Pulmicort or Flixotide

[Kendavis359]

This always gets me thinking on which is the better or stronger of the two. Having been on Flixotide for many years i notice that Symbicort seems to be used by a lot of people this has a built in reliever and preventer. Has any body found that changing from flixotide as helped them because it does nothing for me these days, but doc said it was the best. Love to hear anybodys stories. Thanks

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I used to be on Becloforte, then Pulmicort and then I was switched to Flixotide when it first came out as docs reckoned it was more effective. Not sure whether there is much difference between them. My asthma is brittle and I had been thinking recently about this myself. I have been on flixotide for many years now and wondered whether it was losing effect and whether changing steroid inhaler to a different medicine would help me respond better.

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i went from becloforte to seretide (which is flixotide and serevent mixed together). i found it worked for about 2 years and then stopped working completely. ive never had pulmicort so i cant comment

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I went from becotide to seretide to symbicort...i prefer symbiort to the other two...

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I went from pulmicort to symbicort to flixotide and servet to sertide and am now one qvar and atimos modultie. i prefer having the two spearate inhalers cause me and my gp ahve sorted out that i can up my qvar if need be (well when i was on a lower dose).

i think out of the combos i like seretide the best it seemed to work well but tht could ahve been due to lots of different things durng a stbale time.

Hope you fid one that works well for you

Olive

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Been through becotide to flixotide to seretide (125 - 250) and now on symbicort. For me it seems to be working. Seretide really suited me but the chest phsyician wanted me to try symbicort. Have been using it for nearly a month and so far so good.

Good luck yourself.

Oboelady

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I was on seretide, which worked well, but then I was switched to pulmicort, and then to symbicort. So far I like symbicort the best because I can increase the dose if i am having a bad phase, then slowly decrease, which I think works well for me. I don't use it as a reliever though. Just as a preventer, so I am not following the SMART system, nor the regular... I'm somewhere in the middle.

[yaf_user681_30003]

I went from Flixotide to Seretide 250, whch seemed to work quite well, but swapped to Symbicort a month ago to see whether that change would make any difference to increasing amount of foot cramp. The foot cramp has reduced, but that may because going through a very good time at the moment and generally only using Salbutamol before exercise. So, under this new regime, managed to get more consistent high PF figures, even though fluctuates a lot between morning and night (400-ish AM and 530-550-ish PM). Decided with GP yesterday to stay with Symbicort (this is the 400/12, so not SMART), and, almost in celebration, stunned myself and my trainer at the gym by hitting 640 at the end of a stint on the rowing machine! No question which regime I will be continuing.

Alan

[Kendavis359]

Thanks for all your interesting replies. I think i will give the symbicort a try as they say maybe we are all different and what suits one does not suit the other. Only problem i see is that you cant increase the steroid part of the inhaler with out increasing the reliever part, so how do we challenge this situation. thanks

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It may just be my perception, but over the last few years, there does seem to have been a 'feeling' (nothing more scientific than that, I don't think) among respiratory physicians that fluticasone (Flixotide and Seretide) was in some way better than the other inhaled steroids. However, more recently people seem to be moving back to favouring budesonide (Pulmicort and Symbicort) - probably because of the introduction of the Symbicort SMART flexible dosing regimen, which does not have an equivalent among other inhaled steroids.

In terms of actual objective evidence, there aren't any data that really support the idea of one inhaled steroid being any better than another. The British Thoracic Society guidelines for the management of asthma don't recommend any specific inhaled steroid, just that inhaled steroids should be used. The side effect profiles are very similar for the different inhaled steroids, too. There are a limited amount of data on the newer inhaled steroids, ciclesonide and mometasone, so it may be that one of these will prove to be better than the others, but initial data don't seem to support this.

As ever, though, everyone is different, and some people find that they do respond markedly better to one than another. If your control is not as good as it could be, it's always worth trying an alternative to see if it helps things (the same could be said for other 'within class' substitutions - eg formoterol for salmeterol, zafirlukast for montelukast, terbutaline for salbutamol - very little evidence that one is better than the other, but it's worth considering swapping things around if your control isn't good, just to see if it does make a difference).

In terms of 'strength', fluticasone is roughly twice as strong as budesonide and beclomethasone, in general (the exception is beclomethasone as Qvar, which is twice as strong as other beclomethasone preparations and roughly equivalent to fluticasone). However, clinically and practically, this makes very little difference, as you simply take half the dose of fluticasone compared to the others.

Personally, I'm on fluticasone (as Flixotide Accuhaler), having been on beclomethasone originally when first diagnosed, and then on budesonide. It's difficult to tell as my asthma has changed so much over the years, but I haven't noticed a marked difference between those three.

Does anyone have any experience of changing to ciclesonide or mometasone, positive or negative? I'd be interested to hear what people think - they are about the only drugs (bar Xolair) that I haven't tried for my asthma!

Em H