Add on of Atrovent

[Celie1]

Hi, Hope everyone is well.

I’m having another flare up of my asthma, it has been poorly controlled for about 6 months and I’m on my third lot of prednisolone. I’ve only ever been on one steroid inhaler which is currently Fostair 100/6, having switched to this from Duoresp Spiromax 320/9 a couple of months ago. I’ve now been given Atrovent to take 3 times a day as well. This might seem a silly question but do I take the Atrovent at the same time as the Fostair for my morning and evening dose and does it matter which I take first? It just seems a lot to take all at once 😬. I’ve also been told to take ventolin before going for my dog walk. I’ve been given antibiotics x3 daily and an antihistamine and feel as if I’m rattling 🤦🏻‍♀️ trying to remember which to take and when. 😳

[twinkly29]

I would take the atrovent with your Fostair. It's totally fine to take it all at the same time and makes it much easier. I would do Fostair first then atrovent - partly because (in my head) Fostair was there first so is already done then (lol that sounds crazy) but partly because Fostair has a LABA in it so might help to open things up to make the atrovent get in and down even more effectively (but it honestly won't matter which order if you swap it or do whichever you grab first).

[Celie1 in reply to twinkly29]

Thanks for that 🤗Think I’m a bit of a worrier, need to get things right! 😆

[twinkly29 in reply to Celie1]

It's better to ask than not know. Or cause more worry! If doctors explained things too rather assuming things are known then that would make things easier!

[Celie1 in reply to twinkly29]

Yes. The nurse I saw was actually very good and I had time to ask questions, but not that particular one 😆. Thanks again for your help. X

[Lysistrata Administrator Community Ambassador]

Definitely reduce the mental load and take as many things as possible at the same time! I have somehow ended up with meds of some kind 4x a day which is annoying but I have clustered them as much as possible.

I take Fostair then Spiriva (which is a longer-acting version of Atrovent) in the morning (just Fostair PM). I don't think it matters that much but just remembered something I learned recently and may swap them round. Basically the class of drugs that Spiriva/Atrovent belongs to acts on receptors that are more central in the airways. The receptors that the formoterol in Fostair (LABA) and short-acting relievers like salbutamol (SABA) act on are usually clustered further out/less centrally in the airways. Targeting the central receptors with Spiriva or Atrovent opens things up centrally and gives increased access for LABAs/SABAs to reach their receptors and open the airways more.

However, the order may not matter given some people take triple therapy inhalers, which is similar to having Fostair and Atrovent/Spiriva in one inhaler. Presumably they work together as long as you take them around the same time.

[Celie1 in reply to Lysistrata]

Thank you for taking the time to reply. 😊 That’s very useful information. The nurse mentioned that if the Atrovent seemed to be working she would put me on the long term equivalent which I think she said was Spiriva. I just started taking it yesterday and have developed a wheezy chesty cough - don’t know if this means it’s working to loosen and clear out any debris 😬🤷🏻‍♀️

[Poobah in reply to Celie1]

If the cough gets worse then contact your asthma nurse as Atrovent can, in a few cases, make breathing more difficult. Or you can phone Asthma UK to have a chat with one of their excellent nurses on 0300 222 5800 (Monday to Friday, 9am to 5pm). Always best to check out what side effects require action.

[Celie1 in reply to Poobah]

Thanks very much for your advice and for taking the time to reply to me. 😊 my breathing hasn’t got any worse, just the cough. I think maybe I will have a chat with a nurse at Asthma UK just to make sure things are going in the right direction. 😏

[Celie1 in reply to Poobah]

Hi, I took your advice and spoke to an Asthma Uk nurse, Claire. She was really great. Thank you 🤗

[Poobah in reply to Celie1]

Excellent. Take care. 🤗