Asthma

[Ca12345]

Been put on a symbicort 200/6 anyone know if any good???

[twinkly29]

Inhalers are personal so each one is good for some people but not necessarily the right one for others. It won't take away dysfunctional breathing symptoms though because those cannot be managed by asthma inhalers. So any dysfunctional breathing needs dealing with through the work the physio is doing with you and that will take time. In the meantime, fixating on symptoms is only going to make them worse because anxiety also causes similar symptoms to asthma - again not something Symbicort will help with. Of course continue with that as that's your asthma control (if it's a new inhaler it will take 8 weeks to be effective though) but you need to focus on the dysfunctional breathing things the physio is doing with you because that is what the doctors and physio have said is the issue at the moment and not your asthma.

[Tree20862]

I agree with twinkly... Ever inhaler is good, for the right person. I have used many of the inhalers out there but due to how I progress, decided if they were right for me.

Also insurance coverage makes a difference, too. Listen to your body.

Some make me cough more. Some don't. My doctor and I have a list of inhalers that I should not use.

[Penelope321]

I am currently on Symbicort 200. I’m supposed to take 1 puff twice a day but I usually only take it when I feel like I need it or if I’m going to be in an environment where I will likely be triggered (cold, humidity, scent, heat from cooking - pretty much being alive lol). Asthma sucks big time and my triggers seem only to be getting worse. Symbicort does work to open the airways but I also find it can make me feel panicky and anxious shortly after taking it.

[Wheezycat in reply to Penelope321]

Perhaps you should consider talking this over with your asthma nurse or doctor? You won't get the protection that will reduce inflammation if you only take your Symbicort as and when, and that in itself could make you more reactive to your triggers. I was on Symbicort for years and liked it, but as Twinkly says, it is all very individual. By the way, I recognise your triggers! What I now simply call indoor air pollution is one of my three significant triggers, and they do include cooking fumes (not the heat, but the burning/roasting/baking/......anything that gives a nice brown crust. And of course paints and cleaning materials etc. It is a serious drag isn't it!

[twinkly29 in reply to Wheezycat]

Yes agree with you, Wheezycat - as you've explained, taking Symbicort occasionally or "only when you need it" isn't going to help as it should. The LABA (long-acting bronchodilator) will help in those moments but the main point of it is the steroid which needs to be taken regularly as it takes several weeks build up, so won't then work if only taken ad hoc. So triggers will likely seem worse because the inhaler isn't being used to reduce inflammation over time. Another factor is the side effects - the shakiness, panic, etc are well known LABA side effects when one starts the medication. As it becomes fully effective over several weeks (when taken twice a day as prescribed), the steroid kicks in and the body gets used to the LABA drug and so those side effects you get lessen. But taken only as and when it may be that your body is less used to it so is reacting every time you take it.

A conversation with your nurse or GP would be sensible though Penelope - either to sort out a better plan for you or to discuss the issues. 1 puff twice a day is only a low dose but it may be they could switch you to just the steroid element of Symbicort (which would be Pulmicort) and then use ventolin as required. But you would have to take it twice a day as prescribed or it would be kind of pointless.

[Penelope321 in reply to twinkly29]

Thanks for your response, I understand what you’re saying. Back in September when school started back I was taking it twice to three times a day because of the humidity in my classroom. This was giving me terrible leg cramps at night so I have dialed back. I have read on some medical sites that it’s not good to take fotomerol and budesonide alone. Taken alone the risk of death increases significantly but apparently that risk is cancelled out when those two are combined as they are in Symbicort.

[twinkly29 in reply to Penelope321]

Budesonide taken along is absolutely fine - it's prescribed as Pulmicort usually (a steroid only inhaler, basically like the traditional brown Clenil one but a different steroid).

But I imagine formoterol alone would be a potential red flag like people relying on ventolin, which is why ventolin is often apparently restricted by GPs - it's not actually restricted as such but relying on a bronchodilator (whether short acting like ventolin or long acting like formoterol) is dangerous because it merely opens the airways, but doesn't deal with underlying inflammation, which is what the steroid bit does.

So yes, combined they should work well. Side effects like cramps or palpitations should disappear once the body gets used to it. But taking less than is prescribed means it's not effective ebkug, hence why you then probably need ventolin, if that's the case. However, simply increasing one's potassium intake (easily done through foods) can stop the cramps as they can be caused by low potassium which the formoterol can cause.

[Poobah in reply to Penelope321]

Symbicort is not a reliever inhaler and should be used regularly as it's designed as a preventative treatment. Your symptoms suggest you need a review with your asthma nurse or doctor in order to discuss your treatment options, your expectations and the risks posed by irregular treatment.

The cramp side effects are not unusual as combination inhalers can affect potassium levels in some patients (it explains this in the patient leaflets). Eating a potassium rich diet should help address any shortfall and a good mineral salt will help the potassium become efficient (not table salt).

[Lysistrata Administrator Community Ambassador in reply to Poobah]

It can be used as maintenance and reliever treatment (MART) for some people, but of course that still needs to be taken regularly as well as the as-needed top-ups, not just as and when needed omitting the twixe-daily puffs. It should also be something that a doctor/asthma nurse specifically says to do and explains how to use. Penelope321 I agree with others that a review would be helpful.

[Penelope321 in reply to Wheezycat]

It is a serious drag! And also a drag for people we live with Thanks for your reply!