SMART

[-Butterfly-]

I'm on the symbicort smart system. When I was put on this, I asked the nurse if I should use it before exercise too (as she told me I no longer need a blue reliever) and she said yes.

The GP has recently done a medication review (desktop, not with me) and I see he's left my blue on there.

When I've read literature, it seems to suggest not using symbicort before exercise.

Inhalers only last a month if I only use 2 puffs twice a day, add in a puff before exercise, and usually some after, I get through them really quick!

Just interested to see what others on SMART have been advised before I call the docs next week.

[Patk1]

I'm on mart with fostair but use with salbutamol

[Melanie1989]

If you are on the SMART regime you shouldn't have the blue as well. It is also not recommended to use your inhaler before exercise. If you can't exercise without using a reliever, this shows your asthma isn't as controlled as it could be. If you are concerned I would make an appt and discuss with the asthma nurse. I hope this helps!

[Gareth57 in reply to Melanie1989]

I was told a a review that it was a good idea to use the reliever before exercise? My asthma I generally well controlled but the extra exertion of cycling can sometimes cause a tightness, sometimes a cough or just breathing faster, often early on and the ventolin prevents that. If I wasn't cycling I would be perfectly controlled.

[-Butterfly- in reply to Gareth57]

Yeah, exercise is a trigger for me, so why i was told to use it before. I think ventolin sometimes works better than symbicort before exercise though.

[Melanie1989 in reply to Gareth57]

That is old guidance and not all nurses/g.p's are up to date on new guidelines. The fact you are triggered by exercise shows there is still underlying inflammation even if most of the time you feel well. This puts you at higher risk of an exacerbation. Obviously without knowing your history there may be a reason they have gone off guidelines so obviously always follow your healthcare providers advice.

[Gareth57 in reply to Melanie1989]

I have much better control by staying fit, I am more at risk of an exacerbation when I don't exercise and have never been close to an exacerbation while exercising, ventolin is a precaution but not entirely necessary and your last sentence says it all. I've been asthmatic for over 60 years, and I am very in tune with how my lungs feel and react, I take the minimum quantities of medication required to maintain good control as suggested by my GP practice and have never resorted to hospital treatment so I think it is pretty well controlled. However I will pass on you advice when I have my annual review on Friday, I'm sure they will be pleased to know they are insufficiently trained.

[peege]

And I'm on MART Fostair 100/6 (spray type). I'm encouraged not to use ventolin but quietly request it twice a year on the repeat prescription so I have some for emergencies when I'm ill with infection. The last time I received a text telling me I shouldn't need it! Grrr. Actually my ventolin was changed to Salamol a year ago, I've not had a chance to try it as I had some Ventolin leftover.

I too use an extra puff of MART before exercise but I've made sure I always have spares in the fridge. From experience I never ever want to run out (or have my well working inhaler changed)!

[-Butterfly- in reply to peege]

Oh does fostair have to be in the fridge? Yes, I dont blame you having it on standby!I've just seen my ventolin expired two months ago, so will have to see what happens when I order it. Wonder if I'll get told off too 🤣.

Sometime symbicort just doesn't do it, and ventolin makes a bigger difference.

[beech]

Unlike some others, I have been told to use my (S)MART Symbicort before I do exercise as that can be a trigger for me, and to use it during the recovery from a lung infection whilst I’m short of breath due to inflammation and extra mucus production. Which does mean that I definitely exceed the 120 puff doses available at my basic dose of two twice a day. Which I then have to request via an online additional medication request to my GP and linked Parmacy. I’m not sure why I can’t have 2 per month prescribed, but there we are.

[DollyDutchGirl in reply to beech]

I have two Fostair 200/6 each month. They were prescribed y my asthma consultant several years ago - to enable me to use them as mart. To keep my asthma controlled (along with other asthma meds). It’s two inhalations am and pm and up to four extra puffs throughout the day. Most days it’s an extra two - sometimes three a day - but it’s what works for me…. My GP is happy, the surgery’s asthma nurse is happy and my respiratory consultant is happy - can’t ask for more than that. 😊

[Mushypea15]

I was told to use it before exercise as well as one puff in the morning and one puff in the evening and then additionally one or 2 puffs if symptomatic. I always get my GP to give me a double prescription for all my regular meds because I hate having to order every month, and I often forget. You should be able to request a double prescription with no issues.

[-Butterfly- in reply to Mushypea15]

OK, yes didn't think of just asking for two, then I don't need to worry if I'm near the end of one and the new one hasn't been delivered yet.

[Baldwyn]

I was told by my Respiratory Consultant to use 2 puffs in the morning and 2 puffs at night of Symbicort 200/6 and to use it anytime in the day instead of my blue inhaler, up to a maximum of 9 puffs in total. My GP prescribes me 2 x 120 inhalers.

[-Butterfly- in reply to Baldwyn]

2 inhalers makes sense, I'm going to ask to do that.