Expert: Marc Rubin, RPh Asthma Educator - 7/1/2009

Question
I,ve recently been told I have asthma and put on Flovent 44.( Adult female, suburban US) I've been trying to loose weight and have been gaining instead even while dieting and exercising. Is it possible that this is from the Flovent? Is another medication available that would not cause weight gain? Thanks for your attention.

Answer
Hi Christine,

The effects of inhalation steroids, especially at low doses such as what you are at, are predominantly locally in the lungs. That is not to say that it is not possible, just not likely. Steroids of this type typically cause water retention, but predominantly when taken orally. The oral doses of steroids are many fold higher than inhalation (Prednisone 10mg in micrograms is 10,000mcg versus Flovent 44mcg).

Regarding the weight changes, do not use weight as your guide point. It is great that you are exercising, both for your asthma as well as overall health. Muscle weighs more than fat, and you should be looking at body measurements: waist, chest, hips, thighs, rather than the weight scale. Your weight change, hopefully, is from body toning, and not from the Flovent.

If you have mild asthma, you may ask your doctor about trying Singulair, an oral medication which helps to reduce lung inflammation. If you have allergies, I'd suggest this in addition to an oral, non-drowsy antihistamine, such as Allegra, Claritin or Clarinex. Should you still need your rescue inhaler more than twice a week in the daytime, or are awakened more than twice a month at night, you will still need to be stepped up to an inhalation steroid. Your doctor has many to choose from, and one, Pulmicort, can be taken once a day. Keep in mind, with persistent asthma, the "Gold Standard" is inhalation steroids, for control.

It is essential that you do a reassessment to determine what is going on here. Start tracking your measurements, and the fit of your clothing, before making any changes. Hopefully you will be surprised with the results.

Sincerely,

Marc