Any of the inhaled steroids taken by asthmatic children could stunt their growth.

This includes fluticasone propionate (Flixonase in the UK; Cutivate, a topical ointment or cream in the US) which was introduced in 1993 in Britain as a safer alternative to other corticosteroids, whose side effects include growth retardation and adrenal suppression.

But new research from the Royal Belfast Hospital for Sick Children has found that fluticasone propionate can also have the same effects when used in doses of more than 500 micrograms a day. This high dose is often given, even though the safety levels of the drug have been established only at doses of 200 micrograms.

Another research team, at the Sawston Medical Practice in Cambridgeshire, England, found that fluticasone propionate was safer than two other inhaled steroids, beclomethasone dipropionate and budesonide, when doses were between 100 and 200 micrograms. At these levels, the drug did not affect growth.

!AThe Lancet, 1996; 348:27-9 (Royal Belfast Hospital study) and 63 (Sawston study).