Ventoiln being stopped: I have heard... - Asthma Community ...

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Ventoiln being stopped

Wheesy profile image
20 Replies

I have heard once again that Ventolin used over a length of time is extremely dangerous to the lungs and Doctors are being advised by Specialist to stop prescribing Ventolin. I questioned by wonderful Asthma nurse who has become like a sister to me and always ready to help with my severe lung problems, and she told me that our own specialist has been carrying out tests etc and found that this problem does exist.

It may be worth while go ask our own GPs etc. what they know about this situation, and I look forward to any comments that anyone has with this post

Keep Well & Stay Safe

20 Replies
RACrally profile image
RACrally

Where did you see that wheesy ? That would be concerning , I must admit my asthma isn't that well controlled for the past couple of months. I'm using the ventolin , (or salbutamol I presently have) After seeing a nice asthma nurse I note that my new script ( on my app) will be "Ventolin " I'm ok with that.

She's asked me to report in a month if I continue to need my reliever but yes , that is concerning about stopping Ventolin for asthma sufferers.

My reliever has meant I can actually sleep over these cold months !

Wheesy profile image
Wheesy in reply to RACrally

It was my asthma nurse, while having an exacerbation

Wheesy profile image
Wheesy in reply to Wheesy

Sorry last week in hospital while I was recovering from an Exacerbation

Lysistrata profile image
LysistrataAdministrator

Hi Wheesy,

I've not heard anything about this and while I am not in healthcare, my work currently involves talking to various respiratory specialists who have not mentioned anything about salbutamol (the generic name for Ventolin) being dangerous in itself.

What *is* true is that it isn't safe to rely on a reliever like Ventolin, without also taking preventer medication to address the underlying inflammation. This also applies to the longer-acting relievers that are in combination inhalers like Fostair, Symbicort and Seretide. Long-acting relievers shouldn't be prescribed without inhaled steroids for asthma (COPD is different), and guidelines for asthma are starting to say that even mild asthmatics should have a preventer of some kind, not just Ventolin or another reliever.

If someone finds themselves needing to take a lot of Ventolin, that's generally a sign that their asthma isn't well-controlled, and they may be at risk of an attack, or having an attack. So there is a link between people taking/needing a lot of Ventolin and having serious attacks or sadly in some cases even dying. However, this isn't because Ventolin is a dangerous drug, but because the underlying problems in the airways aren't being treated and the Ventolin just isn't enough - it"s like trying to put out a massive fire with a toy bucket.

Ventolin can also stop helping in severe attacks, or wear off quickly and not help as much - that's a sign that you need to be getting medical attention. Again, that's because the Ventolin alone isn't enough in that situation to open up the airways, and you need other treatments.

I would add that relievers like Ventolin are still needed as a treatment. The goal of asthma treatment is to minimise how much people *need* their Ventolin, but that isn't the same as saying you shouldn't take it if you need it. People with asthma just need to keep an eye on how often they need it and get in touch with their GP/asthma nurse if they need it more. Ideally, they'll have a personalised asthma action plan laying this out.

Wheesy profile image
Wheesy in reply to Lysistrata

I hope that I have not upset anyone with this subject, the subject was told to me by my asthma nurse, as my consultant avoids Ventolin and tries all he can to stop people using it And he will only let people who are terminally ill to have a nebulizer or oxygen. He says he has documentation etc. with regards this topic. Has any other asthma nurse heard about it or is it just my his one of my 3 consultants

Lysistrata profile image
LysistrataAdministrator in reply to Wheesy

I'm not upset, but I find your consultant's stance a bit odd. I would like to see what research he is basing this on, as I have never heard it before - not that I'm an expert but I do have to read a lot of scientific papers in this area for work, so I would be interested to know what research this is based on. My understanding is that steroids longer term are more dangerous than Ventolin - but are still used, because they're needed.

You cannot just not give a bronchodilator when it's needed - and especially in an attack, it is needed, though Ventolin may not be enough on its own in that case. So even if he thinks Ventolin is dangerous as a drug, it's unrealistic to just say it shouldn't be given. There needs to be a reasonable alternative with similar effects to open the airways, that people can use as they do now.

As for nebulisers, while I'm aware that there is research suggesting a spacer and inhaler is just as good in many situations, that may not be the case for severe attacks. The guidelines still say you need oxygen-driven nebs for more severe attacks, and I and plenty of others do find that they help when inhalers and spacers have stopped. I have also heard this from doctors and from someone doing research on drug delivery.

I'm very far from terminally ill but I do have a nebuliser to use with Ventolin nebules at home, even though my consultant is very alert to the dangers of.some drugs. A lot of consultants in the UK admittedly aren't keen on people having them at home, but that's usually because they're worried about people overusing them, then when they stop working they're at home which can be dangerous, instead of in hospital where other things can be done.

As for oxygen, yes it should be used appropriately but may be needed in hospital at times. Very few asthmatics will need it at home though.

I know some consultants do get a bit fixated on things (mine really hates oral steroids, though acknowledges they are often still needed). However, I'm puzzled about what your consultant means since I've never seen anything in the literature about Ventolin being dangerous, except as I said in my first post about needing it being a sign of poor control and it not addressing inflammation.

Poobah profile image
Poobah

This is the only reference I've been able to find; a newspaper article from 2010 referring to research by the University of Leicester:

irishexaminer.com/news/arid...

I know I've read elsewhere about the long term affects of Ventolin but I've also read similar items on the long term affects of long acting bronchodilators and inhaled steroids. Inhaling stuff isn't good apparently, who knew?!

I did come across a NZ consultant on one of my biannual trips to the respiratory clinic, who was adamant that Ventolin was no longer prescribed globally. After a lively debate I got to keep my Ventolin prescription. To say she was frustrated with me is an understatement. But 6 months later I'm sat in front of Prof P, head of the clinic, who explains that I don't respond well to steroids and to use my Ventolin when required.

My respiratory clinic also undertakes research and patients are able to volunteer and learn about advances in asthma treatment. They continue to endorse Ventolin as a reliever.

Wheesy profile image
Wheesy in reply to Poobah

Most appreciated for your knowledge and investigations. I think that these consultants get things into their heads and adamant that they are correct and it is us patients who have to suffer not them. You van make statistics do what you want them to do, it is how they are interpreted.All that I want is to get away into the country side and get on with my life after more than a year shielding.

Keep Well & Safe

Poobah profile image
Poobah in reply to Wheesy

Are you able to have a chat with one of the nurses who work along side your consultant? They may have the time to send you links to the research on which your consultant is basing his decisions. There's no reason why they shouldn't explain the science behind the claims that long term use of Ventolin is dangerous, especially as NICE has not considered the research sufficient to alter their prescribing advice.

Lysistrata profile image
LysistrataAdministrator in reply to Poobah

Thanks for the link, Poobah. Might have a look on Pubmed today.

I will add that in my work we have often been reminded that how cells in a dish behave, or how animal cells behave, doesn't necessarily translate to the same effect in humans. Killing cancer cells in a dish, for example, is very far from having an effective treatment for cancer in humans or even lab animals.

Poobah profile image
Poobah in reply to Lysistrata

Totally agree Lysistrata. I've been using Ventolin for 56 years now so I'm a lost cause, I guess. 😁

Wheesy profile image
Wheesy in reply to Poobah

You are still only a bairn as ye say in Yorkshire. What I always do and think is look for someone who is worse off than me and I feel tons better. Lets hope that we will now be able to see our friends and family.

Poobah profile image
Poobah in reply to Wheesy

You are so right - I don't have to look too far to see someone else who makes me grated for my blessings. And thank you for thinking I'm a bairn! 😄

pink123floyd profile image
pink123floyd in reply to Poobah

Hi Poobah this article is 12 yrs old so why are we only now hearing of the problem with Ventolin as this is also the problem i mentioned earlier for my Nebuliser if GKS has stopped making it how can you still get it as a inhaler? and not Nebuliser vial .as i only picked my meds up yesterday and i had my Ventolin inhaler as prescribed.

Poobah profile image
Poobah in reply to pink123floyd

I think that it NICE and the NHS move at quite a slow pace when it comes to reacting to research and will be looking at variables in how they can continue to treat patients safely and effectively.

Since this thread started I've had an asthma review with my asthma nurse who stated she wanted me on MART with Fostair 100/6 while also taking Fostair 200/6 as a preventer, thereby withdrawing Ventolin (she brought up the issues with Ventolin) and I said I was happy to give it a go. However, my GP scotched that and I remain on Fostair 200/6 with Ventolin as a rescue.

I've tried MART while on Symbicort, but ended up on the maximum dose every day and really struggling. My Prof consultant was not happy that I had been placed on MART and went back to lower amounts of Symbicort plus Ventolin.

Decades ago I took part in some research that wanted to see if taking Ventolin before taking a preventer inhaler would improve the efficacy of the preventer. My results were quite good and so the consultant who ran the research got the asthmatics who, like me, enjoyed better health from taking Ventolin as part of the daily med regime to continue and that was reflected in the instruction label on every box of Ventolin. That continued for years and wasn't picked up until about 7 years ago and there was a bit of consternation that I had been taking Ventolin daily. Too late now.

As for having nebulisers at home, I know that it will depend on the respiratory consultant as to whether or not Ventolin nebs can be prescribed and will be considered on a case by case basis.

The main theme around Ventolin appears to suggest that asthmatics rely on Ventolin too much rather than adjusting their preventer meds or taking preventer meds regularly, and that is considered unsafe due to the nature of asthma, which can deteriorate very quickly and lead to fatal outcomes. I always feel afronted by this suggestion, but there must be enough evidence that there are enough patients who aren't following a regular prevention regime.

Wheesy profile image
Wheesy

I have a good relationship with my 4 hospital based Asthma Nurses who incidentally will call me to see how I am getting on with my 4 lung problems, and are fantastic and very helpful. I will contact them tomorrow with this question, and hope that they will be able to get this consultant to confirm his conviction. I have more than one consultant and he is the only one as far as I know that has these views. Thanks again.

Poobah profile image
Poobah in reply to Wheesy

I would be interested if you do find anything out! All the best.

peege profile image
peege

Something odd here. I believe individual consultants can't just change the rules based on their own opinions & based on their own research. They have to publish and be approved by GMC or NHS in the UK at least . I'd contact BLF (British Lung Foundation) they would know. P

Addendum: your writing 'ventolin used over time is extremely dangerous to the lungs' is very alarming and scary for ventolin users.

I saw your similar post of 3 months ago, readers can see the previous post & 45 replies in Related Posts' to the right (or scroll down on a phone).

Birthday60 profile image
Birthday60

Sounds a bit weird. People who use ventolin on a regular basis have less controlled asthma - often because they are not diligent in taking their preventatives and exercising their lungs to improve capacity. I am on 4 drugs to prevent and work out with a tough cardio programme. Have had asthma for 60 years and took ventolin tablets and medicine as a child - before inhalers were available! In my 40’s I was very ill and it took a good talking to by a consultant befor3 I would acknowledge the need to take my preventative meds EVERY day! I was in denial

pink123floyd profile image
pink123floyd

Just got off the phone with my GP surgery and they have said GKS no longer make it i am now asking can i use 2 Salbutamol vials instead of 1 as i get no relief from Salbutamol

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