With corticosteroids, a treatment for COPD, it’s love-hate for me

Corticosteroids are an effective treatment, but side effects can be tough

by Caroline Gainer | March 20, 2024

Main banner for Caroline Gainer's column,

Note: This column describes the author’s own experiences with corticosteroids. Not everyone will have the same response to treatment. Consult your doctor before starting or stopping a therapy.

At some point, most people with chronic obstructive pulmonary disease (COPD) have had to take a corticosteroid, a type of anti-inflammatory drug. It can be delivered orally as a pill or a liquid, inhaled from a nebulizer or inhaler, or used as a nasal spray. In this column, I’ll look at some common corticosteroids and their potential side effects.

One of the first corticosteroids that comes to my mind is prednisone (or prednisolone, which is the active form of prednisone.) When we COPD patients can’t breathe because our bronchial tubes become narrow or inflamed, it can seem like we have a love affair with this medication. But one thing we hate about it is that it can cause many side effects. I never know which ones will show up for me.

Some common side effects are changes in sleep patterns and appetite, as well as brain fog. When I’m on this medication, the first side effect I experience is not wanting to eat. Then I end up with a ravenous appetite. I’m also unable to sleep for a period, followed by an urge to sleep all the time. The severity of side effects seems to vary for me with each dosing.

Prednisone is usually administered via oral tablet. A similar medication, methylprednisolone, can be delivered via injection or infusion, usually in a hospital setting.

Inhaled corticosteroids for COPD linked to lower cardiovascular risk

Fluticasone, sold under the brand names Flonase and Flovent, is a nasal spray that helps to open up the upper respiratory tract or the nose. I use this spray during spring and fall allergy seasons, as it helps to open my nasal passages and combat constant nasal drip. One of the most common side effects is a slight nosebleed, which I sometimes get after continuously using it for a few days.

Corticosteroids can also be inhaled through the mouth to reduce inflammation in the lungs. One of these is Breztri Aerosphere, which is a combination of three types of medicines, including the corticosteroid budesonide.

Another combination inhaler is Trelegy Ellipta, which contains fluticasone. The Mayo Clinic provides a comprehensive list of other inhaled corticosteroids.

One reason an inhaler is used to deliver corticosteroids is because the medication goes directly to the airways, where it is needed.

The most common side effects of inhaled corticosteroids include oral thrush, hoarseness, and bruising. Rinsing your mouth immediately after using an inhaler can help to reduce the risk of side effects.

The COPD Foundation offers an excellent series of videos to help patients learn how to properly and effectively use inhalers.

Love them or hate them, corticosteroids are among the many tools in our toolbox to help us live well with COPD.

Note: COPD News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of COPD News Today or its parent company, Bionews, and are intended to spark discussion about issues pertaining to chronic obstructive pulmonary disease.

About the Author

Caroline Gainer Caroline Gainer is from West Virginia, the state with the highest rate of COPD in the United States. She was diagnosed with moderate-to-severe COPD in 2013 after a pneumothorax (lung collapse). After two more lung collapses she was diagnosed as severe. She has been very active with the American Lung Association and the COPD Foundation as an advocate for people with lung disease. She hopes that her column, “Life Tethered to a Concentrator,” will inspire others to live their best life with COPD.