Can too much ventolin make asthma symptoms worse ?

[Hannah125]

Hi!

Since I've been struggling to breath for months due to an asthma flare up triggered by the flu, I've been using a lot of ventolin. I have been using it more and more since I feel like my condition is getting worse and I have more intense symptoms. Lately, I noticed that right after taking ventoline (2 or 3 puffs at a time almost every hour) the tigh chest and inflammation in my lungs seem to get worse. Instead of feeling relieved I actually feel like it is harder to breath and with every breath it feels like my lungs are blocked and are about to burst. Expiration is also very hard and I can only take small breaths due to the oppression and tightness of my chest. However, I'm not sure if this is due to me taking too much bronchodilatators (I also une nebs 3 times a day) or if it is caused by my asthma exacerbation ?

Also, I take up to 20 puffs of ventolin everyday and 3 nebs of bricanyl/atrovent and despite all this medication I rarely feel better. Most of the time it doesn't work or it only works for 2 hours and then the tight chest comes back. Does it often happen that the nebs and ventolin don't work ?

[EmmaF91 Community Ambassador]

Hi

Are you on any long term preventer inhaler? And have you had any steroid courses? It sounds like you’re really overdosing on the salbutamol which can cause you issues, but a short course of steroids can really help (if you’re not on them already).

All bronchodilators have the potential to become constrictors esp when overdosed on.

I hope that helps

[Hannah125 in reply to EmmaF91]

Yes, I'm currently on seretide and pulmicort but so far it hasn't changed anything. I've had 2 steroid courses but it didn't really work either though I felt slightly better and had to take less ventolin while on them. But as soon as I finished the course it just came back. The doctor I saw also told me it wasn't normal to take that much ventolin but I don't know what else to do. I wish the preventer would work already but I've been told it could take months.

Most of the time I don't really wheeze but 2 months ago I had a "real" asthma attack with severe shortness of breath and loud wheezing that happened because I didn't want to take ventolin prior to a spirometry test. After hours of shortness of breath it became a real attack and after two puffs of ventolin the wheezing disappeared and I felt better. It has been a traumatic event for me since I'm not used to having this kind of attacks and I was alone at the time. So now I take ventolin as soon as I feel asthma symptoms thinking that it could prevent things from escalating into a real asthma attack. But right now it seems like it's doing more harm than good.

[Thomas45]

I overdosed once, many years ago. I'd been in hospital having nasal polyps removed and caught an infection while recovering in hospital. No-one recognised that I had an infection, and so I was discharged.

I used my ventolin which first worked as normal but as I continued to use it, it became less effective. I saw a doctor who put me on courses of antibiotics and steroids, which solved the problem.

[Hidden]

Taking 20 doses of ventolin daily is way too much and will often cause the ventolin to stop working as your body adapts to it.

Taking 20 doses on one day would not necessarily be a problem, its the continued use.

It is recommended that if you need to regularly use ventolin more than 3 times a week that you see a Dr and get your asthma checked.

You clearly need to see a Dr and probably be referred to a specialist.

[EileenCl]

I can only agree with SimpleSimon, see a doctor, and soon. Your asthma is clearly not adequately controlled. Good luck!

[Hidden]

My doctor always tells me that he Thinks people rely on ventolin because it simply makes them feel better. He says to use it sparingly, as the purpose is to save your life in an emergency. It might not be as effective if that time ever comes if you’re taking it too much. I’ve got a good doctor now, but in the past, advice has been to take it whenever symptoms present (to prevent them becoming more severe). It might just be in my mind, but the relief I get when I do use it now is faster and longer lasting.

[Pam6]

Hya. Thank you for replying. I am in no way struggling so much as you. Hope you get to eel better soon.

Pam

[Hannah125]

Thanks everyone for your answers! I'm really concerned about the ventolin not working anymore because of how often I have to use it. Once the body has adapted to it, is it too late or can you reverse it by trying to use it less ?

I've seen a specialist two days ago and I mentionned to him that I took 20 puffs a day but he didn't say anything. He just said that my asthma was hard to control and he told me to continue using seretide and nebs. He didn't seem to be worried about all the medication I take and about my symptoms. Now, I'll try to take less ventolin even though it is really hard sometimes and I'll just wait for the preventer to start working.

[Js706 in reply to Hannah125]

Hi Hannah, was the specialist you saw an asthma specialist or just general respiratory? (I’m guessing you’re in the US? As you’re on nebs, which aren’t common in the UK and said he was a pulmonologist in your last post)

If not it might be worth trying to see someone who specialises in asthma/allergy because I’m really quite surprised they would describe asthma as difficult to control when you’re only on seretide as preventer medication. As in the UK that’s only step 2/3 of asthma care out of 5! So there are lots of extra preventer therapies that could be added on. And how long have you been using the seretide? As it should kick in within a few weeks of use really

[Hannah125 in reply to Js706]

I actually live in France so I'm not sure what the equivalent is in the UK. The doctor I saw wasn't specialized in asthma but he's supposed to know about all lung disorders.

I first tried seretide in May and I took it for nearly a month but I started to feel worse so I stopped it. Then I tried Pulmicort for a little more than two weeks but once again I kept feeling worse so I stopped everything and decided to take oral steroids. However, they didn't work either and now I'm back on seretide 250 4 puffs a day and Pulmicort once a day. I'm not sure what else I could do to make things better more quickly. What are the other preventers ? Is beclomethasone stronger than fluctiasone ?

[Js706 in reply to Hannah125]

Ah ok, I’m not sure how the healthcare system in France works with specialists but as you may have seen from some posts on this forum, asthma care can pretty poor from those who aren’t specialised in it!

Normally steroid inhalers should be working fully within about 4-6 weeks. There are different inhalers that can be tried - there isn’t necessarily a strength difference between the various inhaled steroids as far as I know (or not much anyway) but sometimes different ones suit different people.

But generally when stepping up treatment in the UK they would try adding things like spireva (another inhaler) or montelukast or theophylline (tablets).

Or it may just be that it’s a bit of a persistent flare and you need a slightly longer course of oral steroids to settle things.

Also I’ve just seen from your post above - the tolerance that you can build up to ventolin will fade if you use it less so it should become more effective again

[EmmaF91 Community Ambassador in reply to Hannah125]

Each steroid inhaler as roughly the same amount of steroid in it, however each individual has a different response to each (it’s that makes sense). For example I get along a lot better with beclomethasone than I do budesonide.

There are other drugs with can help (such as montelukast and theophylline/aminophylline tablets) as well as LABAs like spiriva containing the same drug as atrovent nebules but longer lasting meaning you only take it once a day.

Here’s a website which clearly explains how things work in the UK (for asthma), with the chart (further down) describing what level of management you’re at:

guidelines.co.uk/respirator...

Over here it’s a very big deal needing a home nebuliser (as they are viewed as dangerous due to it potentially stopping people getting help when they actually need it), and you don’t usually get one suggested until you are clearly labelled as severe/brittle/difficult and have tried basically all other options.

I hope that helps

Ps also meant to add it’s really common over here to have GERD/reflux/hay fever etc looked into and treated to help control asthma as they are such common triggers!

[Hannah125 in reply to EmmaF91]

Thank you. Is it possible that steroid inhalers make asthma worse ? If one starts to take a preventer and notices that symptoms are becoming more severe throughout time, does it only mean that the condition is becoming worse or could it potentially be because of the drug ?

I'm asking that question because something really weird has been happening to me with the medication I take and I no longer know if my symptoms are becoming worse because of the inhalers or on their own. For example, the first time I started to take seretide I had moments where the symptoms were becoming increasingly difficult to bear. And withing one week of starting pulmicort I started to have symptoms that I didn't have before.

[Palette]

I have commented before on how Seretdie seems to make my symptoms flare up, tight chest and chesty cough for months. This has lessened now after a course of antibiotic.I had managed to reduce the amount I took last year so that I did not need to take Ventolin and took Seretide only about once every few weeks. I wanted to stop completely but discovered I had nasal polyps last August, so started Seretide again as I thought that was the right thing to do. I then began months of cough, breathlessness, more mucus, until the recent course of antibiotics. I am again trying to reduce Seretide, just a tiny bit wheezy, slight cough, but as I have a respiratory appointment soon will try and use less Seretdie to see what happens. Has something chnaged with these medications or is there a general worsening of asthma symtoms due to some more widespread cause which is being dealt with badly by GPs?

[Hannah125]

I'm currently still struggling though I try to take less ventolin. It doesn't give me much relief anyway because my chest is so sore that I think my main problem is inflammation. I didn't want to open a new thread so I decided to post a new question here.

I took Pulmicort (with nebulizer) for 2 weeks and not only it didn't work but my symptoms worsened. Now I've just realized that it was probably because of the dosage I took which wasn't enough. I only took 1ml (half a nebule) when I read that you could take up to 8 nebules (4mg) for severe asthma. My doctor had told me to take one dose twice a day. So now, I'm thinking about taking at least 4 nebules everyday in addition to seretide. Is it dangerous to take different steroids at the same time (seretide and pulmicort) ? What dose works best for severe persistent symptoms ?

Thank you!

[Js706 in reply to Hannah125]

There shouldn’t be any issue with taking different steroids at the same time (as taking you keep taking inhaled steroids while on oral steroids) but it may be that you don’t get on with the steroid in pulmicort?

[Hannah125 in reply to Js706]

Yes, I'm thinking that Pulmicort doesn't suit me because after using it, it feels like my chest becomes more tight and I have more trouble breathing. I still wanted to try because I really want my asthma to be controlled but everytime the same thing happens. I guess the only option left is fluctiasone or beclometasone. I'm thinking about Flixotide. I'm wondering why seretide still isn't working and I've been taking it for nearly a month, I never missed a single dose. Could it be because I have a severe type of asthma that can't be controlled by any drugs or is it because I need to take a higher dosage ?

Doctors seem to think that my problem isn't serious because I have good spirometry results. That's why they give me rather low doses. But I read that during a flare up we must take inhaled steroids at a very high dosage to get things under control. So, I'm not sure if I should take more seretide.