particularly in younger children or in patients receiving high doses for prolonged periods. Particular care is required when patients are transferred from systemic corticosteroids to products with lower systemic bioavailability (ie, inhalation) May lead to possible adrenal insufficiency or withdrawal from steroids, including an increase in allergic symptoms. Patients receiving prolonged therapy of 20 mg per day prednisone (or equivalent) may be most susceptible. Aerosol steroids do not provide the systemic steroid needed to treat patients having trauma, surgery, or infections.