Changing from prednisone to Midazolam

[Bevash]

from approx 1973 until 2015 I had very mild asthma. Come Feb 2015 following a major neck operation it started getting worse. approx April 2015 the respiratory clinic thought I may have copd. This was confirmed later that year.

My asthma is now classed as severe along with the COPD. I also have Restless Legs. Chronic fatique, Adrenal fatique, Atrial fib . Reflux, & Mild sleep apnea, along with a few other issues.

I have had a few trips to hospital via ambulance over the past 7 years. Normally only kept in for one or two nights except when I had RSV and was held in isolation for 7 days. Admitted to hospital March 2022 to find I had Covid. (I hadnt been out of the house for 10 days) Was kept overnight. Told to double my use of qvar and continue the 40mg prednisone for 10 days then sent home.

For the past approx 2 years I have had an exacerbation usually once a month. When my ventolin wont ease the breathing I normally start on a 5 day course of 40mg prednisone. This settles things down most times and keeps me out of hospital. The hospital advised me. If asthma is bad take 6 puffs of ventolin, wait 10 mins, take another 6 puffs, wait 10 mins, take another 6 puffs wait 10mins. If breathing has still not settled call an ambulance. They immediately put me on 40mg prednisone followed by 1 or two nebulisers. When in hospital they give me ventolin 6 puffs every 4 hrs. until it eventually settles down.

I visited my respiratory specialist this week and he has decided it is time to come off the prednisone and has now given me midazolam to take when i get a bad flareup.

I questioned why was it ok for the hospital to dose me up on prednisone and ventolin (exactly what I do at home to avoid hospital and sometimes a 6hr wait before being seen) to be told the hospital just want a quick fix.

From research i have done on midazolam a few sites state that one bad side effect is (it can cause breathing issues) . I will talk with my pharmacist and my GP.

Is there anyone on this site who is being treated with midazolam for exacerbations. I am presently taking qvar, spiolto and ventolin. Plus a truck load of other meds for my various issues.

TIA

[runcyclexcski]

No experience with midazolam. Re: prednisone, in my experience, the hospital just wants to stabilize you, and prednisone is their default emergency treatment plan. Once you are out, the long-term treatment strategies are supposed take over. I was on 20 mg of prednisone for 1 year, and then it took me 6 months to reduce it to 2 mg (which was a bit of a struggle, but my asthma nurses told me to stick with it). When I had covid, I was told to go back to 30 mg pred for a week. I then asked my lung specialist if the short-term prednisone for exacerbations is likely to make me prednisone-dependent again, and I was told that it was not the case (i.e. temporary excursions are OK).

[Poobah]

Never heard of midazolam, so Googled it. It doesn't look like it's a mainstream asthma treatment and your consultant may be using it as a novel treatment, given your range of health challenges. The Asthma UK nurses may be the best people to discuss this with, especially if no one on the forum has been treated with midazolam. Failing that, are you able to discuss with one of the asthma nurses attached to your consultant's team? Our respiratory clinic nurses are very helpful and usually more inclined to take time to chat things over with patients.