Inhaled Corticosteroids and Oral Adverse Effects

Primary Oral Adverse Effects

• Oropharyngeal candidiasis (oral thrush) occurs with increased frequency in patients using inhaled corticosteroids, presenting as white patches in the mouth and throat that can cause pain and discomfort 1, 2, 3
• Throat irritation is a common adverse effect reported in clinical trials of inhaled corticosteroids, which can manifest as soreness and pain in the mouth and throat 1, 2, 3

Distinguishing Features

• The incidence of oral candidiasis is significantly increased with inhaled corticosteroid use (OR 2.65, 95% CI 2.03-3.46) according to the American College of Chest Physicians 4

Risk Mitigation Strategies

• Using large-volume spacers with the inhaler can minimize oral deposition and reduce local side effects, as recommended by the European Respiratory Journal 5, 6