Clenil - what is a high dose?

[Buddygone]

I’d been on Clenil 100 x2 twice a day for a couple of years with no problems then I had a blip and the dose was increased to 200 x2 twice a day.

My breathing is mostly fine but following a fall I broke my wrist and have recently been diagnosed with osteopenia, I also bruise very easily. Some info suggests there’s a link with high doses but I’m don’t know if 800mg per day is high, my GP says I should stay on the 200 but I’m worried now.

what is considered a high dose?

[fraid]

I don’t know if it helps but I’m on 50mg 2 puffs 2 x day but still have to use Ventolin occ. My asthma been much worse lately - turns out my Clenil was empty! Duh! When I shook it it rattled, tried spray into air, worked ok. Only looked at dosage meter today to see 0. Phoned dox, ‘can’t do anything till Monday’ tried Chemist,they put in emergency request and just delivered it! Astonishing! Why can’t dox be as efficient???🤔

Shall phone and thank chemist. Now wonder if I stupidly put empty one back in instead of refill? M.E brain? Point is I also have OP but long before asthma got bad. All drugs have side effects, it’s a Q of balance- which problem is worse?🤔

Sure someone more knowledgable will come along soon- seems I am a total dummy! Thank goodness chemist so helpful! 👏👏👏

[Mandevilla]

My GP is paranoid about giving his patients steroid inhalers, but even he didn't mind me being on Clenil 200 twice a day, so I think it's fair to say it's a fairly low dose or I'd never have prised the prescription out of him! If you're worried, call the helpline - they are brilliant.

[Buddygone in reply to Mandevilla]

thank you - I’ll call them next week 👍

[Lysistrata Administrator Community Ambassador]

Hi Buddygone,

Your new dose is medium (for the full table if you want it, this is the link - scroll down: cks.nice.org.uk/topics/asth...

Definitely don't stop or reduce the medication as you need it for your asthma - and with worse asthma control you're more likely to end up on oral steroids, which are more of a problem for bones.

You also need to talk to your GP about bone protection, and what you can do about it to stop the osteopenia getting worse - without stopping the steroid inhaler. It might be that if they wanted to increase the inhaled steroid dose any further you would want a chat about other options.

I agree with Mandevilla that it might be an idea to call the helpline and talk this through: 0300 2225800 or WhatsApp [phone] Monday-Friday 0915-5pm

[Buddygone in reply to Lysistrata]

Thank you for this - very helpful 👍

[Chip_y2kuk]

200 x2 twice a day is a high dose.... you can take higher but its not recommended and no GP will recommend a higher dose than 800mcg of beclomethasone (its relatively safe at those doses even though they are considered high)

[Buddygone in reply to Chip_y2kuk]

yes that’s what I thought, it could well be linked to my osteopenia

[Chip_y2kuk in reply to Buddygone]

Yes, I've been told I need to have a bone density scan and am on 800mcg of beclomethasone but I also have frequent prednisolone and can take higher doses of beclomethasone if needed (but not permanently)

I also know from other testing that my adrenal glands are "sleepy" because of all the synthetic steroid in my system

[Buddygone in reply to Chip_y2kuk]

gosh it snowballs once it start doesn’t it. Hope your scan is good 🤞

[Chip_y2kuk in reply to Buddygone]

To top it all off I found out 6 months ago.... its "highly likely I don't have asthma at all" ... I do have "floppy airways" (Excessive Dynamic Airway Collapse)

[Buddygone in reply to Chip_y2kuk]

You couldn’t make it up 🤨, hope you get sorted.

[Lysistrata Administrator Community Ambassador in reply to Chip_y2kuk]

200mcg 2 puffs twice a day is considered a medium dose of Clenil, not high - see table here cks.nice.org.uk/topics/asth...

But 200mcg x2 twice a day *would* be high for beclamethasone extra-fine particle inhalers like Fostair or Qvar, because the fine particles mean they need less to deliver the same dose. Not confusing at all...😂

Whether it would be the best option to have more Clenil would obviously depend on the person.

[andy121]

Although 800mcg is considered a high dose it can actually go higher so your safe at 800 under a gp

[Lysistrata Administrator Community Ambassador in reply to andy121]

You can go higher, but 800mcg a day is considered a medium dose of Clenil (high for Fostair and other fine particle inhalers) - see above.