Flutiform no longer available in my country, what would be a good alternative?

[y0sammt]

I moved to South Korea in 2014, and after 6 months of unwittingly being exposed to black mold in my rented apartment (behind the cabinet attached to wall of my fold up bed) I was diagnosed with asthma.

I was put on Flutiform starting with (I think) a 125/5 dosage twice a day. Over the past 10 years I managed to reduce it down to a comfortable 50/5 dose, once a day.

Sadly, Flutiform (Fluticasone / Formoterol) is no longer available in South Korea, and it doesn't look like it's coming back.

The following ICS/Lama inhalers seem to be more readily available in Korea:

Symbicort Rapihaler / Turbuhaler (Budesonide + Formoterol)

Relvar Ellipta (Fluticasone + Vilanterol)

Componacompact Air (Fluticasone + Salmetarol)

Foster Inhaler / Nexthaler (Beclometasone + Formoterol)

My doctor moved me to a Foster Nexthaler (100/6) but it really hasn't been sitting right with me. I feel a shortness of breath more often than before, so aside from the Foster, what would be good to try next from the above list?

All I've ever had is the Flutiform, so I'm pretty new to anything else / research in this area - I'm not sure what to expect from posting, but thanks for reading!!

[Poobah]

Any change to your maintenance inhaler will take around 8 weeks to become fully effective. So it could be that Fostair isn't yet kicking in. However, if you've been on it longer than that, it's definitely not sitting well with you. Unfortunately, there's no way of knowing how any of us is going to suit one inhaler over another without trying it for a good 8 weeks. For example, Symbicort didn't control my asthma, whereas, Fostair does. But others will do very well on Symbicort.

However, if the long acting bronchodilator Formoterol is in both Flutiform and Fostair, but Fostair doesn't suit you, I would next try an inhaler containing the same steroid as Flutiform; Fluticasone.

[y0sammt in reply to Poobah]

Thanks! I appreciate that people's experiences will differ - what you said about trying something with the same steroid (as used in Flutiform) is useful 🙂 Also, yes... I wasn't aware it would take 8 weeks to become effective, so I can try again for longer. Thanks for the info!

[peege]

Sorry to hear this. Black mould near your sleeping place is not good at all. We give off a lot of moisture when we breath out during the night causing damp areas for mould to grow so it's essential to ventilate. If fresh dry air is impossible then a very small dehumidifier would work. Can you leave your fold up bed down/open during the day to air it. Presumably you might also cook in the same room causing more moisture?

Could it have got into your mattress? If so perhaps a new one if that's possible and get some white (clear) vinegar, put in spray bottle 50/50 with water, spray and wipe off with a clean cloth daily and leave to dry. Hopefully the residual vinegar will remain in the wall to prevent further growth. I've done that this winter when rain came in my bedroom where tge outside render cracked (now fixed). A few vinegar treatments have killed off the small amount of black mould plus my very small dehumidifier - it's amazing how much water it collects!

As for the inhaler, I take Fostair 100/6 , the spray type plus a spacer not Nexthaler. I dont like the powder ones.

Good luck in getting rid of the black mould, it's so important to stop it getting into your lungs. (I know I'm allergic to mould so I'm very careful and now sleep withmy bedroom wide open).

[y0sammt in reply to peege]

Thanks for the advice - fortunately (or rather, unfortunately) that experience with the black mold lasted for about 4-5 months in 2014. I moved out as soon as I could. It's crazy how such a small thing can be a trigger point for everything since.

Quite a few older places in Korea simply wallpaper over old wallpaper, so that (along with the crazy humid summers) is the perfect breeding ground for mold. I'll take your advice to avoid such issues in the future...

...and yeah, I may move onto the spray type of Fostair depending on what's available to me at the local pharmacy - I'm with you on the powder ones.

Thanks again!

[peege in reply to y0sammt]

If you can afford it and if I were you I would get a CT scan. It's a good tool for diagnosis partly because x-rays don't show everything. I was lucky to be sent for one in 2013 because aspergillus was found regularly in my sputum tests. It's a fungal growth which, once established in the lungs of people who are allergic to it can be managed , it's better if found early. Please know that I'm not suggesting for one moment (I'm not a medic) that you have this but just something to eliminate from future diagnosis on what ever (if anything) is going on in your lungs. Take care. P

[crille]

Hi Osammt,

I have been on Relvar Ellipta (fluticasone/vilanterol) 92/22 for at least four years now, and it has worked for me. With Relvar E you only take it once a day. Before Relvar I was on Seretide. It also worked well, but my Doctor changed it to Relvar after a few years. I think that Relvar is cheaper for the health authority. Both worked equally well, though.

[runcyclexcski]

They tried to move me to Fostair, too, and it did not go well. I do not know why doctors are keen to move patients to it. "Advair" (aka Seretide) has Fluticasone as the steroid (same as your old inhaler) -- it appears to be identical to "Componacompact Air" that you mentioned.

My asthma developed after living in a dusty/moldy apartment, too, but I already had some minor symptoms before it. I have moved out a few months after that, but asthma has remained (of course). I also can't go to libraries and book stores since then.

A humidity gauge is a very simple device, it's worth having. Peege is correct about the breathing in a non-vented apartment as the cause of humidity build-up. When I do my workouts, indoor humidity goes up from 50% to 65% in 30 min! Ventilation of the bath/shower is also important (an active air extractor is a must, mine is always on). A heater in the bathroom (especially in-floor heating) helps dissipate the humidity faster and eliminate invisible wet spots.

Some climates are naturally more humid than others. Indoor humidity around 50% is a good target (comfortably dry). Air-conditioned indoor spaces are usually drier in the summer compared to the outdoors, b.c. the AC condenses the vapour on the coils and drains it (hopefully outside). E.g. in the USA, it can be 90% humid outside in the summer, so, venting would be counter-productive in that case. Generally, colder climates are less humid. It requires spending on kWhs to maintain indoor humidity low in the summer in tropical climates, but at least you could control the place you sleep (8 hrs a day of "perfect" air is already a win). Dust mites like humidity, too.

You can also test for black mould in the air commercially, although it's expensive and they generally do not promise quantitative results (quite appalling).

[y0sammt in reply to runcyclexcski]

Thanks - I think I will try and see if I can get one of the two that you and crille suggested (Componacompact Air / Revlar Ellipta).

It's a shame they stopped the sales of Flutiform here.🙁

It seemed a really good combination for me, and that I had reduced it down to one puff of the smallest dose a day made it very affordable (and made me feel like I was putting less chemicals in my body) 😔

Anyway, thanks for the reply!

[Patk1 in reply to y0sammt]

I would talk to Yr pharmacist & get the nearest equivalent for you.dont wait too long x