Equivalent or stronger inhaler Fostair nexthaler 200/6 2 puff's twice a day

[elanaoali]

I been recommended by A &E doctor last night that I need to discuss changing my inhaler/antihistamine.

I have been using Fostair nexthaler since November 2017 which was changed from seretide 250. From what I understand I am on maximum dose for this inhaler. Plus antihistamine fexofenadine top dose. Plus monkelaust, nasal spray dymyista and nasal drops.

What choice is there above this as it seems I reach the top of inhalers. I could go back on seretide which did help me in the past.Changed for newer inhaler with smaller particles.

Anyone on a different high dose inhaler not these two?

[Lotti_321-]

Are you under consultant hospital or just gp? I’m on similar but the inhaler type not the nexthaler- so it could be different. However my consultant added in qvar to provide some additional inhaled steroid so might be worth speaking to them.

Hope you get some relief soon!

[elanaoali]

Thanks for your comments. I am not at present under consultant care since last month when I was utterly back under GO care.

It is interesting what you say about Qvar as it has been mentioned to me in pass conversation with asthma UK helpline nurses. They said it would add an extra dose of steroid to my fostair. Not sure how much I did have extra steroid inhaler flixoide added to my see tide to boost it that way.

I was trying to see by my local news guidelines what could be added I did see taking a steroid tablet everyday. theophylline but that's for breathlessness.

If I have a chance to ring the helpline before my appointment I will to discuss it. Some things to think about it,

[CDPO16 in reply to elanaoali]

Hi,

I am currently on Fostair 200/6 MDI inhaler 2 puffs 4 times a day. This has helped to stabilise my breathing after a rough year when on several occasions 10 puffs of Ventolin hasn't helped and repeated courses of Prednisolone have had little effect. I have been fortunate enough not to end up in hospital as my GP practice offers a very good triage system and, when in doubt, I have contacted them on a Friday rather than risk weekend problems

I wonder if four times a day might help you although I know that this is not a usual dose.

I was previously on Fostair 100/6 2 puffs 4 times a day which was prescribed by a hospital consultant. I am no longer under a consultant and the current dose was prescribed by my GP as my discharge letter said there was scope to increase the Fostair if problems arose. I have to see my GP later today for a review and am concerned that he may want to reduce the dose again. If he doesn't I am also concerned about what happens as & when the Fostair no longer helps in the future. Seretide does not help me at all.

I also wonder if Lotti's suggestion about QVAR might help too. I was not aware of this inhaler.

Sorry to be rambling on and I hope that you are able to get something to stabilise your breathing soon. Not being able to breathe is awful. Best wishes

[elanaoali in reply to CDPO16]

Thanks for your advice. I can see that you have had a similar experience but have a good primary health care team behind you.

I not aware that you can increase Fostair nexthaler to this level of use.

Extra dose of steroid inhaler as an add on to combination inhaler I think could be the way forward. I will let you know what happens with my appointment.

[CDPO16 in reply to elanaoali]

Yes, please do let me know how you get on. I wish you well x

[LDloveslattecoffe]

It seems you are on highest dose of Fostair so won't be able to increase.

Like you I was on seretide (I was on this for a long time) but after more frequent infections which is a sign inhaler is less effective the hospital following A&E decided to change me to Duoresp Spiramax which when ok can take 2 puffs twice a day but if PF or symptoms then can increase to 2puffs 4times a day.

So now I am on

Duoresp Siramax

Ventolin

Monteleukast

Loratadine (antihistamine)

Avamys (nasal spray)

Sometimes change of inhaler works because body is so used to it it becomes ineffective I always think its arbitrary whatever given.

[elanaoali]

Thanks for the input. I had my appointment this morning and the doctor went through my many notes and letters from consultant.

He listened to my chest which is fine.

Decided not to change any medication but recommended to do breathe easy study. The doctor things this will help when or if I get anxious about my breathing.

Before and during my trip to A &E I was remarkably calm even though my chest on the right was very tight. I had forgotten what it felt like to have a tight chest. I had to be very sure it wasn't acid reflux that I feel in the middle of my chest.

In retrospect I should have gone to A &E or call 111 on Saturday evening. I did manage to resolve my tight chest then and was hoping to get through til Tuesday.

Now on a reducing dose of Prednisolone over next 15 days. Tired and have trouble sleeping. Wide awake for about 3 hrs in the night. I know that my healthimprove as I come off them.