SERETIDE and children under 4

Hi All

I'm after some advice - Ollie's (he's 3) asthma is quite bad a moment - went to hosp yesterday and DR suggested changing him from Becotide to Seretide. I didn't think Seretide was licenced for children under 4 in UK (but am aware that consultants can give meds 'off licence'). He suggested that we talk it through with consul at next appt in Nov.

His reasoning was that if Ollie had Seretide as a preventer then he'd probably need less pred and that Seretide is preferable to taking continutual courses of pred over the winter. It makes sense and obvioulsy Ollie can't continue to be this unwell all winter - currently we can't go out - as soon as he hits the cold air that sets him off and after a 5 minute bounce on trampoline today he was not at all well. I hate to see him like this - at 3 all he wants to do it run around and play and being stuck indoors is hell for all of us.

So what i'm wondering is what are other people's views/experiences of using Seretide with their young children. I've checked it out on the net and apart from a list of side effects that is very scary i can't work out the pros/cons of Seretide vs Pred (it looks like we'll be between a rock and a hard place)!

Ollie's currently on:-

Becotide 50 - 4 puffs am and 4 puffs pm

Montelukast every day

and Salbutamol (when needed) currently he's on between 5 and 10 puffs 4 hourly but it doesn't seem to be helping as much as usual.

He's just had a really bad virus which meant 7 day (20mg daily) course of pred and AB. But he's not really that much better!

We're getting really stressed about it as it's only October and we seem to be getting back into the cycle of last Winter. I really hate Ollie having pred and don't really want him to have it all winter again. I also don't really want him to have a medicine that isn't licenced for children under 4. But ultimatlly we also want his asthma to be better controlled so that he isn't ill all the time. I'm sure it's going to be a choice between the lesser of two evils and I'm aware that the risks of having uncontrolled asthma far outweigh the effects of the meds. But as a mother i want to do what's best for him.

Thanks in advance.

Claire

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HelloHello. My daughter is 9 so quite a bit older than your son ( I also have a son of 3 with suspected asthma) My daughter was on becotide 100 mcg 4x day(montelukast, serevent, ventolin & beconase) because they are withdrawing the becotide cfc inhaler they switched her to flixotide with a view to putting her on seretide .... I am not 100% sure which steroid is in the seretide inhaler but it is a combination of the salmeterol - the long acting reliever and a steroid which I think is flucatisone which is flixotide. We have not done that because sophie's steroid dose over the last year has been changed quite a few times and it is easier for them to do that without combining the inhalers (so I was told) Sophie was diagnosed at 3 and in and out of hospital with frequent doses of pred until this last year when we managed to keep her out of hospital. The salmeterol (serevent) did seem to help her a fair bit especially at night. Like you we were giving increasing amounts of ventolin day & night and it was not helping her much. The serevent seemed to make quite a lot of difference. So maybe that is why your GP has suggested seretide for the long acting reliever part of it. Sophie has been on the serevent since she was 4 and a half. I'm sorry this isn't more specific and I am aware your son is much younger, but we have not seemed to have had any major side effects from the drugs - occasionally leg cramps but that could also be growing pains!!! I do hope your son is better soon. Tina

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Hi Claire,

I should point out that I'm not speaking from direct knowledge or experience as I have very little experience of treatment of asthma in children, especially children as young as Ollie.

Certainly in adults, the benefits of being on Seretide and being able to reduce the dose of pred needed far outweigh the side effects. I know that reading the potential side effects of Seretide can be scary, but remember that websites often have a tendency to list every rare event that has ever occured while a patient has been taking Seretide.

Again in adults, there is very very little systemic (body wide) absorption of the steroid, fluticasone, when using Seretide, so a lot of the side effects of pred just don't happen. In children, there is slightly more systemic effect, but I would have thought that it would still be much less than the effects of repeated courses of pred. They should be monitoring Ollie's growth and so on whilst he is on it, but then they should really be doing that anyway.

As far as it being off licence is concerned, I wouldn't worry about that too much - a lot of drugs are off licence in young children, simply because it is very difficult to get ethical approval or to recruit people to studies on very young children, so it is hard to definitively prove that these drugs are safe and effective in young children. Seretide has been quite extensively used in young children, though, so there is quite a lot of experience.

I would discuss your concerns with your doctor if you haven't already done so - hopefully he/she will be able to reassure you.

Hope this helps

Em H

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Thanks

Hi Em H and Tina

Thanks for your replies - we are seeing our consultant in a couple of weeks so will discuss it with her. It appears that it will be a choice between the lesser of two evils and if it means that we can cut down Ollie's pred use then I'll just have to get over my paranoia!!

At the moment Ollie's not really very well - he hasn't been able to go to pre-school for nearly 2 weeks and isn't really well enough to go out in the cold air - it sets him off and we're back on 10 puffs of salbutamol. So if Seretide or something similar means that he and we can have a more normal life then it will hopefully be worth any side effects.

His growth is monitored by our GP and ourselves - he's quite small genetically - there's several sub 5fters in both our families - but he's sticking to his line for weight and height so so far it's all ok.

Thanks again for your responses it helps to get 1st hand experiences.

Claire

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Hi Claire,

I have no idea of seretide and children, sorry, but just wanted to say that I hope Ollie's asthma is back under control really soon. I would say give it a go and see what happens. If the side effects are too much then you can always review again with the consultant. I'm sure they wouldn't let Ollie have anything that would cause him more harm than good though.

Not much help I know. I'm ready to listen if you want to let off steam LOL

Take care

Sarah xx

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Hi.

My son was diagnosed with ""probable"" severe asthma when he was 7 months old. It wasn't long before the paediatrician dropped the 'probable'.

My son has now just passed his second birthday. He has been in and out of hospital since he was first diagnosed. He is on flixotide, montelukast and salbutamol needing predisalone and antibiotics every time he gets a cold.

We have to be very careful about taking him outside. It is very imprisoning, as you say, to have to be indoors all the time and a young child doesn't understand why they're not allowed to go outside.

My husband and his family all have asthma, and the only inhaler that really helps them is seretide. Since being on Seretide, my husband's asthma no longer flairs up in cold air or when he exercises and only rarely with a cold. It's the same for other members of my husband's family - the benefits of seretide have far outweighed the side effects.

So we are asking our son's paediatrician to consider seretide for him. Even though he's only 2, it would seem likely that if seretide is best for the rest of the family then the chances are it will be best for him too. It would certainly be better than spending several days each month in hospital and having to curtail all his activities.

My son also has neurological problems which exacerbate his asthma - for example he has dysphagia, which is a co-ordination problem with swallowing, which means that his wind pipe doesn't get closed over quickly enough to allow him to drink 'ordinary' liquids. He has to have thickened liquids otherwise when he drinks it goes into his lungs.

I hope things work out for you.

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Hi my son is 8 now and he was put on seretide when he was about 3 and he changed over night b4 he couldn't walk across the lounge floor /walk to the corner shop without wheezing and ending up in hospital and no kidding became a different kid once on seretide

been on it eversince he's now 8

my daughter older has been put on it i swear by it just made our lives so much easier

its only licensed for i believe 12 yrs and over but our consultant swears by seretide really has made a difference to our lives

hope this helps if u want to chat pm me

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my daughter's 5 but was put on it when she was 4. As everyone else seems to say, it's the only preventative that seems to be helping. She's still incredibly asthmatic and we're having a tough time at the moment because of the weather but this time last year we were in hospital every three weeks so I can't complain.

We had an awful experience with the monteleukast - she started on the powder when she was younger and I took her off it because of the side effects. She started on the tablets about six months ago because her asthma isn't under control and the side effects were frightening. She turned into a complete monster. As soon as I stopped them she returned to the normal loving child which I know she is. I hate the amount of drugs I'm having to put into her body to keep her stable but I guess everyone on here feels the same way.

Best of luck - hope things improve soon x