Doubled Seretide 500/50 and Uniphylline

For the past month I've barely slept through a night and I've had half a dozen nights when I've slept less than 2 hours if at all because of coughing with asthma. 3 weeks ago I went to see GP after a night when I'd not slept at all and my pf hovered around 54% for some of the time, so she gave me some pred. When I finished the course I was better but still not good, so I saw her again and she doubled my seretide 500/50 to 2 puffs twice a day as she didn't want to give me more pred as she said I'd had too many courses this year already.

Well, today I had a review (as instructed) with the asthma lead GP at my surgery and he's kept me on the doubled seretide (and given me another course of pred) and says he'll review in four weeks. He said that in 4 weeks he's probably expecting to keep the seretide as it is now and maybe add uniphylline/theophylline.

I have a few questions, as I'm a bit confused about some things and just curious about others. The first GP said that the Asthma lead GP I saw today would almost certainly step down the seretide as it's a very high dose. 2000mcgs/200mcgs does seem high to me. How long have others been on this dose and are/were you under the care of a GP or cons? First GP also said that I'd probably have a referal this time, but today's GP said he'd wait a while to see if things settled before refering me. My asthma's been nowhere near controlled since february. I think I'll be asking for a referal at next appointment if things aren't controlled. What do you think? Also, how have you got on with uniphylline/theophylline?

Sorry for the waffle, but lots of things running around in my head and I'm just fed up of being up every night, although I'm very happy to be mostly good during the daytime. Would just appreciate some advice/experiences from people who know what it's like. Will ring asthma nurses when I can aswell. Thanks, Lou

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Hi Lou, I am on 500/50 Seretide two puffs twice a day and Flixotide 500 one puff twice a day. Your gp is correct it is a high inhaled steriod dose but inhaled steriod is better for you long term than tablet prednisolone.

If you need high inhaled steriod to be controlled then trust your gp as he wants you to be healthy as much as you do. Although at times I totally agree it does not feel that way.

You are currently on a new higher inahaled steriod dose for you but gp has scope to take inhalers higher yet.

Plumie

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Thanks Plumie. Have you been on Seretide 500 2puffs twice day long term?

The higher dose of inhaled steroid doesn't bother me too much, but maybe the LABA does a little as I do suffer a few side effects with this. I've said to GP that I can put up with these short term as it's helping with the breathing, but if it were long term I'd maybe want to separate the inhaler so I can have a standard rather than high dose of LABA. I'm not too fond of pred, so willing to try other things to reduce amount of pred I have. xx

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Hi lou, I have been on seretide 500/50. For four years now. I am sorry I cannot answer your other questions. Plumiue

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I think it's reasonable to expect to be under the care of a consultant given how many courses of pred you've had and the need for such a high dose of seretide. My Consultant switched me to Symbicort 400/12 two puffs twice daily after a high dose of seretide didn't really help me. The symbicort has been better although it took a while to have effect.

I was referred to the consultant after being on the high seretide for around 6 weeks with no real improvement in peak flow. I did make a nuisance of myself to get the referral but the consultant said I had done the right thing to push and was annoyed they hadn't referred me sooner when he saw my pf chart.

I've never tried theophylline but from what I've heard it can really help people. You're just trying to get control, and you can step down your treatment again when you're more stable.

Hope that helps x

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Never commented before but this is similar to me

Following an asthma attack my GP increased my seretide but i had another attack resulting in an ambulance call out and as a result the doctors referred me to cons as they felt there was no where to go with my inhalers as I've proved allergic to a large number of inhalers.

I'm currently on seretide 500/50 two times twice a day and have been for over 3 year with little effect in preventing ambulance call out when the consultant tries to reduce seretide so i started uniphyline about six months ago since then asthma seems to stabilize and has picked up the peck flow so from next week i will be reducing the seretide slowly.

My GP is unfamiliar with the drug uniphyline so think you've got a good GP behind you, mine even panicked me when discussed the tablet due to the risks but i have regular blood tests to monitor the levels

Hope this helps

Michelle

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Hello

Is your seretide an accuhaler?

Plumie

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Thanks everyone, I knew I couldn't be alone in being on this dose. Yes, when they doubled my dose I changed from the evohaler 250/25 to the accuhaler 500/50. I was almost caught out the other day when I saw how few puffs I had left and only just managed to get a repeat in time, guess I'll have to get used to a preventer only lasting 2 weeks.

Another thing I was wondering about is how often are the blood tests for theopylline?

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from my experience its within one week of starting at the lowest dose to check the level then after waiting a week to get results they will look at whether the dose need increasing then the process starts again.

i'm having problems on this at the moment as can't get the levels right and i don't bleed well when it comes to giving blood but has still increased my peck flow readings so its well worth the hassle.

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Thanks again, I think it's worth the hassle too. I'm much better, but still not good, so think I'll be trying the theophylline. Slept through the whole night last night

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glad to hear you slept through the night.

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I hope you get on well with the theophylline. I've just been started on it reluctantly - I seem to get toxic blood levels with very low doses, and terrible side effects. They started me on 125mg twice a day of Slophyllin which I couldnt tolerate - I only took one tablet. Now on 60mg twice daily, which is akin to a five year olds dose! It has improved my peak flow slightly. I tried increasing it to 90mg but again had terrible side effects so back to 60mg. Having bloods done Monday so it will be interesting to see what my blood levels are..

If you tolerate it, it can make a huge difference to your breathing and comfort

Lynda

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Hi Everyone

I have been on Seritde for two years was on 500/ 50 am now on 250/ 25 and theopilyline but looks like will have to go back up to 500/ 50 dose soon cause asthma is not happy again. My theopilyline blood test are every 6 months, Asthma nurse said best time to go for test is between 4 - 6 hours after taking tablets. Hopes this helps and they get things sorted for you.

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Thanks again for replies.

Lynda- I hope your blood levels stabalise and that you see an improvement. When do you get the results of yesterdays blood test if you don't mind me asking?

loulou- I hope upping the seretide works for you

[LDloveslattecoffe]

Hi, I am on Seretide 500/50 and advice I have given is that the maximum dose is one puff morning and one puff night.

I have been on Seretide, Ventolin and Monteleukast many years at least 9 years I can remember.

(mind I also have a fluticasone nasal spray so maybe that is why as fluticasone is an ingredient in seretide).

I have never been told I can increase Seretide always being told one puff twice a day is its the maximum.

Get put on steroids tablets if these not working like in infections.

When I was in A&E on Friday no mention that dose could be doubled they made an appointment for me to see Respiratory nurse today at 2pm to look at my meds as had a lot of infections this year. I might ask about this.