Letters Guidance on inhaled corticosteroids

Inhaled corticosteroids: first do no harm

BMJ 2012; 345 doi: http://dx.doi.org/10.1136/bmj.e8204 (Published 20 December 2012) Cite this as: BMJ 2012;345:e8204
  1. Vincent H F Mak, consultant physician1
  2. On behalf of the NHS London Respiratory Team Programme Board
  1. 1Central Middlesex Hospital, London NW10 7NS, UK
  1. v.mak{at}nhs.net

Mackenzie highlights the lack of guidance on use of inhaled corticosteroids (ICS) and risk of adrenal suppression.1 The Medicines and Healthcare Products Regulatory Agency recommends issuing a steroid treatment card,2 but there is concern that this may alarm patients and reduce adherence. There is also no consensus on what constitutes a high dose.

High potency combination inhalers (ICS …

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