Need Advice Combination inhalers

[Jances13]

Hi everyone ,

Two years ago I was diagnosed with asthma. I have been taking Flovent HFA since then. No issues accept sometimes I do feel that I could use a little bit of opening up. Recently went to a new pulmonologist and Dr. recommended Breo . I liked Breo but it made me jittery and sometimes leg cramps. So now she changed it to advair discus 500 . She said that this was comparable to Breo. I am really scared to try advair because of it being 500 that maybe it will be strong also. I also have paroxysmal A Fib and I don’t want to get an episode of A Fib. Has anyone been successful with Adviar 500 or can express there experience with this inhaler. Thank you and I hope everyone has a great weekend.

[EmmaF91 Community Ambassador]

Hi

The jitteriness was probably caused by the LABA not the steroid. Flovent, breo and advair all have the same base steroid (fluticasone). But in breo the long acting bronchodilator is vilanterol, while Advair uses salmeterol. Flovent doesn’t contain any LABA. For a lot of people it’s this and not the steroid that affects the heart.

Hope this helps

[Jances13 in reply to EmmaF91]

Emma , thank you for taking the time to answer . Yes , this makes more sense. So in reality it’s the LABA that causes jitteriness . The 500 was what scared me because I know there’s also 250 and lower . So it seemed like a tremendous amount of steroid . Also is salmeterol not as potent as vilanterol ?

[EmmaF91 Community Ambassador in reply to Jances13]

LABAs are not about potency per say. It’s about preference. Some people will have 0 side effects on one, whilst someone else will get massive side effects. So it’s a case of finding the right one for you.

Here’s some general info about inhalers and the page links forwards to other pages which speaks more about combination inhalers ( healthunlocked.com/asthmauk... ).

The 500 is a stronger inhaler however it isn’t anything really to worry about. If that’s all it takes to get control it’s a good thing. It just means you need a slightly higher dose to calm the inflammation in your lungs.

Hope this helps

[7273120]

I can only tell you to be cautious with Advair. The NP thinks this is what caused me to have AFib. It seems most of the inhalers cause heart arrythmias. As Emma said, try till you find one right for you.

[EmmaF91 Community Ambassador in reply to 7273120]

In some people one side affect may be AF (usually if it’s an underlying issue already), but normally for most people who are going to get side effects to do with the heart it would be more palpitations and tachycardia (which usually settles as the body adjusts). For the OP this may be a warning sign to be cautious as there is an underlying issue already, but the majority of users do not get any arrhythmia at all!

As always find what’s right for you! But to others who may read this thread, don’t panic! 😅

[Jances13 in reply to EmmaF91]

Emma , thank you for your advice . I do have paroxysmal A Fib so should I be worried ? I looked up side affects and a fib was uncommon .

[EmmaF91 Community Ambassador in reply to Jances13]

Don’t be worried. Just keep an eye for if you start to get symptoms. Hopefully you will be absolutely fine, but if you keep getting episodes of AF you can say ‘well that’s the inhaler! Let’s try a different one!’

[Jances13 in reply to 7273120]

Have you been successful with any of the other combination inhalers ?

[7273120 in reply to Jances13]

Actually, the NP took me off Advair and had me start on Pulmicort 180 mcg. Along with that, I take albuterol to open my lungs. Have used this combination for several years with no problems. If I get a respiratory 'bug', I have to get a Zpack immediately so it does not get out of hand. I think running a HEPA air purifier at night also helps me.