement or herb may reduce the likelihood and/or severity of a potential side effect caused by the drug. “Supportive interaction” indicates the supplement or herb may support or aid the function of the drug. “Reduced drug absorption/bioavailability” indicates that the supplement or herb may decrease the absorption and/or activity of the drug in the body. An asterisk (*) next to an item in the summary indicates that the interaction is supported only by weak, fragmentary, and/or contradictory scientific evidence.

References:

1. Smith BJ, Phillips PJ, Pannall PR. Effect of orally administered beclomethasone dipropionate on calcium absorption from the gut in normal subjects. Thorax 1993;48:890–3.

2. Smith BJ, Buxton JR, Dickeson J, Heller RF. Does beclomethasone dipropionate suppress dehydroepiandrosterone sulphate in postmenopausal women? Austral NZ J Med 1994;24:396–401.