Hi there! Thank you for your question. Steroid in asthma are deliver through 2 methods. Inhaled steroid and oral (tablet) steroids. I will describe about each below. All patients who have regular persistent symptoms of asthma need regular treatment with inhaled corticosteroids.

Inhaled steroid are usually started at low doses and then increased until proper control is obtained. The most commonly used inhaled steroid is beclometasone and budesonide. In Malaysia, these inhaled corticosteroids are given in combination with other drugs for more efficacious results. These are the brown coloured inhaler pumps.

There are several side effects with inhaled corticosteroids. Some of which include oral candidiasis (fungal infection of the mouth – this only occurs in 5% of patients), hoarseness of voice and osteoporosis (rare – this only might happen with high dose inhaled corticosteroids). In general, the side effects of inhaled corticosteroids are not as severe as oral corticosteroids.

Oral corticosteroids on the other hand is give in the later stages of asthma management. It is give when inhaled corticosteroids are no longer helping the patient with asthma control. The most commonly used oral corticosteroid is prednisolone. The side effects include facial swelling (water retention), leg swelling (water retention), weight gain (fat deposition in the face, neck and back), muscle weakness, infections (due to the immunosuppressive effects of steroids), osteoporosis/fractures, mood changes, worsens diabetes, cataract/ glaucoma, diabetes and hypertension.

The dose of oral corticosteroids are kept as low and as short as possible to minimize the side effects. It is usually given at low doses daily for long term asthma control or high dose for a couple of days following a severe attack. Long-term OCS is only used in selected patient and should only be initiated by the respiratory physician after a thorough assessment.

So the answer to your question is it depends on you asthma control following the steroid treatment.

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