I’ve literally just signed up because I’m so upset and need some advice.
After suffering with asthma for 30+ years, my doctor today refused my repeat prescription for a ventolin inhaler. When asked why, the receptionist said I had one in March.
I will be booking an appointment tomorrow to see a doctor to ask for a ventolin (which is a complete waste of their time and mine!) but I was wondering if they can do this.
At my annual review, the asthma nurse said that I should be having 4 a year (which would be one every 3 months)
I am overweight and trying to loose it by walking and doing exercise. This obviously means that I have been using my inhaler more.
I’m at a loss at where I stand in regards to this. I think because the last doctor I saw at the surgery said it is a life or death medication and needs to be prescribed when needed.
Any information or comments on this would be great fully accepted.
Thank you
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Emma2821
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I’d like him to breathe and gasp with a tight chest and see how he feels. Tell him it happens during the day and sometimes at night, which mine does. You never know when.
Tell him u could b in a room or out on the street and find u need it to open up your airways due to certain smells, people smoking etc. traffic fumes.
Be very firm about your needs.
Tell him u agree it is a life and death medication, that’s why u want to have it with u at all times.
You are most very certainly entitled to a reliever inhaler. Yes, there is a “rule” about how many relievers you are “allowed” in the course of a year. BUT the “rule” does not say that the patient has used up their allowance and can’t have anymore.
As a general rule if an “overuse” of the reliever inhaler is identified the patient is invited for a review to discuss when and why the blue inhaler is taken and to check other asthma meds are optimised.
yikes that’s tough - frequent use of a ventlin inhaler is often seen as an indication that asthma is uncontrolled. Do you have a preventer inhaler? It’s worth asking the doctor what other medication you could take to help reduce your need for ventolin
it may well be the surgery pharmacist who has looked at your usage and refused the repeat rather than a doctor, I would resubmit the request and say why you are using more ventolin than you should. Some of those pharmacists can be jobsworths.
yes they can only refuse in order for you to get reviews for using more than expected. Dr will prescribe but it’s worth seeing dr in many ways you can discuss your current health and may be add on Preventer to reduce your Ventolin use. It can happen at certain times you can use more inhaler due to exacerbation but it’s better to be reviewed and then prescribed as there’s a limit on repeat .. it shouldn’t be an issue ….hope it helps
The Dr appears to have gone about this in a very unhelpful way. If they have any concerns about your Ventolin use, then surely it's not beyond their wit to invite you in for a review? There's also an apparent communication failure between your asthma nurse and the GP. If your asthma nurse had written up your notes that they're happy with 4 Ventolin inhalers a year, the GP hasn't reviewed your records when making their decision.
If they're trying to shoehorn all their asthma patients into a rigid medication regime, it would suggest to me that they're not treating the patient as an individual nor are they attempting to understand your experience of asthma, which certainly won't be the same for everyone.
Personally, I would ask my GP what they intend to do, treatment wise, to lessen my use of Ventolin. Saying that I assumed they had a plan as they would never withdraw a rescue inhaler without a long term strategy. If they do update your treatment, make sure that you have a follow up appointment in order to review your progress and to consider any additional treatment required. But ensure you secure your repeat prescription for Ventolin until you're comfortable with your preventative treatment is working well for you.
This happened to me at an appointment with a respiratory consultant, who I hadn't seen before. They weren't happy with my "why?" when she announced "no more Ventolin, you don't need it." So she explained that "no one is using Ventolin anymore." I pointed out that my asthma plan advised occasional rescue and emergency use of Ventolin and what was she going to replace the Ventolin with in my plan. I know she was annoyed, but there was no way I was going to let this stranger dictate to me based on her own preference.
A compromise was reached and I committed to try MART, but have Ventolin for emergency use only. My asthma declined and by the time of my next respiratory appointment, I had resumed Ventolin in order to cope. The next consultant explained that I wasn't a suitable candidate for MART and to use Ventolin as needed.
I know there's an occasional drive to reduce the use of Ventolin, but this should only be done with care and with an individual strategy for the patient. Blanket withdrawal is poor practice, in my opinion.
You need a meds review from an asthma nurse or a GP who understands asthma, they cannot simply stop your ventolin, as that is your safety net. Having no ventolin for me would be very unsafe.
Your frequent use of ventolin suggests that your meds are not working as they should be, they need to find out, why.
This morning I would have a chat with the asthma UK helpline on 0300 2225800, office hours. The asthma nurses there will help you work out how to phrase it all to the GP and the receptionist.
Looks as though you have had some good advice already, but it is apparent that you could do with a face to face appointment with your doctor or asthma nurse to discuss your usage of ventolin. It maybe that your preventative is not working for you and that could be the root cause of your great need for ventolin, and maybe a change or higher dose may help. I hope you are helped very soon as fighting for breath is not pleasant and needs to be dealt with sympathetically. Bless you. 🙏🎨🤗
Hi and welcome to the forum, how dare the doctor refuse you your prescription and we all know it's to save money but I will say the over use of ventolin can also be dangerous, so I would suggest as you said booking an appointment ASAP to get this sorted as you may need to start taking a preventive inhaler.I hope you get if sorted soon and again welcome to the page
Are you sure of the reason they are refusing you. I am having a similar problem,but they refused me Ventolin because it is being discontinued. They gave me the new Salbutamol which is bitty and makes me cough also horrible taste. I am now trying to make a special request for Ventolin but I don't hold out much hope. If that is not the reason I would push for an inhaler ,I like you have had Asthma for many years and am allowed one every 2 months. Obviously if you are getting very wheezy all the time and your preventer inhaler is not helping you need to be seen by your asthma nurse. Good luck anyway
Ventolin isn't being discontinued, but there's a move by the NHS to a generic inhaler that has 5% less carbon emissions; Salamol. However, patients have successfully requested Ventolin as Salamol doesn't suit everyone. Fortunately, the cost of both inhalers is pretty much the same, so at least there's no push back in terms of the cost. Definitely request Ventolin if it works better for you than the generic version in terms of providing relief from breathing difficulties.
for me, I've had three of the generics fail just this year. One had about 32 doses in the middle where no medication was released. One stopped releasing medication when it had about 60 puffs left. The third didn't have any medication for the first 40 puffs; I thought this one might last longer, but it didn't.
I've asked for the brand "Ventolin," but my pharmacy can't get it. My insurance will not cover it anyway.
Between the faulty generic inhalers and my asthma being largely uncontrolled since a bout of Covid two years ago, an inhaler only lasts a couple of months. Prior to the brand change and Covid, they lasted several years (like 5-10).
In the UK, we can buy Ventolin via online pharmacies from £7.50 (approx $10), if we choose to do so.
For the UK NHS, it isn't cost that has affected this change, but a drive to reduce the carbon footprint of aerosol inhalers. These generic inhalers fail, as the design, using less propellant, just doesn't reliably deliver consistency. In addition, the generic meds maybe of a lesser quality. As you have experienced, delivery is woeful.
Either way, cost and the environment, aren't clinically based factors and that's a weakness for the patient, whatever the healthcare system.
Just a thought - have you considered trying a dry powder Ventolin/Salbutamol? Different design and once you perfect the technique, delivery is not dependent on a propellant.
My Asthma nurse last week told me it was being discontinued in the form it is now but they are working on a similar version that would be more climate friendly
You're right. Stage III trials ATM, so yet at the licence stage. In the meantime, GSK continue to manufacture Ventolin. Hopefully, GSK's design will be better than the generic version.
GSK's 90% less carbon Ventolin inhaler hasn't reached the market yet as it's still in the trial stage. The only CFC free GSK Ventolin inhaler currently available is the dry powder version.
GSK aren't comparing their new Ventolin product to other Salbutamol inhalers that are available when it claims it will be 90% less carbon, but it will have approx 90% less carbon than the current GSK Ventolin aerosol inhaler.
In it's development blurb, GSK claims their new propellant has been in development for several years and doesn't indicate that they're using the identical propellant to Salamol (HFA-134a).
As far as I know, only dry powder inhalers are totally greenhouse gas free, so even Salamol MDI has some emissions as it uses HFA-134a . HFAs are greenhouse gases, but they cause less global warming than CFCs.
This is an interesting article published by the American Thoracic Society on the subject of propellants, old and new. They raise the matter of prescribing based on emissions rather than clinical need.
Apparently, GSK Ventolin evohaler uses more HFA propellant, so even though it's the same HFA, it is more effective for the patient than Salamol.
I guess GSK are going one better than their evohaler with their new Ventolin product, which they hope to licence in the next couple of years. Less greenhouse gases overall. Currently, doctors are guided to prescribe other relievers as they contain less propellant gas than GSK Ventolin.
My mistake in calling it CFC instead of greenhouse. Only gas free inhalers are dry powder versions. GSK are claiming a 90% reduction in greenhouse gases in their new product.
It's a balancing act between delivering the meds in a MDI and reducing the greenhouse gas propellant. Finding a propellant that's effective but less harmful to the environment is challenging.
It seems that nowadays that the Practice pharmacists give you a poke to justify use of medications by stopping them. Just tell the Dr of your useage and need and Im sure you will get it.
Hi Emma. I swear by Fostair. I rarely need Ventolin. My brother, a severe asthmatic swears by it too. Persevere. GP changed me to LUFORBEC a cheaper option and it was awful. Gave it a couple of months but it just didnt work. Back on Fostair and I have taken a month to settle back on Fostair. Good luck.
Emma, if you run out of options, you could go to an A&E and request the prescription there. I've done it with prednisone. I personally run through two inhalers per month when my asthma is poorly controlled.
I think the wording is commonly wrong from the receptionists but the gist is correct.... asthma UK guidance/research suggests that needing to use ventolin more than 2-3 times a week makes you more likely to have an asthma exacerbation and need medical attention (and it's quite a high percentage, something like 85% I think)
So some genius has worked out that if your having more than 4 a year... your likely to need to be reviewed for a medication change/tweak/addon.... it should really be to help you....however its not the first time I've seen here that it's been refused and the receptionist has said your having too many.
Hopefully you're review with the GP will go well and maybe a different inhaler will help you use less ventolin and feel less breathless .... can only be a good thing for your weight loss journey
Thank you so much for all of your help and advice. Managed to get an appointment today with the doctor that refused the prescription. He said what I have read on here - I am using it too much. He said one blue inhaler should last a year! I explained how I work both indoors and outdoors all year round and that cold has an effect on my breathing and wheezing. Also explained how I’ve been exercising which obviously puts me out of breath. He has told me about an app to track my peak flow etc on (asthmahub England) and has given me a powder version of the blue inhaler which should work well with the fostair. Again thank you everyone for your advice. I’m the only one in my family and friends that has asthma and so no one close to me understood my panic! Fingers crossed this new inhaler will be added to my repeats! 🥰
Glad you've got somewhere Emma2821! I think there's a lot of confusion with the way this message is communicated, as others have said. Yes, the blue inhaler SHOULD last longer and you SHOULDN'T need to use it more than 2-3 times a week - but if you are, the solution is not to say no you reached your limit, or suggest that you just need to try harder to be controlled. Asthma is not controlled by willpower and deprivation of reliever!!
If you keep needing it more than 2-3 times a week - even with exercise. basically for any of your triggers, then that suggests your preventer isn't doing its job and you need a review. Tracking your peak flow sounds useful but isn't the be all and end all - if you're frequently symptomatic then definitely go back and say you're still needing it a lot.
This page may help as a starting point and something to discuss with your GP/asthma nurse: asthmaandlung.org.uk/condit...
As others have said, you may also find it helpful to give the nurses a call if you're struggling - they focus on asthma and have more time to chat through and explain:
Call us on 0300 2225800 or WhatsApp on 07999 377 775 Monday-Friday 0915-5pm
sorry to hear you have had trouble. I would try asking for an appointment with an asthma nurse / specialist instead of a gp - in my experience they are much more helpful and knowledgeable than a gp, and may be able to prescribe more medication for flare ups etc.
In my personal situation i have ordered many inhalers and had oral steroids prescribed this year, due to on going issues. They want to limit the amount I am ordering, ensuring I use the correct amount of puffs at a time or call A&E if things get really bad, but have also told me to keep using my reliever inhaler if needed, and won't let me be without.
Make sure to explain your symptoms and concerns, as adding an extra layer of worry on top of asthma symtoms definitely makes things worse! Good luck, and if you have trouble with a gp try an asthma nurse.
I use Alvesco which is a corticosteroid preventative inhaler. I also have the blue Salbutamol inhaler but I have never needed to use it because the Alvesco keeps my asthma under control. I would suggest you speak to your doctor about using a corticosteroid inhaler.
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Confused and looking for advice please :) 
Using Fostair 100/6 & Ventolin Advice 
Medication advice please
Advice needed - how can I regain control?
