Australia. Adverse Drug Reactions Advisory Committee (ADRAC) in Australia has received 10 reports of inhaled corticosteroid-associated adrenal crisis. Eight cases involved children aged 3 10 years who had received fluticasone propionate (Flixotide) 250 1500 µg/day; in six cases, the daily dose was > 500µg, the upper limit recommended by The Thoracic Society of Australia and New Zealand and by The National Asthma Council in Australia, before referral to a respiratory physician. The committee notes that higher fluticasone propionate doses may not confer greater efficacy and prescribers are reminded that "inhaled corticosteroids should be given at the lowest effective dose and reviewed regularly".
Reports in WHO-file: Adrenal insufficiency 100
Australian Adverse Drug Reactions Bulletin 22: 6, Apr 2003.