The most common side effects with inhaled steroids are thrush (a yeast infection of the mouth or throat that causes a white discoloration of the tongue), cough or hoarseness. Rinsing your mouth (and spitting out the water) after inhaling the medicine and using a spacer with an inhaled metered-dose-inhaler reduces the risk of thrush. When a dose is prescribed that is normal or higher than the normal dose in the package insert, some systemic side effects may occur. Keep in mind, however, that an inhaled steroid has much less potential for side effects than steroid pills or syrups. There have been concerns regarding the possibility of growth suppression in children. Recent studies have not shown growth suppression over several years of treatment.
Nebulisers are machines that turn the liquid form of your short-acting bronchodilator medicines into a fine mist, like an aerosol. You breathe this in with a face mask or a mouthpiece. Nebulisers are no more effective than normal inhalers. However, they are extremely useful in people who are very tired (fatigued) with their breathing, or in people who are very breathless. Nebulisers are used mainly in hospital for severe attacks of asthma when large doses of inhaled medicines are needed. They are used less commonly than in the past, as modern spacer devices are usually just as good as nebulisers for giving large doses of inhaled medicines. You do not need any co-ordination to use a nebuliser - you just breathe in and out, and you will breathe in the medicine.
Some parents worry that children who use inhaled corticosteroids may not grow as tall as other children. A very small difference in height and growth was found in children who were using inhaled corticosteroids compared to children not using them. 3 And one study showed a very small difference in height [about in. ( cm) ] in adults who used inhaled corticosteroids as children compared to adults who did not use inhaled corticosteroids. 4 But the use of inhaled corticosteroids has important health benefits for children who have asthma. If you are worried about the effects of asthma medicines on your child, talk with your doctor.