Adult asthmatics taking not more than 10 mg of prednisone a day with regular supervision seem rarely to suffer serious unwanted effects.1 Hydrocortisone, prednisone and dexamethasone have been given by aerosol to achieve a local effect but their systemic activity2 and uncertain local effects have limited their use in asthma. Hitherto, corticosteroid aerosols have not achieved selective local activity and are readily absorbed. Beclomethasone dipropionate (Becotide - A & H) and betamethasone valerate (Bextasol - Glaxo) have recently been introduced in aerosol form because of their proven topical effectiveness in some skin diseases without unwanted systemic effects.3 Both are potent vasoconstrictors when applied to normal skin. A local action confined to the bronchial mucosa without harmful local or systemic effects would be valuable in asthma.
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