In the meantime, people with limited or no drug coverage under their insurance plan could save money by shopping around in their area. Call your local pharmacies and ask for the lowest available price or the best deal they can offer. Don't leave out independent pharmacies. Our secret shoppers recently found that they sometimes have the lowest prices (and sometimes the highest, too), so it’s worth a call to find out. Other less-expensive pharmacies can include Costco and Walmart, and two . websites, and .
When used in high doses, a small amount of the medication is absorbed into the bloodstream and some side effects beyond the mouth and throat may develop. The most likely to be encountered are easy bruisability of the skin and suppression of the adrenal glands. The significance of adrenal gland suppression is discussed in further detail in the pamphlet entitled Asthma and Steroids in Tablet Form , prepared by the Partners Asthma Center. The risk from the long-term use of inhaled steroids in terms of hastening thinning of the bones (osteoporosis) is currently being studied. However, it is widely agreed that any risk that may be discovered will be far less than that resulting from use of steroids in tablet form in doses needed to achieve the same control of asthma.
There is, however, some evidence that higher doses of inhaled corticosteroids can result in adverse BMD changes. In a high-quality RCT of 412 participants, aged 40 to 69 years, with mild to moderate COPD, use of higher-dose triamcinolone (1200 mcg/day) was associated with decreased lumbar and femoral neck BMD over 3 to 4 years. 4 The differences in BMD between the inhaled corticosteroids and placebo groups at the femoral neck and lumbar spine were % ( P <.001) and % ( P =.007), respectively. However, the risk of fracture or height loss did not increase at follow-up.