Steroid card with Fostair?

[TeachKat]

I have been on Fostair 200/6 2 puffs twice a day since Christmas- I recently read that I should carry a steroid card - does anyone know if this is the case? I have also recently started taking Montelukast.

Thanks!

[EmmaF91 Community Ambassador]

Hi

It should say on the patient info whether a steroid card is needed or not. I’m pretty sure it is suggested for that dose of fostair. You can pop in to any pharmacy and ask for them and usually they’ll give if you explain why you want it

Hope this helps

[TeachKat in reply to EmmaF91]

Thank you - I’ll ask at the pharmacy tomorrow.👍

[Wheezycat in reply to EmmaF91]

I looked through it and didn’t spot anything. But I could easily have missed it.

[CDPO16]

Hi, I'm not sure whether I should or not, but I am on a high dose of Fostair 200/6 and have this on the steroid card I carry. I also keep the card up to date with the dates of the (many) courses of prednisolone I have had. Whenever the card is full, my pharmacy supplies me with another. It also helps me to keep track of the prednisolone courses I've had.

[mylungshateme in reply to CDPO16]

Ooh that's a good idea re keeping track of prednisolone courses and dose changes, thanks for that tip!! 😁👍🏾

[CDPO16 in reply to mylungshateme]

You are welcome. I read quite some time ago on a patient information leaflet for prednisolone that some things should be avoided for up to a year after a course. Can't for the life of me remeber what (🤔) but it was then that I started keeping a note incase I got asked by someone. I do find it useful for my own information too.

[Wheezycat]

Interesting! Though nothing is crystal clear it certainly seems that people taking Fostair, high doses of, should definitely carry such a card. Ditto with Symbicort 200/6, which I was on for years and never knew. I am also on Fostair 200/6, 4 doses daily. Next time I pick up meds I will ask.

[TeachKat]

Hi Wheezycat (great name) , I asked the pharmacist today and he confirmed that you should have a steroid card when on high doses. He also said that they’re meant to include one with each prescription for this but that, ‘We don’t usually bother’! Bit alarming...

[elanaoali]

I have one I keep in my purse. I got mine from my GPs.

I am on the same dose and inhaler as you.

[Wheezycat]

For each prescription? Surely only steroid ones? Otherwise I would have a small card deck of them.

[TeachKat]

Apparently it’s every time they dispense Fostair 200/6 2 puffs twice a day! I can see why they don’t do that but they should perhaps ask if you want one.

[Little_spark82 in reply to TeachKat]

Hiya,

I am on 3 puffs 2x a day with fostair 200/6 (still rubbish when it comes to actually doing much … work is crazy hard with it (work at a hospital as a clinical support worker - but I just try smash through) but if you’re saying the pharmacist should give me one for 2x2 a day - I’m on more than that and don’t bat and eyelid when I pick up prescriptions …. So, when I go get my next one I will ask - thanks for the heads up x

[Starstream]

I am on Fostair and Montelukast but have no card 🤷‍♀️

[elanaoali in reply to Starstream]

Are you on the same dose of fostair ie 200/6 2 puffs twice a day.

[TeachKat in reply to elanaoali]

Yes - I’ve been on that since Christmas and recently had Montelukast added.

[elanaoali in reply to TeachKat]

Hi I was asking starstream this question I already know that you are.

[Starstream in reply to elanaoali]

Sorry only just seen this, yes 200/6 2 puffs twice a day plus Montelukast. I dont think the Montelukast has helped me at all so I may stop this. I have a appointment with my consultant next Tuesday (telephone appointment)

[elanaoali in reply to Starstream]

Why do you thinl its not helping you ?

[Starstream in reply to elanaoali]

I end up on Prednisone every 5/6weeks the first month I was on Montelukast I had 7/8 good weeks but then went back to normal feeling crap every 5/6 weeks.

Been taking Spiriva for thr last 4 weeks and been much better

😀

[elanaoali in reply to Starstream]

Interesting I have been on monkelaust for nearly 5 years for the allergic part of my asthma. My old asthma nurse said it would either work in two weeks or not. As you can see it has and no side effects.

I hope and pray you find the right combination to keep you well.

[Starstream in reply to elanaoali]

Thank you,

Stay safe 😀

[Melanie1989]

I have never had a card, but recently they have updated the steroid card from the blue one and improved criteria. I received it in the post yesterday, so you may get one.

[mylungshateme]

Hi, I was put on fostair 200/6 4 puffs a day last week at hospital and with the inhaler was the steroid card with my label on it, and another steroid card for my prednisolone with my TTA's. I've been on prednisolone for most of the past 9 months and never had a card! Also on montelukast and spiriva, beginning of year was on sirdilpa and flixotide. Never had a card at all before last week. 🙂👀

[TeachKat in reply to mylungshateme]

I asked for a steroid card at the pharmacy today and they couldn’t find any! They’re going to order some in.

[mylungshateme in reply to TeachKat]

Pahahaha sounds about right...

[asthmatim]

As I am now in Australia I can't help you with the S card. But I can help you with any montelukast questions that you have.

[Some12U in reply to asthmatim]

Hi Asthmatim,

I have a question about Montelukast please, if you can help. I was prescribed it last summer when I went to see the practitioner nurse saying it was hard to cope with my pollen allergy. I was just taking anti histamines. When I got it home and looked at the side effects and saw 1 in 10 suffer frequent infections, it put me right off. That being the last thing I want! So I struggled on, coping as best as I could. This May-August has been even worse and I would have taken it, but that worry held me back. People do seem to report that it’s it’s well tolerated. Thank you for your advice.

[EmmaF91 Community Ambassador in reply to Some12U]

Lots and lots of people take Monte with no increase in infection rate. In fact in all the people I know who’ve tried it (30+) only 1 found increased infections, but they were already highly susceptible to infections (that was the driver for their asthma, not allergy). All drugs come with a list an arm long of possible side effects, but most people don’t get any of them, and if you do get one it either passes or you stop the drug. It’s worth giving it a go cause uncontrolled asthma is a lot more dangerous than the possible risk of an infection. ESP as when they make the lists they can’t always tell if it’s the drug or just nature... if someone who never gets infections suddenly gets one it’s unfortunate but life, if that same person had just started a drug they can’t tell if it’s life or a side effect so it goes as a side effect. People on monte are more prone to infections anyway, so short term reporting may elevate the risk of frequent infections if that makes sense...

If you’re still feeling poorly controlled and it’s still being offered it’s worth a try. If you don’t get on with it, or if you do start getting lots of infections then you can easily stop taking it again.

Hope this helps

[Some12U in reply to EmmaF91]

Thank you Emma for your reply. I missed out saying that I do get frequent viral infections, six or seven last year in fact and a course or two of steroids with each one. I take your point about the reporting of infections as side effects. I suppose I'm a reluctant to suppress my leukotreines! I'll try it next year when the problem comes around again. Thank you 😊

[EmmaF91 Community Ambassador in reply to Some12U]

If it helps I’m someone who also seems to get viruses quite frequently. I noticed no change in this when I was on monte. It just also didn’t do much for my asthma either so it was stopped 😅. I was in a situation where the team threw 4 new meds at me all at once cause I was so uncontrolled, so we then had to do the ‘do you miss it?’ approach... I didn’t miss monte when it was stopped so it wasn’t restarted

The only side effect i can remember getting is vivid and lucid dreams (I relived whatever I watched last on TV knowing that was happening. It was 🙄🙄 a couple times and I learnt to not watch GoT or shark documentaries just before bed... no nightmares but even now I can remember how unamused I felt in those dreams, knowing what was happening 😅😂😂) which may have stopped had I switched to taking it AM (the thought never occurred to me at the time 🤦‍♀️🤦‍♀️😅)

[Lysistrata Administrator Community Ambassador in reply to Some12U]

Just to add to what Emma said: I am also on montelukast and looked up the side effects just now, including in the Summary of Product Characteristics (SPC; this is like the healthcare professional version of the leaflet). They both say 1 in 10 get more upper respiratory tract infections (URTIs) - so basically colds, and you would expect this in pretty much any trial population with or without the drug, especially when the people in the trials included people like you and Emma who may be more prone to viral infections anyway, like Emma says. The SPC actually has a note saying there was the same rate of URTIs reported in the placebo groups in the montelukast trials.

My work often involves reading detailed clinical trial reports for all sorts of drugs, and almost always they have a high rate of URTIs and similar for active and placebo groups - it would be more unusual if there were a low rate of these! The concern over infections with drugs is usually about more serious ones that you wouldn't expect to occur naturally and frequently in a healthy population. I agree with Emma that the risk here is definitely more with uncontrolled asthma vs infections you'll probably get anyway (but may have more impact on poorly controlled asthma than if you are better controlled).

[Some12U in reply to Lysistrata]

Thank you, Lysistrata. I read your post to me yesterday, but wasn't able to respond then. I appreciate your looking up the SPC and the fullness of your explanation. Your experience together with Emma’s has encouraged me to give Montelukast a try when the pollen season comes around again, (it’s a blessed relief now!) Otherwise my asthma is well controlled. Many thanks again.

[Starstream in reply to Some12U]

Hi, I have been on Montelukast for almost a year, with no side effects although I dont really think it is doing anything for me. I take it at bedtime

[Pipsqueak77]

Hi All

Personally I have only ever been given steroid cards from hospital pharmacies... they seem to be the only ones that bother!

That said I have been using high dose steroids for years and have not needed to use a steroid card once... so I am not too bothered about them really.

There seems no point when nobody ever asks for them!

If you have a condition where you are likely to be unconscious or similar .. maybe it’s worth it. But otherwise I’m not sure of their usefulness??

Take care 😊

[Lysistrata Administrator Community Ambassador in reply to Pipsqueak77]

I've never really used them either - they're not the easiest format and need to be updated.

Having said that, I think it's useful to have something on you (a medic alert, maybe a card like the one Melanie posted about: healthunlocked.com/asthmauk... if you are regularly on high-dose steroids and steroid-dependent, in case you are ever in an accident and not able to mention your steroid dependence. No-one ever told me about this when I spent a lot of time on pred! However, I don't think the usual blue steroid cards they hand out would be the best way to do this.

[Pipsqueak77 in reply to Lysistrata]

Hi

Well I carry a biologic card.. so I’d like to think they would make the quantum leap to inhalers..😂 but I guess you never know!!

Take care 😊