I have received messages from my Gp telling me that due to changes in NHS prescribing guidelines, my Fostair inhaler has been changed to a Luforbec inhaler as Fostair contains excessive hydrofluorocarbons which are chemicals used as propellants. And they wrote that Luforbec has the same medicinal drug and strength with less hydrofluorocarbons.
What does this mean? Does it mean that Fostair is actually bad for our health/body and is this why they are changing it to Luforbec? Ive been using Fostair for a while now and now I am worried.
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Bluesky__
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That sounds a bit concerning, but might be similar to how salamol has less propellant than ventolin. I actually get on better with the salamol as found the ventolin sprays with such force it feels like it hits the back of my throat and also gives more side effects... but taking salamol with a spacer works the best.... hopefully the luforbec will work just as well as fostair and can be used with a spacer?
What is the propellant in inhalers used for? Is it harmful to our health and body? (Sorry if I sound dumb but Ive only recently found out that inhalers have propellants and after receiving these messages from my Gp I am actually scared)
I didn't mean to scare you. Try not to worry and phone your GP if you need to. From what I understand, the propellant is the gas / chemical used to release the medication... in the example i used comparing ventolin to salamol, they both contain the same medication which is salbutamol, but the ventolin is a slightly bigger cannister and has slightly more propellant. Despite the salamol inhaler being smaller and having less propellant, i personally find it works better. And even better still with a spacer.
So, in your case, if you are changing from fostair to the same inhaler medication, but slightly smaller and with slightly less propellant, I am trying to reassure you that I think it will work fine for you. and if you are able to use it with a spacer, then even better.
I am really sorry if I worried you, and that wasnt my intention. I was trying to ease your worries by giving my experience trying out both salamol and ventolin. Both of which work and have the same important drug. I think you will be absolutely fine, but definitely talk to your gp or asthma nurse if you are concerned about the change in medication. By the sounds of it, you shouldnt notice too much difference if any at all. Especially if they are both the same type of inhaler and not a dry powder.
Looking at Luforbec, it looks to be the exact same medication as Fostair, but probably slightly better for the environment with less propellant. I don't believe you have any reason to worry, but I understand that these changes are scary , so sorry if I didnt explain myself very well.
Thank you so much for the reply and for easing my mind a bit. And no, you shouldn’t apologise, I get anxious and worried very easily and the Gp should have clarified things in a better way. You didn’t do anything wrong at all.
Are propellants harmful to us (those who use the inhalers) at all though and do you know if all inhalers have them?
No problem. I could have at least explained better in my first response . As far as I know it’s just the powder inhalers that don’t have propellant , but I could be wrong. I don’t think this is too harmful for us though as inhalers like this have been used by asthmatics for many many years . The only issue is I’ve noticed increased side effects such as jitteryness from the ventolin compared to salamol , but both have propellant and give some side effects with a lot of use. I guess there’s a trade off with all medications.
Completely relate with anxiety and hope you manage to find ways to ease it.
I’ve been using inhalers with propellant for years and no issues
I struggled with the Salamol version as the strong taste and smell made me nauseous so am back on Ventolin. I tried Fostair briefly after my meds prescribed by a hospital consultant were changed by a random visiting asthma nurse at my surgery - I was told that Fostair is a very cheap drug and they were going round GP practices moving patients across. I soon moved back after a bad reaction to Fostair!! You just have to try all these drugs and make an informed decision in tandem with your GP and asthma nurse
try not to worry. Even if they change your medication, you can talk to them about the changes, and its still possible you may be able to stay on what you are using.
I am so sorry for worrying you. It wasn’t my intention at all. If they do change yours too, I hope it works well and if not, like Jamesd1234 said, you can try asking them to put you back on Fostair.
Please don't worry about that 🙂 Bluesky_ . I momentarily panicked (unlike me 🙄). I soon realised that there's no point in worrying about things that haven't happened yet. I've managed to save up some packs of Fostair 100 in my fridge for just such an occasion. I'd find it disastrous to be swapped during the winter months when asthma is much worse.
I have not been told I have to stop using Fostair. It's the propellants that's the problem, it's not green - World has gone potty, the propellant is a relative short lived greenhouse gas anyway - No trace after 15 Years -- luforbec has the same ingredients, but will it work as well? I hope to sta on Fostair, best preventer I have ever had,
Rightly or wrongly they are doing this type of thing because of the environment. It isn’t about you. This is the same as trying to move people from ventolin to salamol. It is a natural progression in that as people (especially scientists) become more aware of potential dangers (NOT to the patient)things will be changed.
IF you find the new medication doesn’t suit you then simply ask to be put back on your previous medication. That is what some people have done re ventolin. Give the new medication a fair go and you may find it actually suits you better.
Thank you for the reply. It’s a relief to know that they are not changing it because it’s harmful for patients. It honestly made me very anxious seeing those messages from the Gp as I’ve been using Fostair for a while now. I believe they should have been more clear regarding this and explained this better to people.
Bevvy with respect the propellants in Fostair is short lived - Not trace after 15 years - UK with our combined greenhouse gasses used, makes up just 1% of the worlds greenhouse gasses. I have a problem if duoresp is a dry powder inhaler.
I thought I made it clear in my response that I wasn’t defending the change to different inhalers. I was giving reasons that explain the change from my understanding. I was trying to reassure Bluesky that his previously prescribed inhaler was safe and that any change was not due to concerns about said medication.
Bevvy, I know full well you was trying to reassure Bluesky - As was I.
I had read your post. I think I made it clear I am against the enviromental reasons for changing inhalers. I was stating banning inhalers because of the propellants would have no real effect on the enviroment. I also said I would "ve a problem if duoresp is a dry powder inhaler."
I agree Fostair is safe, that's why I want to keep it. I understood you post well and had no problems with it.
Maybe it is more about cost cutting. I don’t know. What I do know is NHS is haemorrhaging money and if they can save money then so be it. For the vast majority of asthmatics - who probably aren’t on these pages because their asthma is very well controlled - they will have no issues with change. As I said if someone is struggling with change then they should ask to return to previous inhaler.
They are trying to hudwink you, the reason they attempting to change from Fostair to Lubfec is down to it being cheaper, it's plain and simple they attempted this with me but I stood my ground explaining that Fostair had been a game changer in 27 years of using inhalers amd I also mentioned the fact they were changing to save money isn't the right thing to do, so if Fostair works for you then explain this to your doctors as I did, I'm still on Fostair thankfully.I hope this helps
The old type of propellants destroy the ozone later. It has been phased out of all propellant canisters and I believe medication is the last to lose their old type of propellants. The active drug is exactly the same.
they both contain the same propellant, I haven’t been able to find any information on the amount, does anyone know if there is much difference?
My surgery were making the change because of costs to the NHS. I tried but really didn’t get on with the new inhaler after being happy with Fostair for years, they allowed me to change back again
I was the same, Luforbec didn't work for me, gave me a terrible cough. I talked with my asthma nurse who informed gp and was then changed back to Fostair.
I've tried to find a table to show the various propellant amounts in each inhaler but only came across a short US table with data on a handful of inhalers. Fostair & Luforbec weren't included as these meds aren't available in the States. Frustrating that we can't see the data, but neither can our doctors, they're just advised on prescribing protocols.
But in my search, I now realise that the HFA-134a propellant used in Fostair and Luforbec is almost a last generation gas, as the drive to replace HFAs with new generation HFOs gathers speed. If my reading of the blurb is correct, GSK is trialling a new Ventolin inhaler with a new generation propellant in order to re-establish their device as the leader of the pack once again.
Hurrah! Found it. There's a toolkit for choosing inhalers based on carbon footprint. I can't share it as it's PDF, but if you Google "Inhaler carbon footprint comparison tool NHS" it comes up on the PrescQIPP website.
Interestingly, both Fostair and Luforbec are considered high, so as far as the GP is concerned it's not an environmental decision but probably one of cost, Luforbec being cheaper.
That's a really interesting table - thank you for finding it for us!
Interestingly I was changed from one 'high' inhaler to another but it did go via a 'low'
I was changed from Seretide to Symbicort but didn't get on with the (more common) dry powder Symbicort so got put on the aerosol version which I like much better but had a hard time getting hold of initially as it's much less common than its dry powder brother
Poobah thank you just been to look. Very interesting indeed. Equally ventolin which is high being changed to Salamol which is Medium? Why not Easyhaler that's green. I have taken the Fostair Luforbec screenshot.
I think the easybreath is dry powder and that's why it's green. I find dry powder inhalers easy to use, but many don't, and increasingly generic MD inhalers are being chosen by the NHS as they contain less HFA propellant and are often cheaper. But the downside is delivery can be affected by using less propellant. Maybe the answer is to always use a spacer? A debate for those who use MDIs.
I think we'll see the original manufacturers of the trade named inhalers, like Ventolin, aim to create more environmentally friendly MD inhalers as they won't want to lose their market share to generic competitors.
hi Blue sky my inhaler has been changed too when I asked the asthma nurse to explain why she told me they have greenhouse gases which damage the planets ozone layer so the new inhale is smaller but contains the same meds just without the greenhouse gas. Far better for the planet. I use salamol but with a spacer. This works as well as the previous one which had the green house gas.
NO - Sounds like hydrofluorocarbons affecting the climate that is the problem, I am on Fostair and I have heard nothing - I don't want to change. hydrofluorocarbons are short lived pollutamts, up to 15 years - Will make hardly any difference to global warming.
Hi Blue-sky, just in case you missed this in the various threads above, I attach the relevant information taken from the toolkit that doctors and asthma nurses use to choose inhalers based on their carbon footprint. As you can see, Fostair and Luforbec MDIs have an equal footprint, so you could challenge the assertion that Luforbec is kinder to the environment, especially if it's not as good at controlling your asthma.
If you want to see the full PDF toolkit, Google "Inhaler carbon footprint comparison tool NHS" it comes up on the PrescQIPP website.
Everyone is different- things that work for one person are not the same as things that work for another. I did give the Lufobec a go but it made me cough more and asked to go back on Fostair which the GP did change back.
I was put on Luforbec Gp said because it was cheaper! Used it for 6 months gave me a bad cough every day also contents clogged up the spacer I was using mentioned this on my copd review with respiratory nurse she said quite a few patients have had problems now back on Fostair 200/6 no problems
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