My GP told me I don't need Ventolin because the Fostair can be used in the same way as the Ventolin when needed. Why then so many years I've been taken the Ventolin prescribed and the Fostair used only in the morning and evening. Any comments on this would be much appreciated. Thank you so much.
Fostair and Ventolin: My GP told me I... - Asthma Community ...
Fostair and Ventolin
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Sunflower2323
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As far as I understand it, the thinking is that while Ventolin opens the airways it does nothing to address the underlying cause eg it is a sticking plaster not a treatment. By using the preventer inhaler as a reliever the airways are still opened while the steroid element treats the underlying cause. This is called a mart ( Maintenance and reliever therapy) regimen.
I am on mart, but also still have a blue inhaler.
Thank you Troilus. That was my understanding as well. You highlighted exactly the way I knew it and been explained to me some years ago. Not sure why at this point the GP told me to choose which one I have to give up the Fostair or Ventolin. As I'm getting older I'm not necessarily getting me better in order for me to give up on such medication. I need the Ventolin for when I'm short of breath, I don't want to use the Fostair instead. Thank you again.
GPs do not have a great understanding about bronchiectasis and asthma, i am lucky that i see a specialist once or sometimes twice a year and he tells the doctor what medication i need after we have a chat about it. he always goes along with what helps me or does not, we all react differently and the patient sometimes does know best especially at my age of 84.
Fostair is a steroid inhaler with some bronchodilater effect too.see how u go,but if it's not enough and u still need ventolin,tell yr dr
Thank you Patk1. I always used the Ventolin and it's the one I carry it with me. In the morning and evening I use the Fostair but the Ventolin is when I need it. Especially when I catch a cold it's the Ventolin I use it. I just don't understand the way the GP is thinking.
Fostair may settle down the inflammation,reducing need for ventolin,but I'd have it with u for whn u need it.fostairs gd as made of v small molecules so it's absorbed well by lungs.x
I am on Fostair on a MART (maintenance and reliever) regime. Fostair contains both a steroid (beclometasone) and a long acting bronchodilator, Formetrol. Formeterol is as quick acting as salbutamol, so it can be used as a reliever like salbutamol but will last longer. The advantage of using fostair as MART is when you are more symptomatic and using your reliever you also increase your inhaled steroid dose to help dampen down any inflammation which salbutamol as a reliever does not.
asthma.org.uk/symptoms-test...
you are quite correct Lilly_the_unicorn. As a doctor with an internet in asthma ( and the Healthunlocke police have checked that I am actually a doctor!)- This is one of the six licenced products for MART ( Maintenance and reliever therapy) in the U.K. the rationale is that if your asthma is out of control you need the reliever to open the airways by relaxing the muscles, however, as others have said when this happens, the inflammation causing the asthma flare up must be treated as well. That’s why the combination of the inhaled corticosteroid together with the reliever is licenced for use for the MART system.
Some people have responded that they prefer to use their salbutamol for relief however the fact is that the Formoterol ( the reliever in Fostair & the other MART licenced products) works as fast as salbutamol. Importantly, if 6 extra puffs of Forstair is not controlling your symptoms or if you are getting worse despite using extra Fostair or salbutamol, then you should in my view be calling for medical assistance in addition to using your salbutamol.
Suggest read the instructions that are included for MART in the inhaler box if your doctor has not provided you with a written MART asthma self management plan.
The six MART licenced products in tge U.K. are the low dose (100/6) Fostair dry powder and pressurised inhaler, two Symbicort ( 100 & 200) strength Turbohalers, Fobumix (160/4.5) Easyhaler, & DuoResp ( 160/4.5).
Thank you very much Africanleopard, very useful and detailed input.
Hi Sunflower. This is the advice my consultant gave to me, which I appreciate may not be applicable to everyone. He also told me that Fostair can be used both as a preventer and reliever. If I see a reduction in peak flow, my first plan of action is to increase the dose of Fostair. I am currently using 2 puffs Fostair 200/6 in the morning and same in the evening, and can do up to 4 puffs twice a day if needed. He also said I could take 2 puffs 4 times a day if I preferred.
I also have a blue salamol inhaler. He didn’t say anything about stopping that. One of my triggers is exercise and his advice was to carry the blue inhaler and use it mid run as soon as I start to feel wheezy.
I’d be happy to increase my Fostair dose if I see symptoms but wouldn’t want to be without the blue inhaler in case the maximum Fostair dose still left me wheezy/coughing.
Good luck getting this sorted with your GP
I do fostair 200 6 two puffs morning and two puffs evening. My asthma nurse on occasion also puts me up to eight puffs a day, however I have been told eight puffs a day is beyond fostair 200s official license.
Thank you gemwatercolour for your reply. This is exactly how much I've been advice by another GP. But sometimes It's a different one. I'm also worried to use Fostair too often. It may affect my thyroid function.
Good morning Sunflower.I also use the Mart regime if asthma especially uncontrolled.
In a severe episode Fostair doesn't work quickly enough for me so have both Ventolin inhaler and nebulized Ventolin.
Was always advised that Fostair wouldn't work in a severe exacerbation.
Hope that you are able to get some clarity on this.
I am also on long term prednisolone so don't know if that makes s difference.
Best wishes.
oh dear, I fear this is wrong.. I have been taking fostair for years.. it’s a preventative & should only be taken twice a day (two puffs).. I use ventolin a lot,,it’s my savour. GPs are only delegators, not specialists,,please see one & get the correct advice.. hope this helps xx
You are perfectly right. Nobody is asking me about how much is the peakflowmeter or if I see the asthma nurse, nobody is checking the peakflowmeter.
Hi, as Troilus says Fostair is a MART inhaler . I've been on it I think for 4 years and I find it utterly brilliant so much so that its changed my life. It really works as MART as in you can take more or less as your needs alter. My asthma is more difficult to control during the winter months, 1 puff in the morning and two 12 hours later works well, somesometimes I need 2 puffs in the morning. Then in summer 1 puff am & pm is sufficient. On this regime I rarely need ventolin - or Salamol as it's now called - . I did use it a lot all of January when I had a horrendous virus & chest infection which still niggles with SOB, I couldn't have coped without it.
I probably only need two Ventolin inhaler per year however, I'm guilty of ordering 4 per year as I'm worried that the surgery will take it off prescription if I show I dont need it so often.
It's really worth a try, the particles are much smaller in Fostair so get where they're needed.
If you're prone to asthma attacks that see you ending up in A&E, it's important that you get your asthma plan updated to show how you use Fostair in an emergency situation. I had this conversation with a consultant when they wished me to try the MART regime and they ended up agreeing to me keeping my Ventolin and the associated emergency treatment (10 Puffs one minute apart).
If your asthma is not that volatile, then using Fostair like Ventolin, in addition to the regular doses, should improve things for you over time. Your doctor will make clear what the maximum puffs are in a day. If you find this isn't working for you,then definitely go back to your doctor to review your progress or lack of it.
However, if you're not confident in ditching your Ventolin, then ask your doctor if you can have one, just to be on the safe side but commit to trying the full MART for a set period of time; say 6 months. Just knowing you have the Ventolin without actually using it, will give you the piece of mind that you might need. It's important your doctor checks on your progress at the end of the agreed trial period.
Thank you very much Poobah. I'm in trouble only if I start having a cold when my nose is running and start coughing, otherwise I'm not coughing, but if the cold is bad then the best is the way you are using the Ventolin with 10 puffs at an interval of 1 min each. I've been advice to increase the puffs with one after each minute, it was one occasion when my cough was really bad because of a cold.
my doctor took me off ventolin and put me on fostair with out any consultation,i find its a pain to use compared to ventolin.i play badminton and can pick up ventolin and use when required.the doctor said it was better because of gas used in ventolin was bad for the planet.i looked up the cost of fostair compared to ventolin and it was over £ 100 cheaper and i think this was the reason for the change.he did not want me to have both..
The doctor could have switched you from ventolin to salamol and achieved the same effect on greenhouse gases. Salamol is not as powerful as ventolin but is very convenient as you can use when you like.
I'll tell my doctor not to stop my Ventolin because I'm not getting any better or younger for my condition to improve. Thank you for your reply.
I had an instance where the local asthma nurse removed one of my inhalers - due to cost I was told even though I have difficult to control asthma -she also decided I had COPD.My lovely respiratory consultant who knows me well after many years of caring for me raised an eyebrow crossed through the COPD label and put me back on what she had originally prescribed.!
Hope that you can get this issue of Ventolin resolved for you satisfactorily.
the fostair can be used on a MART regime where you can use it more frequently as it contains both preventive and air openers drugs Your GP is probably trying to keep costs down. I’m on fostair however I prefer to use my blue inhaler if required rather than the fostair but this is purely because my blood sugar levels are high and I don’t want to raise them more X
I perfectly agree with you. But what about the steroid also in the Fostair which can affect the thyroid function if you use more Fostair whenever needed as we do with Ventolin.
I think a good chat with your asthma nurse / consultant is required to decide which is the best way forward for yourself. I was changed to fostairnexthaler after I felt my previous steroid inhaler wasn’t doing a good job. Unfortunately there are side effects with drugs and I suppose we go with the lesser evil or take the better drug for our conditions. Take care 🤗
Depends how your told to use it. morning and evening possibly 2 puffs each time in between you use Ventolin or you go on the M.A.R.T. review and you do not use Ventolin but can use up to 8 puffs of Fostair a day. your Asthma nurse should have explained this properly to you hope this helps. I've just been put on the M.A.R.T. review and its taken a while but I think its working. good luck.
The problem is that about 4 years ago the asthma nurse cut my Fostair from 200 to 100 g, so I asked why is this cutting the dose and the reply was that if I catch a cold I need to increase the dose of Fostair and they have nothing to offer me if the Fostair dose is already high. The pharmacist advice me at that point to use the Fostair 4 times a day, if necessary.
That seems like a backwards way of looking at it. You should be on the lowest dose that controls your asthma. If it's not controlling your asthma, it's too low. If you get a cold or some other trigger and you need extra treatment then you need it and there should be a decision on what that treatment should be, but it's much less safe to keep your asthma on a dose that isn't controlling it just to have a reserve.
Just based on what my sister, an asthma nurse, told me: if your asthma is stable they like to put you on the MART regime (Maintenance and Reliver Therapy; i.e stuff like Fostair). So when I was recently switched to Fostair from Clenil I asked my own nurse if this meant I no longer needed Ventolin. She said I would still have the Ventolin as my asthma was not stable (hence the switch to Fostair).
If you feel safer having the Ventolin as well, I would push for it. Fostair has been amazing for me and I think I was suffering too long on Clenil that was no longer working. But I would be anxious if I didn't have the Ventolin on standby (or Salamol as it now is, they no longer prescribe Ventolin at my GP surgery).
I’ve been on the mart regime for a few years now. I have 2 puffs twice a day and can have up to 4 extra as and when needed. This seems to be working really well for me. Recently my doctor has taken my blue inhaler away so can no longer order it on repeat. It really annoyed me at first but looking back over the last few years I’ve not used the blue much really. I had a spirometry test few weeks ago and said to the nurse about it and she said they are stopping the blue inhalers for those that are combination inhalers such as Fostair as they can be used as a reliever which is much better as they treat the problem as well as reliving it. She also said if I need anymore then then 8 puffs in a day then I’ve got problems and should be seeing someone urgently for further treatment. Wouldn’t surprise me if more people start getting the blue taken away now.
I'm just worried that the Fostair might cause some problem to the thyroid function as it is based on steroid. So if I use it more often to replace the Ventolin than I create a change of hormone balance in my system.
My only issue with that is if you have a sudden asthma attack. Asthma Uk then advices to take a puff of salbutamol once a minute until it lifts. And you can take up to ten puffs. What would be the equivalent with Fostair? Especially Fostair 200, which you are not supposed to take more than 4 of per day.
Steroid can also affect bone density. I don't know if that would include inhaled steroids. I am on Fostair 200/6 and take it 4 puffs daily in winter, 2 in summer, and my ashtma is nearly as perfect as it could be. I think I picked up you like me have a lot of years to your name? I have so far never had any issue with my thyroid function, but I now have osteopenia. I take extra vit D and calcium (prescribed).
Perfectly right. Salbutamol I use it much much for often if I catch a cold the way you describe it. And it's always handy if I'm short of breath. I try and do my best not to put a strain to my body or lungs.
That really shouldn't be something they do for everyone! MART (ie using the Fostair or Symbicort as a reliever and preventer) can be great for some people, but it doesn't work for everyone, or their needs may change. Healthcare professionals shouldn't really be approaching asthma care as a one size fits all, because it isn't.
I also think it's good to have the blue there for backup - though agree if you do need more than the max Fostair puffs you should be seeing someone asap. But if no blue, you can't follow the advice for asthma attacks in the moment about taking 10 puffs through a spacer while you wait for help, as Wheezycat has mentioned above. Absolutely you can and should be calling for help if you need that, but not having a blue inhaler at all in that situation seems a little risky - I would have thought ideally they give you the blue with strict instructions on how and when to use. And if you (general you, anyone) do find you're needing to use it often then maybe MART isn't right for you.
I have plenty of blue at the moment so I’m not to concerned. Just annoying I can’t order more. I will be taking it up with my asthma nurse at review end of May as I feel if I don’t have it I will need it. Also I like to sometimes have some blue before the Fostair if I’m feeling chesty.
My new doctor (a youngster)did a med review and took the blue off repeat without consulting me which I wasn’t happy about. Things he should be doing but isn’t so I’m going to see him soon for one last chance.
Yeah it sounds like he's not great at actually discussing with patients and is maybe a bit rigid. Hopefully he'll learn!
I use Fostair morning and evening as it is a long term preventer and reliever. There are times when I need a reliever during the day and so need to have Ventolin available. If you only need it occassionally then GP should make it available to you. If you need it frequently then the GP needs to review your long term preventer in case it isn't working. My GP prescribes both fostair and ventolin for me. It is part of my treatment plan.
I think some areas are putting GPs under pressure to prescribe fewer medicines, but it isn't good clinical practice.
Yes indeed I haven't received any medical explanation on why they stop my Ventolin.
I am also on fostair . I have a ventolin inhaler which I use when needed. The only time I use both is when I have a flare up. Then gp puts me on regular ventolin but it is on a reducing dose eg 4 times a day 2puffs for 4days, then three etc
The medical profession are unhappy with people taking steroids for years on end!
Being on inhaled steroids and controlling asthma is much better than having poorly controlled asthma and multiple courses of oral steroids though.
Although there are obviously exceptions, so I'm not going to say there are no side effects with inhaled steroids, most people don't have too many problems with inhaled steroids, especially at lower doses. And it's better than poorly controlled asthma, which can be fatal.
I read some literature about that and I'm sure the medical profession is not happy with too much steroids in the system, it's so obvious.
Hi Sunflower, Forstair is both a preventative and reliever for our asthma. I've been on Forstair for nearly 4 yrs with no added reliever (Ventolin) Hope that helps.
I just read your comment on thyroid. I was diagnosed with hypothyroidism in 1995. I first started inhalers in the 1980s so hard to tell if there was a correlation? But my bone density aged 72 is still above average for my age. I had my first scan in 1997 when I was 46, they said I had the bones of a 30yr old woman. During the interim years, I've taken Alendronic Acid and vit D tablets. So seems the endless inhalers, steroids etc haven't been a factor for me. Good luck.
Hmmm I wouldn’t be happy having my salbutamol pulled. I’m on Symbicort 200/6 2 twice daily with a Symbicort 50/3 inhaler as back up if the salbutamol doesn’t work well enough which occasionally happens. I guess you’d call it a MART plan of sorts but the Formoterol takes 3 minutes to start working and peaks at 15 minutes. The Ventolin has a lot quicker action. I’m in Australia by the way so our treatment plans probably have different names. I’d be asking for a second opinion.
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