Steroid inhalers make me worse

[Asthmapatient]

I’ve tried several steroid inhalers, they all make my cough worse. I find using Serevent much better than a steroid. Anyone else have this problem.

[Bobcat_44]

You should never use Long-Acting Beta-Agonists (Salmeterol, Formoterol...) without ICS, because LABA medicines when used alone can increase the risk of hospitalizations and death from asthma problems.

[Asthmapatient in reply to Bobcat_44]

That may very well be the case, but I have a big problem that seems unsolvable. I’ve tried a lot of steroid inhalers, for the first month or so they are tolerable, after that without exception, I start to cough more. Eventually I spend the whole coughing and coughing and coughing. When I stop the steroid inhaler, the coughing gradually decreases. If I then add the Serevent the coughing becomes controlled. What am I supposed to do, take a steroid inhaler that makes the cough unbearable, or take a long acting drug that controls the cough. Any suggestions?

[Lysistrata Administrator Community Ambassador in reply to Asthmapatient]

Have you tried any combination inhalers so far eg Seretide (since Serevent seems to help)? May also be that the propellant is causing issues - are they all the same type of inhaler, metered dose with the canister? Or have you tried dry powder too? Spacer (doesn't work with dry powder of course but with others)? There are newer types of inhaler device as well which may avoid this problem - is GP sympathetic/helpful?

May be worth asking the AUK nurses for advice.

[Thomas45]

Having done a quick Google search. it appears that coughing is a known side effect of some steroid and some non-steroid inhalers. I use a dry powder steroid inhaler (DuoRespSpiromax 320mg/9mcg). I am supposed to rinse my mouth our with water after each dose, or clean my teeth, but often forget. Fortunately it does what it's supposed to do, with no side effects. If I was in your shoes I'd seek medical advice. I've had asthma for 44 years but while I know what works for me, I have no idea what works for other people.

[Angrywheezer]

I've maintained for decades that inhaler steroids don't work for me but I might as well talk to a wall. I did a bit of digging and I found a paper that suggested in some people the receptor molecule in the alveolar (lung sac) wall which the steroid molecule 'docks' with is reversed in some people i.e the wrong way round, with the docking mechanism inside the alveolus instead of outside, so the steroid molecule can't find it.

I found Serevent (twice daily) perfectly serviceable and had no issues. I was even able to forget it for up to the days with no problem. My quality of life improved a lot since I no longer needed to carry an inhaler or worry about forgetting it. Unfortunately 'computah says 'no'', or at least the asthma nurse does and I'm now wheezing along on Relvar. I would dearly love an inhaler vending machine - it wouldn't hear me either, but at least I'd have medication.