Hi there, I’ve (24M) been on fostair as a preventer inhaler since around the age of 17/18. My asthma has been extremely well controlled on 2 puffs BD for a number of years. However a few weeks ago I have quite a bad flare up which landed me in A&E twice and had a 2 week course of prednisolone. Since then I feel as though my preventer isn’t as effective as it was previously, I saw a nurse practitioner at my GP and mentioned this to her. She advised me to increase my fostair maintenance to 3 puffs twice a day. However I was under the impression that 4 puffs was the max per day for fostair when you use a reliever inhaler also and not using the fostair under the MART plan? Was just wondering if anyone here has had any experience of this, I’m unsure whether to go back to my GP and question it or whether this dose is okay or request to switch my preventer.
Fostair 100/6: Hi there, I’ve (24M... - Asthma Community ...
Fostair 100/6
I was originally on Fostair 100/6 and the maintenance max dose per day is 4 inhalations, however, for the maintenance plus reliever plan the max is 8 doses per day. As you've had a bad flare up it would be good to use the maintenance plus reliever plan and avail of the additional doses. It takes a while to get over a bad exacerbation and the respiratory system can be quite sensitive and prone to irritation, so extra help in the short to medium term can be necessary.
If you find that the additional Fostair isn't having the desired effect, talk with your GP about additional short term treatment.
My exacerbation was about 4/5 weeks ago. I’ve definitely gotten a lot better but feeling as though my fostair isn’t as effective anymore and I’m still using salbutamol at least 4/5 times a week. She’s told me to go back in 6 weeks if it hasn’t helped so I don’t feel like it is meant to just be a short term plan you know. I’m getting bloods done tomorrow so might ask about it aha
I find that it can take quite a while sometimes to get over any chest infection or exacerbation as the lungs are still not back to normal, hence the feeling that your ordinary meds just aren't as effective and it's necessary to step up asthma treatment until everything settles down, even if that takes months. Once things are back to normal for a good while, then you can ask to step down from the additional treatment.
You may find taking two inhalations 3 times a day better than 3 x twice a day - whatever you find best suits your activities.
Maybe the bloods will show up raised eosinophils or IgE which may explain the need for additional treatment.
Quite agree with Poobah.
My asthma nurse sometimes used to put the extra doses, above the normal four a day, part way through the day, because it suited me better.
As long as you keep below the max of 8 a day, the asthma nurse has quite a lot of flexibility, as to how he or she organises it.
So I would accept what the nurse said, and just go back if it does not work.
Also be rather pedantic at avoiding whatever triggers your asthma.
Yes, if your Fostair is 100/6 MDI (spray type) then it's licenced to be used within the MART regime ie as a reliever as well as a preventer, up to 8 times per day. Using a spacer is best as you get more medication that way as long as you inhale correctly. It should explain on the leaflet.... and it should have been explained when you were first prescribed it. When I first got it I was given a smart little booklet describing how to use it plus I had to sign a declaration that I understood how to use it. My practice are mean about prescribing spacers so I buy my own from time to time.
Good luck, I've ever looked back since starting it and rarely need ventolin (or salamol) except during a bad exacerbation.
Yes I always use a spacer. I’m a paediatric nurse so very aware how much more effective inhalers are with them. I’ve not had an issue on fostair in years, was very rarely using salbutamol however since this exacerbation I just feel as though it’s not as effective anymore
I'd be inclined to give it a go as she's prescribed it,either 3bd or 2puffs 3xday,see if it helps.airways can remain twitchy for a while after exacerbation.Ru on salbutamol too x
I'm surprised she has upped it to 3 puffs bd and not just done a standard MART regime which would probably be better long term.
The fact that you had the exacerbation shows your old regime wasn't working as well as it could, and the new one isn't sustainable long term! I would ask for an alternative regime at your next review, as it might be that you need a different inhaler for a while.
8 puffs is the maximum ... its to do with the beclomethasone being "well tolerated " by most up to 800mcg... This doesn't differentiate by mart/non mart
So your asthma nurse/GP is right 6 puffs is fine I'm on the fostair 200 and take 4 puffs every day (and 6 if needed for "emergencies)
my understanding of fostair is max 2 x 2 puffs a day! Been on it for 3 years but older than you but I was told by doctors not to exceed this.
Im on fostair 200/6 im sure up to 8 puffs a day when your struggling is what ive been told and dont accept them changing it to that Luforbec its just not got the same values...Almond King
when I was on the 100/6 I was told by both a GP and pharmacist that you can take up to 8 doses per day if needed which is basically 4 doses per day of the 200/6
I tried Fostair under the advice from my GP pharmacist. He told me it should replace my Seretide, and maybe my reliever too? Even on the max dose, Fostair wasn't working for me? I had stopped ventolin all together because it was giving me palpitations? My main reliever has always been Atrovent... It stops my coughing. I gave Fostair my best shot, but even after an hour or two I would be coughing and needing my Atrovent. I was using more Atrovent than when I was on Seretide. So, I had to ditch the Fostair and go back to Seretide and Atrovent and all is well again.
Starting Fostair 100/6
Using Fostair 100/6 & Ventolin Advice 
Fostair 200/6 as MART??
Fostair Inhaler 100/6
Seretide to Fostair?
