Qvar And Fluticasone Inhalers

[Matman]

Hi Folks

My question is, if you use - or have used - a Qvar or Fluticasone Inhaler (of the type that only delivers the fine particle steroid but not a LABA component) how do you (did you) get on with it? Any observations on side effects or other issues with those devices?

I'm currently using both Clenil and Fostair Inhalers (don't ask, it's complicated) but have a desire to get off Fostair (even though at times it has proved very helpful). Fostair seems - after a while - to irritate my lungs (especially my right lung). I suspect this is down to the LABA Component rather than the Steroid, but that's a guess and it could be the other way round - which would nobble my theory and planned experiment.

One of the advantages of Fostair is that, as many will know, the 'steroid' component (unlike Clenil) is fine particle, and the finer particles are supposed to reach deeper into the Lung.

I'm thinking of asking to try either one of the Qvar Inhalers or a Fluticasone Inhaler (versions that don't include a LABA component). Both Qvar and Fluticasone Inhalers - I understand (ike Fostair) - contain a fine particle steroid component, but versions of each of these Inhalers are available without a LABA.

Basically, I want to test how I get on without a LABA, and so will need to revert to reliance solely on a SABA (e.g. Rescue Inhaler like Ventolin) when breathing gets difficult, but will aim to keep my use of Ventolin very low. (Ideally, I'd like to still keep a Fostair Inhaler close at hand, as I find it works very well if used for just several days only when symptoms get worse, rather than every day). For example, for use following an infection or when increased irritants (like pollen, dust mites etc) abound - but I don't know if the Medics will buy into that proposal. However, I do need inhaled steroids every day, as my FeNO is off-the-scale high (130).

Thanks in anticipation.

[Jenhcat]

I don't have personal experience of these but my son had Flixotide (the little peach one) and my daughter has Clenil (the beige) Neither are LABA I don't think. I know I didn't get on with LABA. I had seravent once and it gave me terrible palpitations, but seretide was OK. Symbicort 200 is what I'm on usually (currently 400 though) but they tried that as smart therapy and I couldn't cope with taking it as a reliever too. I don't use my reliever until I really need it and by that stage I can't suck the inhaler hard enough!

I'm sure you have a right to try whichever inhalers you think will work for you. Can you get an appointment with an asthma consultant if the GP won't do it? I phoned up my consultant who had discharged me in May and I'm back on the books.

[Matman in reply to Jenhcat]

Thanks jenhcat.

[Hidden]

I'm on flixotide 250 (which is fluticasone only) but I use the accuhaler which is a dry powder version. Personally I prefer it and it suits me very well. A consultant did suggest that I go on to fostair, but since my asthma is mostly very well controlled (and has been since I was put on flixotide) I refused point blank to switch. Prior to my current medication I was on beclometasone (in the form of becotide); it never fully controlled my asthma. I was not impressed by the idea of going back on it.

[Matman in reply to Hidden]

Much appreciated. Duly noted.

Can I ask how long you've successfully been on flixotide?

[Hidden in reply to Matman]

About twenty years now. In that time I've only had one exacerbation that was severe enough to merit oral steroids and that was brought on by a very nasty infection which worsened significantly at a weekend (inevitably). Unable to access my GP practice I ended up seeing a practitioner nurse who was useless and sent me away with nothing. By the time I saw my GP (two days later) things were really out of control. But apart from that one blip, it's done a brilliant job. The dose I take varies depending on the time of year and, of course, the conditions within a year. Usually I would reckon to be on one dose morning and evening in the summer, and two morning and evening in the winter, with a transition period of one in the morning and two in the evening in spring and autumn. This year has not been so good for me (but of course we did have a very wet June) and I've been on one morning, two evening from about April through to last week. But we are nearly in November, which is about right for the switch to the higher dose.

[Hidden in reply to Matman]

I note you also ask about side effects. The one that I do definitely get is that my voice is more inclined to go a little hoarse every now and then - but I gather that is not unusual, particularly with the dry powder inhalers. It's certainly not permanent, and quite frankly I'm prepared to put up with that happening occasionally (and it is occasional) if my asthma is being controlled effectively.

I've never had oral thrush (but I do have a very thorough rinsing out routine after I've used my inhaler). One consultant gastroenterologist did try and pin oesophageal thrush on my inhalers, but that was (and still is) disputed my myself, by a consultant in respiratory medicine and at least one GP. There was no sign of oral or pharyngeal thrush at the time (which the gastroenterologist admitted) which was, I gather, the main reason why it was thought very unlikely that my inhalers were to blame.

[Matman in reply to Hidden]

Thanks for all the additional info - very useful. I'm due to see a Consultant soon, so will discuss flixotide / fluticasone as well as Qvar.

[Skigoddess]

I have been very well controlled on Qvar for about 3 years until a recent severe exacerbation due to a virus/sinus infection . I have used it with a spacer ( as with ventolin) on a higher dose over the past 2 weeks . I find it very effective. No hoarseness ( except when taking oral steroids!) .

[Matman in reply to Skigoddess]

Thank you.

[frustratedasmathic]

Hi Jen car can u please tell me what LABA stands for? Thanks

[Matman in reply to frustratedasmathic]

LABA's are typically part of a two-drug inhaler, containing an inhaled steroid plus a long acting reliever (the LABA) often the reliever / LABA lasts 12 hours (unlike SABAs - such as Ventolin - which are stronger but only seem to give relieve for a couple of hours). Usually you take LABAs twice a day so that, effectively, you are always (24/7) breathing with the aid of the LABA. They can certainly help, but my view is that they are best suited for getting you through a bad patch and then - if possible - swapped for something else, except - maybe - where Asthma is both chronic and permanently severe. Don't start using one until you've researched 'LABA Safety' online. Also, Inhalers that include LABAs can irritate the Lung, thereby further increasing your need for inhaled or other medication. Additionally, if your 24/7 365 on a LABA Reliever, will that increase or decrease your prospects of long term improvement, and how will you tell if you can do without the LABA once you've become dependent on it, other than by trying to cope without it? There are undoubtedly pros as well as cons so it's essential anyone contemplating LABA's should throughly educate themselves becofore progressing on to this treatment. I'm no medic so this is all my personal opinion and please check with a professional before deciding what's best for you. One of numerous links which come up when you search for LABA Safety is given below:

uptodate.com/contents/beta-...

PS check the date of any web article as more recent research may give a better insight

[Jenhcat]

As far as I know LABA stands for long acting beta agonists. It is a type of long acting reliever inhaler. Can help to keep peak flow up if it keeps dipping.