First course of steroids

[EssexEve]

Hi there, I am in Portugal on holiday and have my first asthma flare up/respiratory infection (wheezy, painful & productive, 3 weeks after a +ve covid test). I have mild asthma, diagnosed a year ago after my first bout with covid.

I feel like I’m starting to improve after seeing a local doctor (who prescribed levofloxacin, Prednisolone, pulmiben, kestine, avamys and upping my Fostair to 8 hourly).

I’m curious, having not been prescribed prednisolone before, how the pred prescription compares to any UK protocols?

I’ve be given a box of 60 x 20mg tablets and told to take 1-2 per day. I’ve been taking 1 x 20mg and assumed I take them for as long as I take the antibiotics for (one week) then stop.

I’ll try and see the GP or asthma nurse if I’m still symptomatic back at home next week.

TIA and wishing you a healthy Christmas!

[Homely2 Administrator]

When I have a very bad asthma attack and go to gp or hospital. They give me 40 mg of pred per day for five days, to be taken with a meal. They call this a short course.

Longer courses than this you have to be more careful with, and there are many people on this forum who can talk about them, but not me.

Do you really mean fostair 8 hourly, I assume you mean daily. Fostair 100 has a max dosage of 8 a day and fostair 200, 4 a day

[EssexEve in reply to Homely2]

Really appreciate knowing that Homely2 , thank you for sharing. My asthma is mild and well controlled (usually) so reading the replies 20mg for 5 day feels proportionate (I’m also very small). The dr said to do 2 puffs of my Fostair 100/6 every 8 hours, so three instead of 2 times a day for now. I am feeling the benefit. Happy Christmas!

[Poobah]

Sorry to hear you haven't been well on your holiday. The doctor has definitely thrown the kitchen sink at this, but at least you have a good range of treatments.

My emergency pack of Pred is for 7 days, 40m pd, taken in one go with breakfast. My emergency antibiotics are for 7 days also. If after 6 days your symptoms aren't improving sufficiently well, you could ask advice about continuing with another 7 days or of Pred from the doctor you saw. Beyond 14 Days, specific advice should be given by the prescribing doctor on how to reduce the Prednisolone dose day by day, over time. Short, sharp courses are OK, but if taken beyond 14 Days the body needs to adjust from artificial steroids back to our natural hormone function.

If the doctor has asked you to increase your Fostair then it will be within prescribing guidelines. I'm on Fostair 200/6 & can take 6 doses a day during a flare up per my asthma plan but I will keep my asthma nurse in the loop. That goes for using my emergency packs of antibiotics and Prednisolone too.

When you get home definitely bring your GP &/or asthma nurse up to date with your medication regime from Portugal.

Hope you feel better soon.

[EssexEve in reply to Poobah]

Yes, definitely the kitchen sink was chucked my way 😅 Thank you for explaining Poobah as that has really helped me to make some sense of what I’ve been given. I will get follow up as I think in part I’m being treated to solve an acute problem but it crept up on me so I want to avoid getting so poorly again/not lose track of how much prednisolone I have over time. Hope you’re having a lovely Christmas!

[Celie1]

Hello,

Sorry to hear you’re poorly atChristmas and away from home too!

I’m in the UK and I have at least a couple of flare ups a year. I’m usually given 8 prednisolone (40mg) per day,for 5 days to begin with (sometimes longer but think 5 days is the usual length of time ). The advice is to take them all together in a morning with food.

I take Duoresp inhaler max dose, so this can’t be increased like Fostair so can’t comment on this.

Your doctor seems to have given you a lot of meds (I’ve only heard of Avamys which I also take) so hope they work and you feel better soon and you can enjoy Christmas 🎄 x

[EssexEve in reply to Celie1]

Celie1 that’s super useful to know, thank you for replying! Yes, I’ve not ever needed more than an item or two at a time so it was a bit overwhelming but I’ve also never felt so rubbish and, so far, it’s only helped improve things so, in combination with the collective brain of the asthma forum I feel less overwhelmed/at sea/likely to misstep with it until I next see a dr. Merry Christmas x

[Celie1 in reply to EssexEve]

Thanks. You too x

[Birthday60]

pred is quite normal and is usually taken a 5-6 day intense course

[EssexEve in reply to Birthday60]

Good to know, thank you Birthday60 that helps me. Happy Christmas!

[Oscarpebbles2021]

Sorry to hear u ill on your hols,. Blimey 60 steroids,. When I am having a, REALLY bad flare up I get 40 mg a day for up to 7, days, which is 5, mg per tablet so 8 of these altogether after breakfast.

[EssexEve in reply to Oscarpebbles2021]

Thank you Oscarpebbles2021 that really helps me as I don’t think this was a REALLY bad flare up just a relatively bad one for a usually mild asthmatic. Steroids are so tightly stewarded in the UK that having a box of 60 feels like contraband 🤣 Merry Christmas!

[EssexEve]

Thank you for taking the time to reply Hidden - much appreciated. Ok, that’s really good to know the general lay of the land with short pred courses, and yes, that’s the smart thing to do (have my chest listened to). Merry Christmas!