Why You Rinse After a Steroid Inhaler

You take your inhaler, put it away and move on with your day.

Done?

If your inhaler contains a corticosteroid, there may be one tiny step missing: rinse your mouth with water and spit it out.

It takes only a few seconds, but those seconds have a job.

Why Does Your Mouth Need a Rinse?

Steroid inhalers, also called inhaled corticosteroids, are commonly used to reduce inflammation in the airways. They may be used for conditions such as asthma and COPD. The medicine is intended to reach the airways, but some can also be deposited in the mouth and throat.

Think of it as medication taking the scenic route and leaving a few passengers behind.

Those leftovers are one reason people using inhaled corticosteroids can develop local side effects such as a sore mouth, hoarse voice or oral thrush.

What Is Oral Thrush?

Oral thrush is a fungal infection of the mouth. It can cause symptoms such as white patches, redness or soreness.

The NHS specifically recommends rinsing the mouth with water or brushing the teeth after steroid inhalers such as budesonide or fluticasone to help prevent oral thrush. Read the NHS guidance on budesonide inhaler side effects.

This does not mean steroid inhalers are “bad for your mouth” or that you should stop using one.

It means good inhaler technique includes a little aftercare.

Rinse — And Spit

After using an inhaler containing a corticosteroid:

1. Take your prescribed dose as directed.
2. Rinse and swish your mouth with water.
3. Spit the water out rather than swallowing it.

Official medication instructions for inhaled fluticasone tell patients to rinse with water without swallowing to help reduce the risk of oral candidiasis. See the DailyMed prescribing information.

So this is not a post-inhaler hydration challenge. The water has completed its assignment—let it go.

Does This Apply to Every Inhaler?

No.

Not every inhaler contains a corticosteroid.

Some inhalers contain other types of medication, while some combination inhalers contain both a corticosteroid and another medicine.

That is why it is important to know what is in your specific inhaler and follow its instructions.

If the directions on medication labels sometimes feel like very small print carrying very large responsibilities, read Dose vs Directions on a Label: What’s the Difference?.

Your Technique Matters Too

Rinsing is helpful, but it does not replace correct inhaler technique.

Depending on the type of inhaler, factors such as how you prepare the device, breathe in the medicine and use a spacer when appropriate can affect medication delivery.

If you are unsure about your technique, ask your pharmacist, respiratory educator or another healthcare professional to watch you use your inhaler. Even people who have used an inhaler for years can benefit from an occasional technique check.

And while you are checking your device, do not forget the other little number with a big job: the dose counter. Read Check Your Inhaler Dose Counter Before It Reaches Zero for another simple inhaler-safety habit.

What If Your Mouth Is Already Sore?

If you notice persistent mouth soreness, white patches, throat discomfort or a change in your voice, speak with your pharmacist or prescriber.

Do not simply stop your prescribed steroid inhaler because you are worried about a side effect. Steroid preventer inhalers are used to control airway inflammation, and changes to treatment should be discussed with your healthcare professional.

The Bottom Line

With a steroid-containing inhaler, remember:

Puff. Rinse. Swish. Spit.

Your inhaler has finished its shift. Your mouth does not need to keep the leftovers.

For more practical medication-safety information, visit the NatalieRx Blog.

Disclaimer

This article is for general health education only and is not medical advice. Inhalers and their instructions differ. Always follow the directions supplied with your specific inhaler and advice from your pharmacist, prescriber or other qualified healthcare professional.