2000 micrograms Budesonide per day

[768990]

Is 2000 micrograms of Budesonide safe to inhale per day?

I am on Symbicort 400/12, and for me 3 puffs in the morning 2 at night feels good.

[twinkly29]

I think 1600mcg of budesonide is the max.

I assume from your post that it's prescribed as 2 puffs twice a day but you've increased it? Meds shouldn't be altered in prescription really other than by a doctor, not just because of "safe amounts" but also efficacy and side effects - side effects (including those we don't notice) might well be ok at one dose but not at an increased dose. The formoterol element in Symbicort will also be increased with too many puffs and that increases heart rate as one side effect, which is obviously ok up to the max allowed dose or it wouldn't be allowed, But it could be unsafe increasing it.

However, if you don't feel your asthma is controlled on 2 puffs twice a day (ie you're having to use your reliever more than 3 times a week), talk to your nurse or GP - I don't know what else you're on but there are other things that can be added in so that it's safe but things are also controlled.

[768990 in reply to twinkly29]

im also on montelukast. two puffs in the morning/evening is prescribed to me. Im wondering if I should try and get the brown inhaler on perscription, as it is only a steroid. and then i can use it with my symbicort, and get a more accurate dose of the budesonide for my requirements, with out having to inhale more formoterol

[twinkly29 in reply to 768990]

A variation of that is possible, eg a lower dose of Symbicort (such as the 200/6) with a separate add-on of a just steroid inhaler to maximise the steroid without overloading the LABA (long-acting bronchodilator) element. But it does sound as though you're already on the max steroid dose for budesonide so they wouldn't want to go over that I wouldn't have thought - ie you're on max steroid now and if you had lower dose Symbicort+steroid only inhaler you'd still only be able to go to the max dose for budesonide which seemingly doesn't do the trick.

If you're not controlled, it might be worth asking about something like Spiriva which is a LAMA rather than a LABA (more info in this post: healthunlocked.com/asthmauk... )

Often adding in more steroids isn't the most effective way of improving control, once one is on those that is.

[Poobah in reply to 768990]

My asthma nurse was happy for me to try adding a steroid only inhaler to my Symbicort 200/6. I tried it for 4 months but it didn't impact my asthma. In the end my AN suggested swapping to Fostair and that definitely made a difference. Definitely discuss your options with your AN or doctor. Good luck.

[Keisha192001 in reply to twinkly29]

Some doctors will recommend higher than the max amount. Ie. Currently I’m on 8 puffs Fostair as my preventative treatment as well as whatever amount of reliever puffs I need which is at least 2 at the moment as well as currently being on oral steroids

[twinkly29 in reply to Keisha192001]

True but a doctor allowing an "over the maximum" dose would normally be as a short term approach due to a flare (as in your case) - and as you rightly mentioned definitely prescribed by the doctor.

If someone is routinely needing such doses then alternatives need to be considered - which may be different inhalers or additional medication of some kind.

I hope your flare settles soon!

[Hidden in reply to Keisha192001]

is that 8 puffs of 200/6 fostair, or 8 puffs of 100/6 fostair? Just interested.

[Poobah in reply to Hidden]

I think 100/6 has a daily maximum dose of 8 inhalations. medicines.org.uk/emc/medici...

[Hidden in reply to Poobah]

Yes, that's right. That's why I wondered if Keisha was taking the higher dose or not., where the recommended dose is 4 puffs a day maximum.

[Keisha192001 in reply to Hidden]

100/6. 8 puffs as maintenance plus extra as needed as reliever

[runcyclexcski]

1600 ug per day == 1.6 mg per day == sounds safer than 20 mg day of prednisolone. As long as the inhaled steroid works, it beats the oral one. They also recommend washing the mouth after using unhaled steroids -- at least for my Seretide.

[Anselm198]

I take it in the nebuliser and have 4000