Eventually, most people with any type of chronic lung disease will find themselves taking an anti-inflammatory medication at some point in their treatment. Anti-inflammatory medications improve breathing by reducing swelling of the air passages. Some anti-inflammatory medications are taken for short periods to help speed recovery when a patient has a respiratory infection or other problem causing a flare-up of breathing difficulty. Some anti-inflammatory medications are taken long-term to help prevent swollen air passages and improve lung function.
Corticosteroids vs. Anabolic Steroids
Before we go any further, let’s clear up some confusion that many people have about the term “steroids." The steroids used in the treatment of lung disease are corticosteroids, which are very different substances than the anabolic steroids that we sometimes hear about athletes abusing.
Corticosteroids: Medications that imitate the effects of a hormone produced in the adrenal gland called "cortisol," which has many functions in the body including fighting stress and reducing inflammation.
Anabolic steroids: Synthetic versions of male sex hormones that increase male characteristics. Athletes sometimes use them illegally to increase muscle mass and strength. There are legitimate medical conditions for which anabolic steroids may be prescribed, but lung disease is not one of them.
Oral Corticosteroids
Oral steroids, such as prednisone, prednisolone or methylprednisone, are sometimes prescribed to people with cystic fibrosis (CF) for short-term treatment. They are not recommended for long-term therapy because of the potential for serious side effects including:
- Growth retardation in children
- Diabetes
- Cataracts
- Osteoporosis
- Decreased ability to fight lung infections, such as the potentially deadly Pseudomonas aeruginosa
Inhaled Steroids
Inhaled steroids, such as Qvar (beclomethasone), Pulmicort (budesonide) and Flovent (flucticasone), are delivered directly to the lungs and have less side effects than oral steroids. Studies have not shown any particular benefit of long-term inhaled steroids for people with cystic fibrosis, though, so the Cystic Fibrosis Foundation advises against the routine use of inhaled steroids in people with CF unless they also have asthma.
Non-Steroidal Anti-Inflammatory Drugs (NSAIDS)
As the name implies, NSAIDs are a group of anti-inflammatory medications that do not contain steroids. NSAIDs do not carry the same risk of side effects as steroidal anti-inflammatory medications, but with long-term use, they may cause internal bleeding or kidney problems.
Ibuprofen, which is sold over the counter and by prescription, is an NSAID that has been shown to slow the loss of lung function with long-term use in people with cystic fibrosis. Since the potential benefit of ibuprofen is greater than the risk of serious side effects, the Cystic Fibrosis Foundation recommends long-term use of prescription-strength ibuprofen as a treatment option for people with cystic fibrosis who are at least 6 years old and have an FEV1 of 60% or greater.
Important: Do not take over-the-counter ibuprofen for long-term treatment of cystic fibrosis without first consulting your physician.
Source:
Flume, P., et al. “Cystic Fibrosis Pulmonary Guidelines: Chronic Medications for Maintenance of Lung Health." Am. J. Respir. Crit. Care Med. 2007. 176: 957-969. 31 August 2008.
