The growth of children and adolescents receiving orally inhaled corticosteroids, including QVAR, should be monitored routinely (., via stadiometry). If a child or adolescent on any corticosteroid appears to have growth suppression, the possibility that he/she is particularly sensitive to this effect should be considered. The potential growth effects of prolonged treatment should be weighed against clinical benefits obtained and the risks associated with alternative therapies. To minimize the systemic effects of orally inhaled corticosteroids, including QVAR, each patient should be titrated to his/her lowest effective dose [see Dosage and Administration ( )] .
"The big clue that we've learned over the years is that if you have to use a rescue inhaler often -- waking up more than two nights a month or having to use it more than two times a week -- you ought to be on something that gives you more protection," says Honsinger. "These drugs just help you for the moment -- they don't keep the increased mucus away or the scarring of the lung away. For that you need something that gives you better protection and longer action that decreases the inflammation of the lung, like an inhaled corticosteroid or a leukotriene inhibitor."