Seretide 250 vs seretide 500

[Sazb3010]

I'm currently on seretide 250 2 puffs twice a day my asthma has been all over the Place lately lots of chest infections I've tried fostair 200/6 but it has not agreed with me at all ..... so thinking of asking the doctor for seretide 500 is it worth asking ? Many thanks

[Hidden]

There are a lot more medications out there. I would see an asthma nurse if your gp surgery has one. No harm in trying others.

[Sazb3010 in reply to Hidden]

Hi thanks for the reply I'm booked in for the 15th August but didn't really want to wait that long to see the asthma nurse 😩 So was going to speak to the doctor first 😷 I'm currently under The respiratory department at the local hospital but not due to see them till beginning of September ? They were the ones who put me on fostair shall I ring them and see what they say ?? May be .. 🤔

[Hidden in reply to Sazb3010]

Yes definitely my asthma is chronic too and I'm under a hospital too. Do you know how low your peak flow drops? For example at me best it's 420 at my worst it drops to 220. You can use the variation to help your gp understand the level of your asthma attacks.

[Sazb3010]

Mine is constantly on 350 and maybe drops to 300 I'm 42 and 5ft not sure if that's good or bad really as only recently started doing my peak flow as I've been ok for over 15 years on seretide never thought to do it 😳

[Hidden in reply to Sazb3010]

Im 35 and I only do the peakflow when I feel a blip in prevention occurring. I used to use all sorts of preventer inhalers until I found one that works..maybe if you kept a track of peakflow before and after that would give you the idea of how much it increases. For example pre seretide my peak flow is 300 and after its near 410 to 420. Previously I used symicort and it did nothing 300 to 270 (the wrong way plus sucking in powder is hard work!) do you use a spacer device?

[risabel59]

Are you using the Seretide 250 dpi? Or the evohaler? If you are using the dpi, changing to 500 won't make much difference. Also you can't use more than 1 puff twice a day.( of the 500). It may be that you need a steroid add on inhaler. My go to steroid, Is Alvesco (ciclesonide 160). Its expensive so they may not prescibe it. I also think the pulmicort turbohaler. is pretty good. But more oral side effects.

There are other add on treatments that you could discuss with your doctor, such a LAMA, like Spiriva, and or a montelukast such as Singulair.

I think best to talk to your respiratory team.

R

[Sazb3010]

I'm already taking montelukast tablets at night I have rung the hospital so hopefully they will ring me back

[Karenc48]

I'm on symbicort after using seretide for years never looked back feeling good give it try I didn't like fostair

[Sazb3010 in reply to Karenc48]

I think I will talk to them as a few people have said try symbicort thanks I was awful on fostair couldn't even walk around the house with out having to use my ventolin

[green881]

The ICS component of Seretide is fluticasone. I would switch that to equivalent dose of beclomethasone before upping the dose of Seretide. You can always come back. So that would be Fostair 200/6. Also in my experience some people do better with different delivery systems (eg powder vs HFA). I did Qvar HFA with Serevent powder just to change it up - you could feel your lungs opening up.

Don't be afraid to experiment if you are not controlled.

[Karenc48 in reply to green881]

yes i wish i had done this earlier as i am on less symbicort half the dose with seretide and done my first ever peak flow at 500 . Is symbicort 100/6 x 5 times daily half the dose i was on which was 500 seretide x 2 daily

[green881 in reply to Karenc48]

Symbicort is budesonide ICS. Budesonide is supposed to be even weaker but I'm on it for nasal right now so we will see if there is any truth to that. I had an experience a decade ago when I was maxed out on fluticasone and when I switched to Qvar (beclomethasone) I did much better on less dose

[Karenc48]

yeah i am finding that i was on seretide 1000 and now on 100/6 symbicort 5 times a day 2 in morning one at lunch an 2 at evening and i am blowing 450/500 on peak flow cant believe it !! does this mean i have halfed my dose?

[green881 in reply to Karenc48]

Yes I think you have halved your ICS dose. The ICS levels are not identical but they are close as far as I remember when I looked into this a while back. I'm glad Budesonide works for you. The jury is still out on my nasal story. It's funny but I never did well on fluticasone (the ICS in Seretide) in any form, nasal or chest.

[Karenc48]

thanks for the reply i did try the new relvar which was good too if you could try that