Can Inhaled or Nasal Steroids Cause Addiction?

Inhaled Nasal Steroids and Addiction

So, the question: “Do inhaled or nasal steroids cause addiction? Should we be afraid of using them?”

  • Inhaled and nasal glucocorticoids act LOCALLY! They have a local anti-inflammatory effect, not a systemic one.
  • They do not n affect the entire body, but only the area of application – and this is the bronchial mucosa and nose.

Yes, when prescribing inhaled glucocorticoids, you should always consider the possible systemic effect.

Remember that tablets and inhalers have different forms of release, and side effects are also different because tablets and inhalers have different ways of delivery to the body.

Yes, inhaled / nasal hormones are absorbed into the total bloodstream, but the percentage is small, compared with systemic glucocorticoids (prednisolone in tablets).

In other words, most of the hormone is absorbed and acts only on the mucosa of the respiratory tract, and therefore the effect of the systemic effect is very minimal.

For example, Pulmicort at recommended therapeutic doses has a significantly lower effect on adrenal function than prednisolone at a dose of 10 mg (only 2 tablets).

Accordingly, there will be a smaller frequency of side effects than when using systemic glucocorticosteroids.

Nasonex spray is practically NOT determined in the blood plasma. The suspension is very poorly absorbed from the digestive tract.

Therefore, a small amount that can enter the digestive tract (after inhalation into the nasal cavity), before it is excreted in the urine or bile, is subject to active primary metabolism (destruction).

Do inhalation hormones affect growth with long-term use?

  • Children and adolescents receiving treatment with glucocorticoids (regardless of the method of delivery) for an extended period are recommended to regularly monitor growth rates;
  • In studies of children older than 3 years, the use of budesonide in a dose of up to 400 mcg/day did not lead to systemic effects;
  • Biochemical signs of the systemic effect of the drug may occur when taking the drug at a dose of 400-800 mcg/day and above.

Treatment of bronchial asthma with glucocorticoids can cause dysplasia.


The results of monitoring children and adolescents who received budesonide for a long period (up to 11 years) showed that the growth of patients reaches the expected normative indices for adults.

  • Inhaled and nasal hormones prescribed in adequate therapeutic doses do NOT cause addiction, and their systemic effect is minimized!
  • Internal steroids do not cause cancer, they do not destroy the bones, they do not gain weight from both the long-term administration of systemic steroids, and do not cause the cushingoid syndrome!

You feel better not because the illness is gone, but because you get anti-inflammatory treatment. Unauthorized withdrawal of drugs may lead to an exacerbation of the disease

  • Inhaled steroids prescribed in small and medium doses and for a short period of time do not require a gradual cancellation and reduction of doses;
  • If you are diagnosed with bronchial asthma, inhaled glucocorticoids are vital for you!

They are not addictive – they are needed!

You should understand it. Inhaling the dose in the mornings should be the same habit as brushing your teeth. Thus, you ensure an optimal quality of life.

Tableted prednisolone, used for up to two weeks, will not have a clinically significant load and pronounced changes in the function of the adrenal glands.

The gradual withdrawal of the drug, with a decrease in dose, is not always necessary and justified (provided that this is a short course, and the patient does not take prednisolone on an ongoing basis for a long time).

For example, in an exacerbation of asthma in adults, prednisolone is given in a dose of 40-50 mg (8-10 tablets) for 5-7 days with complete cancellation (without dose reduction).

The main thing is that you need to use hormones correctly, in the right dosage, only for direct indications, and for the purpose determined by your doctor.

Category: Asthma School

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