I have been taking fostair net 200/6 2 puffs twice a day for over 4 years. Lately in the last year I bruise more easily than I did before. I rang asthma UK helpline this afternoon and if my inhaler is the cause. The nurse said it could be the reason.
She did also ask about my asthma and how many causes of steroids I had had in the last year. One in March (covid), one in December (a cold) and the last one about a month or so ago (sand). The nurse said that there were too many courses (although my GPs are fine about it).
The nurse has advise me to get a blood test to rule out any other causes of the bruising. Also ask my GP if I can be referred to a severe asthma clinic at my local hospital (GPs can do this). The possible severe asthma I may have is because I am highly allergic to house dust mite and I could have a phenotype of asthma.
Any thoughts or advice please
Written by
elanaoali
To view profiles and participate in discussions please or .
I have severe asthma, I am also on fostair 200/6 for the past two years now, and I have been finding that I am bruising more easily than before as well. I do advise that you try and get your doctor to refer you to a chest specialist, as they might be able to do blood tests and also to try and find ways to ease your asthma. Good luck.
I definitely bruise more easily, especially where my skin is thinner like on my forearms and shins. Seems to be common for people on steroids and I keep asking doctors and dermatologists but they don’t seem to think anything can be done for it.
I have had 3 doses of steroids in past 12 months and doctors not happy and said this is too many - put me on fostair to try and combat asthma and whilst it is brilliant for my asthma……..lots of pain in joints and muscles but no bruising as yet but only been on fostair 6 months.
Bruising on fairly high dose inhaled steroids is common
3 courses of steroids is a lot... but I average a course every 2-3 months if I'm lucky (and quite often I'm not) .... so while it's not good to need them I wouldn't be concerned about 3 courses in 7 months for me thats good ... but could be a sign your asthma treatment is in need of review and adjustment (thats what asthma UK where likely getting at)
As for the phenotype of asthma yes ... asthma is effectively a ton of different types of airway reaction .... they believe I have "a mucus asthma phenotype" so my airways fill with mucus ... problem in my case is I also have large airway collapse so I can't cough it clear, because the airways collapse causing it to get stuck and pushed further into the airways (it ends up in a lot of chest infections)
The gp is unlikely to be able to refer you straight to the severe asthma clinic ... they normally refere you to the "respiratory clinic" at a hospital and then they refer you onto the severe asthma clinic... but definitely worth the waiting and effort the severe asthma clinic are "the gods" of airway conditions.......they are the only ones that spotted my dynamic airway collapse.
The helpline nurses advise is excellent. There are clearly two issues that need urgent attention. First, Fostair is not a high dose corticosteroid so that may not be the cause of your bruising unless you are taking a lot of it, in which case you may need different treatment. The fact that you had three recent courses of oral corticosteroid tablets is very important. This is a clear signal that your asthma is poorly controlled and that you need a very urgent referral to a severe asthma specialist. The two reasons for this is that your Fostair is clearly not controlling your asthma and that two or more courses of steroid tablets are an indication that you may have severe asthma requiring biologic treatment. Only a specialist in severe asthma can expedite this- so please ask your doctor for an urgent referral to the nearest severe asthma clinic.
The second issue is your bruising. There are lots of causes of bruising and this needs to be investigated urgently as well. Your doctor can do blood tests, which would be helpful, however a haematologist, ie a specialist who deals with blood and bruising problems, can do more specialised tests. So I suggest you also request a referral to a haematologist in addition to tge tests your doctor orders while waiting for the appointment.
Your comment that Fostair 200/6 is not a high corticosteroid is helpful as I had always thought it was and had blamed the increase in bruising on my arms and legs on going from the lower 100/6 dose to the higher one. I will ask my GP if there’s likely to be another cause. Thanks!
It is the highest dose you can have. I do have a steroid card. The sand was because my 1:1 (SEN) threw sand at me and it got down my top. Reaction to this came hours later.
I always thought the fostair 200 I was on, was a high dose but recently I had a letter from my hospital asthma nurse, talking about asking the consultant re my going on a high dose corticosteroid inhaler.
I bruise really easily too, I am on relvar ellipta and have had several steroid courses in a year. I was refered through to severe asthma clinic and after tests they found that I have bronchiectasis which I hadn’t even heard of - With all the new treatments for severe asthma they will hopefully have something helpful for you
It sounds to me as though referral to a pulmonologist or asthma specialist is a good idea. In the meantime, I would do as much as possible to eliminate possible sources of triggers in your home/office.
In your bedroom, replace your pillows with new ones that can be washed in very hot water and dried thoroughly once per month. Buy mattress/box spring/pillow encasement (special snug-fitting covers that zip closed and provide an additional barrier between you and dust mites, mold, pollen) and can be removed and laundered each week.
Remove and have thoroughly cleaned any draperies (replace with blinds that are easier to dust each week). Remove and launder throw rugs, or prioritize removing carpeting in your bedroom in favor of hard surfaces (wood, tile, vinyl, etc.
Remove all small items, books/magazines/papers on top of surfaces and store inside drawers, cabinets, closets.
Then wipe down all surfaces with water-dampened cloths to pick up all the dust. Don't use cleaning products, room fragrances or other chemicals.
Buy good HEPA filtration systems, either whole-house or quality room-size, with replaceable filters.
This will make it easier for your immune system to calm down, and responses to food challenges by the allergist to be accurate.
I am on the same inhaler and ive only got to rub past something and huge bruise appear ,i was told it is the steroid preventative inhaler and ,too many courses of prednisone causing it .
Just want to add an update. So far I am unable to get an appointment with my doctors. I went to see my local pharmacist who said that my bruises were caused by blunt force trauma ie. being hit really hard. I tend to believe that my bruises were caused by that.
However I will still go to the doctors to talk over my asthma and the last year courses of steroids March (covid) and December (cold) two courses. Then last month June (sand).
Finally managed to get an appointment for today. Saw GP who looked at my bruises. I explained the cause of them (child with challenging behaviour) and the fact I have had bruise before and they haven't been as bad. The doctor said as we know the cause then not too concerned. She said that prednisolone can cause people to bruise mire easily. My last course last month. The doctor said that she would get ne to do a blood test just to check any other unlining cause. Blood test next week
My asthma is stable even though I have had 2 courses of steriods last year. (Know causes) no ongoing symptoms. Keep my inhaler at on current level. No stepping up or down.
Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them.
Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.
Thinning skin and purpura from inhaled steroids
steroid inhalers and oral thrush 
Adrenal Insufficiency and reducing steroid inhaler
Tapering off inhaled steroids due to steroid induced adrenal insufficiency
Clenil - what is a high dose?
