What medication next?

[HaydiesMum]

Hi all, my son has an emergency appointment with his consultant this morning after another admission on Friday (3rd in 6 weeks). He is currently taking 2x Flixotide 250 and 1x Formoterol morning and night plus montelukast and an antihistamine daily. At our last planned appointment in August his consultant said next line treatment would be a daily maintenance dose of oral steroids but he saw us 3 times Friday when we were in and mentioned there may be other inhalers we could try. (He came off seretide and switched to the Flixotide and Formoterol earlier in the year).

Just wondering if any of you have ideas what they might suggest or if there is anything I should ask about?

Really want to try and get my poor boy stable, he's 13 and should be enjoying being a teenager not spending days at a time between hospital and the sofa!!

TIA

[EmmaF91 Community Ambassador]

Hi - sorry to hear his been so poorly recently

It may be worth asking about theophylline tablets. It’s an ‘old fashioned’ treatment but can make massive changes to an asthmatics QoL. It may take a while to sort out levels, required blood tests to check levels occasionally and he’d have to avoid caffeine (coke etc) but it can work really well, and doesn’t come with that many long term side effects which maintenance pred can cause (‘scary’ short term ones if levels get too high which is why they start on a low dose). He may also be thinking of changing his inhaler to something like relvar, which is one puff once a day but the LABA is different than in other inhalers.

Is he under a respiratory specialist hospital? If he isn’t it may be worth asking for a referral if they’re now talking about maintenance pred... it could be his eligible for a biological treatment (such as xolair) which often makes a massive difference!

I hope that helps and that today goes well for you x

[HaydiesMum in reply to EmmaF91]

Thanks Emma. Unfortunately we are having to wait a bit longer to find out what the plan is. He is recovering from his most recent nasty flare up so have an appointment at the beginning of December but staying on his current medication until then.

I am not sure if it is a respiratory specialist hospital but the only territory hospital in the region and I know very well thought of in terms of paediatric medicine. He has been under the same consultant since he was 10 months old but was also seem by someone else for a while when they were querying if he may have CF and his consultant is making a referral back to him again due to the other staff within his clinic (nurses etc).

Will read up on the things you have mentioned and hopefully be well informed ready for his next appointment, Thank you again. X