What is one of the side effects of long-term use of inhaled corticosteroids like fluticasone?

Long-term use of inhaled corticosteroids, such as fluticasone, can lead to adrenal suppression, which is a significant concern for patients. Inhaled corticosteroids are designed to reduce inflammation in the airways, but when used over extended periods, they can suppress the hypothalamic-pituitary-adrenal (HPA) axis. This suppression can reduce the body's ability to produce natural corticosteroids, particularly cortisol, leading to symptoms associated with adrenal insufficiency.

Adrenal suppression occurs because the body's feedback mechanisms react to the external corticosteroids, which can signal the adrenal glands to decrease or halt their own production. This can result in various problems, especially in situations where the body may need an increased amount of cortisol, such as during stress or illness. Understanding this side effect is crucial for managing patients on long-term inhaled corticosteroids to prevent potential adrenal crisis and ensure proper monitoring and management strategies are in place.