Update on my Sirdupla changes

[LittleZebra]

I received a call from the health Centre today to say that the consultant doesn't want me to come off inhaled steroids all together. He would like me to swap to the Fostair Nexthaler and keep on my Spiriva. He also wanted to put me on Montelukast to help with the transition. Unfortunately I have been on Montelukast before and I had to stop taking it (I think it caused attacks to come on more quickly and strongly but it was a while ago now so I can't remember for sure). So I will have to try to change without it. I also know that Fomoterol didn't last as long for me as Salmeterol which is how I ended up on Sirdupla (I tried it with the conventional form of Sirdupla). I am a bit nervous of trying the powder inhaler as inhaling powder (however fine) seems counterintuitive but I have to trust the consultant at this point although I am not due to see him until early February so I hope it works!

[Lysistrata Administrator Community Ambassador]

I'm very glad to hear that's been sorted out - I figured it was probably a mix-up, but you never know! It seems like a sensible approach to the swap, though it's a shame you can't use the montelukast.

I'm on Fostair Nexthaler and find it good. I used to be on Symbicort but found it hard to take properly when my asthma flared up. I've not had that issue with Nexthaler, and haven't found an issue with powder getting where it shouldn't be. There is also a spray version (metered dose inhaler) version of the Fostair if you do struggle with the Nexthaler, and other options entirely if you find formoterol not as good.

Interestingly, there was a study done a while back (with children, but I think in this case it would apply to adults too) suggesting that genetically people seem to have slightly different receptors, and it seems that if you respond to salmeterol you are less likely to respond to montelukast, and vice versa. Salmeterol never did much for me but montelukast does, though it isn't as good as it used to be for me.

[LittleZebra in reply to Lysistrata]

Thank you that is very interesting. I quite often find that I respond to medications a bit non-standardly for instance I seem to be very sensitive to antidepressants and so I can be on a 'subclinical' dose and it mostly controls my anxiety (enough to pass as 'normal' anyway) whereas a normal dose will make me feel physically dreadful. So every time I start to take something new it feels very much like a personalised experiment. It is good that there are different options so if something has an ineffective or paradoxical effect so each of will 'hopefully' have something we can take. I suppose it is at least partly down to how quickly or slowly we metabolise drugs. I read recently that Formoterol starts working more quickly than Salmeterol but wears off more quickly which, I suppose tallies with my experience of deffinitely feeling in need of it by my usual time whereas with Salmeterol I can usually take it an hour or two later and not feel like I am struggling. I first started on a beclametasone inhaler and then had a separate Salmeterol added to see if it helped. Somebody then suggested Fostair which I tried for a while in a standard type inhaler but I didn't get on as well with the Formoterol in it for the reason I just outlined. I would love to have a chance to try a combined inhaler with beclamethasone and Salmeterol in it but I don't think such a thing exists? Anyway I shall just have to see how I get on with the new utterly different inhaler when I get it