For people with more severe asthma, higher dosages of inhaled steroids or the frequent use of oral steroids can also predispose to the development of thrush. Once thrush has developed, a person may need treatment with nystatin mouthwash or oral Diflucan (fluconazole). Some people require periodic rinsing (once daily to a few times per week) with nystatin in order to keep thrush from coming back.
The use of a spacer device with a steroid metered dose inhaler can be helpful in reducing or preventing thrush. This device acts to reduce the amount of medication delivered to the mouth, and helps more medication get to the lungs, where it’s needed most. Unfortunately, many new inhaled steroids utilize dry powder inhalers (such as Advair, Pulmicort and Asmanex) that don’t utilize a spacer.
Dry powder inhalers seem to especially predispose people to getting thrush. The powder from these inhalers doesn’t dissolve well in water, so some people find that rinsing their mouths and brushing their teeth doesn’t help to keep the thrush away. For these people, rinsing with an alcohol-based mouthwash, such as Listerine, may be more helpful in preventing thrush.
Want to learn more? Find out about the side effects of inhaled steroids.
Source:
Schleimer RP, Spahn JD, Covar R, Szefler SJ. Glucocorticoids. In: Adkinson NF, Yunginger JW, Busse WW, et al, eds. Middleton’s Allergy Principles and Practice. 6th edition. Philadelphia: Mosby Publishing; 2003:870-914.
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