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The growth of children and adolescents receiving orally inhaled corticosteroids, including QVAR, should be monitored routinely (., via stadiometry). If a child or adolescent on any corticosteroid appears to have growth suppression, the possibility that he/she is particularly sensitive to this effect should be considered. The potential growth effects of prolonged treatment should be weighed against clinical benefits obtained and the risks associated with alternative therapies. To minimize the systemic effects of orally inhaled corticosteroids, including QVAR, each patient should be titrated to his/her lowest effective dose [see Dosage and Administration ( )] .
Pulmicort (budesonide) can come in solution which for asthma is then inhaled by using a nebulizer machine to aerosolize the medication. Swallowed Pulmicort (budesonide) is combined with other components such as Splenda to create a slurry which is then swallowed. This Swallowed budesonide (Pulmicort) Slurry may be used for those who may have more difficuly with dry swallowing fluticasone from an MDI. For those who are on swallowed steroids it is recommended not to eat or drink anything for 30 minutes after taking this medication so that it can provide optimal coating of the esophagus. Furthermore, anyone on these medications should swish and spit or brush their teeth after each use to remove any residual steroids in the mouth where it may have unwanted side effects.