What doses of Pulmicort Turbuhaler are considered well tolerated?
Safety can be divided into local safety and systemic safety. Systemic safety in children is also described in Paediatric asthma . Depending on test methods used systemic activity of inhaled steroids may be detected after inhalation of various doses. Continuous systemic glucocorticoid activity may or may not translate into clinically detectable systemic side effects. Suppressive effects on the hypothalamic-pituitary-adrenal (HPA) axis measured as 24-hour excretion of urinary cortisol, integrated 24-hour plasma cortisol or ACTH tests are sensitive enough to detect systemic activity. Morning cortisol is insensitive as cortisol is secreted in a pulse-way manner. A normal HPA axis function during treatment with inhaled steroids is generally considered as a clear marker of safety. Compared with placebo no suppressive effects on the HPA-axis have been found with doses of Pulmicort Turbuhaler up to and including 800 µg daily. A daily dose of 1600 µg has in some studies resulted in a small but
