A review of available data is reassuring. However, long-term prospective studies concerning many systemic side effects still need to be conducted properly. These include topical side effects, systemic side effects, and side effects secondary to withdrawal of ingested corticosteroids. These occur occasionally and are medically minor. Oral candidiasis is the most common, and is likely secondary to deposition of orally inhaled corticosteroids.
Dysphonia is thought to occur secondary to a local steroid myopathy of the vocal cords.
It is seen chiefly with chronic use of higher doses and also can be reduced by the use of spacing devices and probably by dry powder inhalers. This often improves as the asthma control improves. This side effect responds quite well to use of a spacing device. There appears to be much less of this problem with the Turbuhaler , perhaps because there are no additives or fillers. Occasionally subjects appear to develop a sore mouth or pharynx without obvious candidiasis or other infection.