Symbicort 100/6 to 200/6

[Misscrisps]

Hi, I've been trying out Montelukast, (4 weeks now but no noticeable improvement). So the asthma nurse has now suggested trying increasing my Symbicort from the 100/6 (I take 2 puffs morning and night) to the 200/6. Is this likely to make any particular difference? I think the theory is, it's better to have a little more steroid every day rather than the short sharp courses of steroids (I had 5 course of pred last year). Thanks for any input.

[Homely2 Administrator]

It is worth experimenting with different dosages to find out what works for you.

This time last year I was in and out of hospital and lots of pred, this year I have avoided hospital, and much less pred.

The difference has been caused by lots of changes to my medication etc.

So it is really good to have an asthma nurse that will guide you through finding out which medication works best for you, and helps you to avoid needing pred.

If you want to discuss it, ring the asthma UK helpline on 0300 2225800. They normally have ideas to help.

Have you been referred to a consultant.

[Misscrisps in reply to Homely2]

Thanks for your comments. No referral. I did push for that, following advice from the helpline, but the GP stance is we've got to try everything WE can do first. Which is probably understandable. Hence the trying of Montelukast. If, after another month, that has not improved things, the higher Symbicort is the next step.

[Poobah]

Definitely worth stepping up to the stronger Symbicort and reviewing after several weeks. The other option is to try a different combination inhaler. Even though all combination inhalers contain both a long acting bronchodilator plus steroids, it doesn't follow that every patient reacts the same to all these combo inhalers.

I was on Symbicort 200/6 for years and my asthma control continued to decline. My consultant doggedly stuck with Symbicort, as he explained, "these inhalers are all the same". It was my asthma nurse who suggested a change of inhaler and the positive effect was instant and over several weeks, my control improved.

[Misscrisps in reply to Poobah]

Thanks. She wants me to try another 4 weeks Montelukast and then if still no improvement , the increased Symbicort is next. She did mention changing to Fostair, but ultimately decided an increase in Symbicort would be the best next step.

[Poobah in reply to Misscrisps]

It does take time, every step and review, but it's worth it once you establish the right level and type of meds. 8 weeks of Montelukast is definitely more than enough time, if a little over cautious, to check for improvement in symptoms.

Inhaler changes can take 8 weeks as inhaled steroids build up effectiveness over this time and increasing the doseage of your current inhaler is a good first step rather than a whole change of inhaler.

I'm currently on Fostair 200/6, after trying 100/6 first, and it suits me very well, but we're all different. I liken it to shoe shopping - trying every shoe in the shop to find the most comfortable fit.

[76RL]

I can recommend this course as I have a history of winter asthma and being very poorly and having prednisone to often. This year is my first year on Symbicort 200 and it has made a vast difference and has also reduced the need for Ventolin although still carry it with me. My only reservation is feeling congested in the mornings which is a little annoying but overall a vast improvement. I hope you to feel the benefits in due course Misscrisps.