Inhaled Corticosteroid Oral Effects — MFDS Part 1 MCQ

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EasyPharmacologyInhaled Corticosteroid Oral EffectsMFDS Part 1

A patient uses a high-dose inhaled corticosteroid for long-term control of asthma. Which oral adverse effect is most characteristically associated with this treatment?

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Correct answer: A — Oral candidiasis

The correct answer is **A, oral candidiasis**. Inhaled corticosteroid deposited in the oropharynx causes local immunosuppression, predisposing to candidal overgrowth; the risk increases with higher corticosteroid doses. Patients should rinse their mouth with water and spit it out, or brush their teeth, after each dose. An appropriate spacer can reduce oropharyngeal deposition when a pressurised metered-dose inhaler is used. Gingival enlargement is associated particularly with calcium-channel blockers, phenytoin and ciclosporin. Medication-related osteonecrosis is linked mainly to antiresorptive and antiangiogenic drugs, while intrinsic tooth discolouration and oral lichenoid reactions are not characteristic adverse effects of inhaled corticosteroids.

Reference: Electronic Medicines Compendium. Clenil Modulite 200 micrograms inhaler, Summary of Product Characteristics, sections 4.4 and 4.8. Updated 2023. https://www.medicines.org.uk/emc/product/6976/smpc