An Evaluation of the Risk of Bronchospasm with Intrapulmonary Aerosolization of Flunisolide

To determine whether the practice of nebulizing flunisolide solution (Nasalide) is detrimental in children with asthma, we administered Nasalide solution to 10 asthmatic children (age 12.9 ± 2.9 years) in a double-blind randomized fashion. Three separate solutions (placebo: 2.5 ml normal saline; 1.0 ml Nasalide + 1.5 ml normal saline; 2.0 ml Nasalide + 0.5 ml normal saline) were administered on three successive week-ends following a 24-h washout period, and pulmonary function studies (FEV₁, FEF_25-75, PEFR) were followed for 1 h postinhalation. In addition, twice-daily peak flow determinations and symptom diaries were recorded during each week. No bronchospasm was seen during the study period following the inhalation challenge with Nasalide, nor was there exacerbation of asthma symptoms during the week. We conclude that single-dose inhalation of Nasalide does not cause bronchospasm in asthmatic children. Studies of long-term effects of inhaled Nasalide, including safety, efficacy, and dose—response curves are necessary before physicians can follow the practice of administering this agent to asthmatics.