Asthma symptoms whilst taking Fostair

[Celie1]

Hi, hope you are all doing ok.

I’ve got a question I hope you’ll be able to clear up for me. Just before Christmas my meds were swapped from Duoresp spiromax 320/9 2 puff, twice a day, to Fostair on a SMART regime. As I was reducing steroids over the first week, I was told to take 8puffs for 2 weeks and then reduce the dose slowly to 2 puffs twice a day. I’ve been down to 2 puffs twice a day for a few days but I became breathless a couple of times and I’m wondering should I add in a puff of Fostair or use the ventolin when this happens?

.I’ve also had a ‘mucus’ cough which is bad in the morning when I walk my dog and comes and goes throughout the day. I’ve had this since I went on the Fostair and am hoping that it clears by the time I’ve been taking it for 8 weeks.🤞

[Beach_48]

HelloI am taking 2 puffs of Fostair morning and night on a SMART regime to relieve mild asthma. I also have some periods of breathlessness during the day and put this down to increase stress and the weather. I take a puff of ventolin and this certainly helps me. My nurse recommends taking an extra 2 puffs of fostair or ventolin. I prefer to take the ventolin, just a personal preference. Hope this is helpful. Keep safe👍

[Celie1 in reply to Beach_48]

Thank you 😊

[twinkly29]

It might be worth trying to speak to your nurse or GP to clarify. If someone is on the MART system then they wouldn't be using ventolin as a routine reliever - if they are, it's not MART. If they are on MART they should have a proper plan for this so they know what to do and when (arghhh so many people don't seem to be given actual advice with this and then it's deemed not to be working 🤦‍♀️)

Some people find MART really works for them and others find the likes of Fostair great as a preventer twice a day but prefer ventolin as a reliever - it can be trial and error to find what's best for you but you need proper guidelines for each process.

Also regarding your cough, changing to a new inhaler with a different steroid might have caused the (hopefully temporary) increase in asthma symptoms there as it's like your body was starting again with building up a new inhaled steroid. As you said, hopefully this is improving the longer you've been on the Fostair?

[Celie1 in reply to twinkly29]

Thank you for the advice. 😊What’s the difference between MART and using Fostair as a preventer? From what I gathered during my conversation with the asthma nurse, was that using the Fostair would help if I was having a flare up, as I could increase the dose, rather than having to take prednisolone (unless it got worse). At the moment, I’m just having a bit of breathlessness. I wasn’t sure if this indicated that I should ‘up’ the Fostair and keep it at that level. Is that what MART is?

[Poobah in reply to Celie1]

Your asthma nurse should have given you a written asthma plan for MART, explaining when you can increase your Fostair and to use it as a reliever. It would also say what the maximum number of doses you could take in a day and when to seek help from your GP practice or A&E. If your asthma nurse wants you to use Ventolin then it's not a MART regime, though you can still increase your daily dose of Fostair while having a flare. Again, a maximum dose should have been discussed and when to seek help.

It maybe best to talk with your asthma nurse to establish what she wants and to ask her to send you an asthma plan by email.

[Celie1 in reply to Poobah]

Thank you. I’m using a temporary GP practise and spoke to the asthma nurse there and she gave me lots of information. There may have been some that I didn’t take in at the time. She definitely said MART and I thought she mentioned ventolin 🤔 mmm! Probably need to talk to her again 😆

[twinkly29 in reply to Celie1]

Kind of. EmmaF91 explains it in this post much better than I can (scroll down and you'll find the MART bit!)

healthunlocked.com/asthmauk...

[Celie1 in reply to twinkly29]

Thank you 🤗

[Blue-Breeze in reply to Celie1]

Hi I'm on Fostair MART. I use 2 puffs morning and night and can use it as My reliever up to my maximum. I also been told to use ventolin on discharge from hospital and in clinic. You need to speak to you asthma nurse to see what she wants you to do. I cant believe a one size fits all. Some flares I can manage on Fostair alone, others I need back with nebuliser and or prednisolone if not in hospital.

[Celie1 in reply to Blue-Breeze]

Hi, Thanks for the reply. 😊 Yes you’re probably right.

I was hoping that the change to Fostair would mean my asthma would be under control and I wouldn’t need pred. 🤞Do you have to take other meds too?

[Blue-Breeze in reply to Celie1]

Hi, yes I'm on Spiriva Respimate x2 puffs in the morning. Avamys nasal Spray, and fexofenadine.I've tried Montelukast but it didn't agree with me.

My asthma is not well controlled, and I'm hoping for a severe clinic referral.

It did take me quite awhile to get in to the swing of Mart. I was on Symbicort at first that one didn't work. I like that this one can be used in my areochamer.

[Celie1 in reply to Blue-Breeze]

Hi, sorry to hear your asthma is not well controlled. 😏🤗I’m just on Fostair. I was on symbicort before, then switched to Duoresp. They seem to work well for me, but not controlled enough to stop me having to go straight onto pred when I get a cough/cold/infection, my trigger for a flare up. That’s why I’ve changed to Fostair, to try and tackle the mucous in the small airways. Then hopefully I’ll be able to ‘head off’ the flare up and maybe prevent infection. 🤷🏻‍♀️

Hope you get your referral soon. 🤞

[Blue-Breeze in reply to Celie1]

Thank you. I hope you find this works for you, I found Fostair 100/6 to be good ( fingers for ever crossed) so far because I can adjust the dosage

[Celie1 in reply to Blue-Breeze]

Thank you. I hope so too. Good luck 🤞

[awilso]

It’s the lactose in Fostair - I had the same problem. Get another brand that doesn’t use lactose.

[Celie1 in reply to awilso]

Hi, thanks for the reply.😊 I drink milk and don’t have any intolerances that I know about. It’s worth a thought though 🤔. Which inhaler did you switch to and do you have a lactose intolerance?

[awilso in reply to Celie1]

I didn’t realise I had a lactose intolerance until I used Fostair. I switched to seritide and was cured immediately 😊

[Celie1 in reply to awilso]

That’s strange! Did you give up all dairy products too?

[awilso in reply to Celie1]

No, I changed over and immediately stopped coughing- I gave up dairy about a year later. So it was definitely something in the inhaler and the only difference was the lactose powder in the inhaler. Been fine ever since.

[Celie1 in reply to awilso]

hi, I’ve just been looking at comparisons of the inhalers but there are different kinds of seretide, which one did you swap to, was it the dry powder one?

[awilso in reply to Celie1]

No it was the canister compressed gas one. I think most of the powder ones use lactose as a distribution agent.

[ALUK_Nurses Partner Administrator ALUK Asthma Nurse in reply to Celie1]

Hi, Fostair pMDI (aerosol) does not contain lactose, however Fostair Nexthaler (Dry powder DPI) does. All aerosols are non-lactose and all DPI's contain some lactose.

You might find our MART page useful: asthma.org.uk/advice/inhale...

With regards to dairy causing asthma there is no scientific link, diary is only a problem with asthma if you have a known allergy to it as this could cause an asthma flare up. Hope that helps, do ring us if you would like to chat it through 0300 2225800 M-F 930-445

[Celie1 in reply to ALUK_Nurses]

Thanks very much for the advice and information. 😊I’ll have a look at the link you sent. 👍

[Celie1]

Well that’s amazing. I’m glad you’ve managed to get rid of your cough. Do you take anything else?

[awilso in reply to Celie1]

Er yes, unfortunately I need prednisone on an ongoing basis to manage my asthma as well.

[Celie1]

Oh that’s hard. Hope it improves for you. Thanks for the info. 😊