Whilst the use of inhaled steroids and long acting beta-adrenoceptor agonists (LABA) are recommended in asthma guidelines for the resulting improved symptom control,  concerns have been raised that salmeterol may increase the small risks of asthma deaths and this additional risk is not reduced with the additional use of inhaled steroids.  Other side effects from this drug combination may include increased blood pressure, change in heart rate, an irregular heartbeat, increased risk of osteoporosis, cataracts, and glaucoma.  With available studies, the safety of inhaled fluticasone propionate cannot be questioned for its effect on growth of asthmatic children. A systematic review published in year 2013,  could not derive any significant adverse effect on HPA function, growth and bone mineral density in asthmatic children when inhaled fluticasone is used for long duration and followed for up to three months.
In the meantime, people with limited or no drug coverage under their insurance plan could save money by shopping around in their area. Call your local pharmacies and ask for the lowest available price or the best deal they can offer. Don't leave out independent pharmacies. Our secret shoppers recently found that they sometimes have the lowest prices (and sometimes the highest, too), so it’s worth a call to find out. Other less-expensive pharmacies can include Costco and Walmart, and two . websites, and .