Fostair Nexthaler

[hearty1]

I am new to all this. I was diagnosed in 2017 with ischemic heart disease and heart failure. I have developed a terrible cough. I get it some of the time. The GP visited me the other day and said he thought I had late onset asthma and gave me Fostair Nexthaler to try and I've to phone him in a couple weeks to let him know if there's an improvement. I've to do two puffs morning and evening. I feel it has helped the cough, hardly have it anymore but it seems I come over shaky and trembling after using it is this normal? Will I get used to the inhaler so the shaking etc will stop altogether? I have never used an inhaler before. Thank you for any advice.

[EmmaF91 Community Ambassador]

Hi

Sorry to hear you’ve not been well. Inhalers can take time to kick in, and tremors are a common side effect of combination inhalers like fostair. Over time they should calm down as your body gets used to the drugs.

For more information about inhalers in general; healthunlocked.com/asthmauk...

Hope this helps and that the shakes calm down soon!

[EmmaF91 Community Ambassador in reply to EmmaF91]

Ps you’re also on the strongest dose of fostair I think (fostair nexthaler is usually 200, and the max dose for 200 is 2x2) so it may be that you don’t need the dose you are on, and usually a lower dose causes less side effects. Just something to discuss with your doctor - esp as you may be able to manage on a low dose steroid inhaler like clenil, which will likely have less impact on your heart condition. Also have you discussed the cough with your cardiac team? Coughs can be heart relate.

[hearty1 in reply to EmmaF91]

Hi Emma

On the Fostair Nexthaler box it says 100 microgramd/6 micrograms per actuation. I have no experience of Asthma or inhailers. This is a bolt out the blue for me! Yes I did mention the cough to the Consultant Cardiologist he said the congestion in my lungs is due to the heart not pumping correctly

The mitral valve is leaking slightly too. I'm on a lot of preventative medication. He didn't give me a solution for the cough. I asked the GP if he could give me something for the cough which can be terrible sometimes and he gave me the inhaler. I don't know if his diagnosis of late onset asthma is correct or not but the inhaler seems to have helped the cough. He knows I'm on Heart meds. Hope it's ok to be on them and use the inhaler as well!

Thank you for your help with this it's very much appreciated.

[EmmaF91 Community Ambassador in reply to hearty1]

Ah ok. Am glad it’s the 100, as was a bit 😅🤦‍♀️ when I thought it was 200. I’m glad the inhaler helps and that you’ve informed you cardiologist.

If you’re on an ACE inhibitor (usually ends in -pril) they commonly cause a dry irritating cough. But it sounds like you may have what used to be called ‘cardiac asthma’ which is what your consultant seemed to suggest from the description (persistent night cough, wheeze and breathlessness are all symptoms of heart failure but also of asthma). But if the inhaler is helping that’s a good thing! I know that cardiac asthma (whilst technically not actually asthma) does respond to inhalers, so hopefully it’ll calm your symptoms down. If you were on any contraindicated meds the nhs system would have flagged it so try not to worry about that. It may be worth talking to the guys on the BHF forum or giving their helpline a call

Hope this helps

[hearty1 in reply to EmmaF91]

Oh Emma thank you so much for your help with all this. It's so reassuring.For the heart condition I take :

Amlodopine Besylate

Apixaban

Bisoprolol Fumarate

Isosorbide Mononitrate

Simvastatin

I don't know if any are ACE inhibitors. The newest one they put me on is the Amlodipine Besilate so perhaps that's causing the cough and I don't have Asthma after all!

Also take Levothyroxine as have Autoimmune conditions too.

Oh right good idea to see what the BHF forum says. I am a member.

I'm trying to help my falling to bits list become less!

I'm going to the hospital tomorrow for an assessment on the cataracts which have got worse in both eyes. Oh the joys!

Many many thanks Emma so much appreciated!

[EmmaF91 Community Ambassador in reply to hearty1]

Good luck tomorrow. If it is ‘cardiac asthma’ it responds to bronchodilators more than steroids etc. So the non-steroid inhalers may actually benefit you more. But discuss it with BHF as they’ll be more used to that issue!

[hearty1 in reply to EmmaF91]

Ok right thank you. I don't know what Asthma I have but I feel it will be more heart related. I would rather not take a steroid inhaler.I will see what bhf says. Many thanks for pointing me in the right direction. Your a great help! I hope you're doing ok🎉

[hearty1 in reply to EmmaF91]

Hi Emma

Thank you for your quick reply. That's great and reassuring that it takes time for the body to get used to it. I will persevere with it.

I hope you are feeling ok. Keep safe and well.