Ventolin vs salamol.

[Wouldntitbenice]

I had been taking ventolin for many years. Doctors changed it to salamol. I have tried this for months and occasionally got ventolin when I repeatedly asked. However was told I was using too much salami as I didn't find relief without more puffs. Asked for ventolin. Told they are the same, then what is the problem in prescribing it I asked. Lots of nuclear replies. I asked if it was the cost of Caroline and told no. Finally told me it's because salamol is cfc free and its, 'better for the environment '. Have insisted on Caroline but they haven't put it on repeat. So will have to go through the whole saga again this month.

[Jamesd1234]

I would try getting an appointment with an asthma nurse and explaining you get on better with ventolin due to the way the medicine is released. They should be able to change the prescriptions for you. Having a great and supportive asthma nurse has been a god send for me personally… p.s I think you may have a few typos in your post - salami and Caroline ?

[Wouldntitbenice in reply to Jamesd1234]

Thanks James. Posted thinking I had got all of the auto changes. Mortified. Have spoken to the asthma nurse she refers me back to the doctor. Not as good as yours it seems.

[Jamesd1234 in reply to Wouldntitbenice]

Not to worry , it made me laugh a bit . Sorry to hear that. Keep on battling with them and emphasise that you find ventolin works much better and struggle with salamol. This seems to be a common problem asthmatics are facing. We should be able to choose our medication

[Poobah]

There's a national NHS protocol to get asthma patients onto inhalers that are more environmentally friendly. Inhalers are now graded by NHS as high, medium or low in terms of their carbon footprint. Ventolin is high, Salamol is medium.

GSK, who make Ventolin, are currently trialling a new Ventolin inhaler design that will have a low carbon footprint, as it sees its market lead dented by Salamol and other generic inhalers. Unfortunately, the necessary trials, approval and licencing process takes time and we won't see this inhaler on the market for another couple of years.

In the meantime, it's been identified that you're using more Salamol than Ventolin in order to achieve similar results. My argument would be, the carbon footprint is probably similar if you have to double up doses of Salamol to every one dose of Ventolin. So prescribe Ventolin. My additional argument is that a clinical result trumps a minor saving in the overall carbon footprint of one inhaler.

Alternatively, you could ask to try the Ventolin Accuhaler 200mcg by GSK, which is the dry powder version and has a low carbon footprint, so beats Salamol. There's also the Easybreath Salbutamol dry powder inhaler, which design is easier to use than the Accuhaler, but isn't by GSK, and comes in 100mcg & 200mcg.

If you want to see the NHS table of all inhalers and their carbon footprint grading, Google "Inhaler carbon footprint comparison tool".

All the best.

[peege]

Just to say if it was the same there wouldn't be so members writing in saying it doesn't work for them. I'm sure I read somewhere of the difference .....all I can suggest is you put Salamol/ ventolin in the search bar and see what comes up. I hope there's something you can take along with you next time you have this conversation.

[L8Again in reply to peege]

ashcroftpharmacy.co.uk/blog...

[NLGA]

pretty much having the exact same issues

Just get met with replies that don’t allow for further discussion and a general lack of interest in my views from the GP staff

But your right it doesn’t work the same

[L8Again in reply to NLGA]

Recent research suggests otherwise:

’The effectiveness of the fully subsidised bronchodilator in New Zealand, Salamol, has recently been questioned. We compared the efficacy of Salamol and Ventolin inhalers in relieving acute bronchospasm. We also tested the efficacy of partially used Salamol inhalers because of concerns that the device may become blocked during use. 12 asthmatic subjects were enrolled in this randomised, single-blind, 3-way crossover study. Subjects inhaled methacholine to produce a 20% fall in forced expiratory volume at 1 second (FEV1) on 3 different days. Salbutamol was given post-bronchoconstriction as Ventolin, Salamol (new), or Salamol (used) in random order. Inhalations of 100, 100, and 200 mcg salbutamol were delivered at 5 minute intervals via spacer and FEV1 was measured 5 minutes after each dose. The main outcome variable was the area under the salbutamol dose response curve. There was no significant difference in the bronchodilator response to salbutamol whether delivered as Ventolin or Salamol (p=0.63). Furthermore, there was no difference in bronchodilator response between used Salamol inhalers and new Salamol inhalers (p=0.60) or between used Salamol inhalers and Ventolin (p=0.08). The final FEV1s at 15 minutes (after a total of 400mcg salbutamol) were also similar for the different inhalers. We found no evidence that either new or partially used Salamol inhalers are less effective at relieving acute bronchoconstriction than Ventolin.’

When I discussed this with my asthma nurse, her response was two-fold: one, patients do not like change and, two, in most cases the reported problems with Salamol are related to poor inhaler technique. Salamol has less propellant than Ventolin so I was told that it is important to take long slow and deep breaths when using non CFC inhalers. Both use salbutamol in the same dose/puff.

[NLGA in reply to L8Again]

I know what works best for me and it’s ventolin for the last 40 years

[JazzySalmon in reply to L8Again]

I understand where you're coming from but 12 subjects is not a good trial. 120 subjects would still be too small in my opinion. 1200 and you might be getting somewhere. There are plenty of asthmatics not set off by dogs, for instance, and you can easily find 12 people who are ok with them just by chance. Finding no dog triggered asthmatics amongst 1200 is more unlikely. The same issue might happen in any trial. Sample size is vital and this is not a useful study.

If it is inhaler technique then doctors need to be checking inhaler technique when people complain about Salamol va Ventolin. Many people will have been using the same "poor" technique for decades on Ventolin where they could get away with it due to the propellant. Now they understandably need a training session, but this isn't happening. They are told it's all in their heads or they need to stop breathing well for the sake of the environment. I work to be as environmentally friendly as I can and yet this is not acceptable.

[Gareth57]

If you prefer Ventolin but they won't give it because of cfc's ask if you can try the Ventolin Accuhaler which is a dry powder and therefore completely cfc free, it also gives a double dose in 1 compared with the mdi. Both my inhalers are dry powder now as I prefer not to have the gas propellant.

[lilacs15]

I have had a similar problem the Dr changed me over to Salamol and it tasted awful and was bitty and made me cough so I spoke to the pharmacist who said he had lots of complaints of the same nature. Contacted my surgery and eventually got a ventolin. I had a period in hospital a few months ago and had a follow up appointment with asthma outpatients who wrote a letter to my Dr asking for me to be given Ventolin which they do. Eventually Ventolin will be phased out but the asthma nurse told me that the makers of ventolin are working on a new inhaler that does not have the problems of salamol.

[Thomas45]

Have you looked at the excellent short videos of using different inhalers on the Asthma and Lung UK website? They may help you to get a better result with Salamol. I was switched years ago, and find it works fine, especially with the short spacer.Do you have a preventer inhaler as well? You appear to indicate that you use your reliever inhaler often, more than three times a week, which indicates that either you need a preventer inhaler, or if you already have one, that it is not working properly.

[Wouldntitbenice in reply to Thomas45]

I do take spiriva and fostair as well as montilukast and a daily anti histamine. I will take a look at the website. Thankyou.

[Birthday60]

have you tried asking for a thorough asthma review as it’s now normal practise for patients to have 1 or more preventer tablets and/or inhalers if they rely on too much ventolin. I didn’t get on with salamol as it made me nauseous

[JazzySalmon]

I've found different gases really make a difference to me. I have a 100mcg inhaler and a 200mcg inhaler of the same drug and the 100mcg sets me off coughing like nothing else. It's a different manufacturer and it tastes different. I haven't bothered bringing it up with a doctor because I know they won't believe me and I don't need the 100mcg so much any more.

Doctors need to remember that asthmatics all have different triggers. Anything can set us off, including specific propellants.

Good luck staying on Ventolin though if you're needing a new rescue inhaler every month you might want to talk about trialling better preventer inhalers.

[Wouldntitbenice in reply to JazzySalmon]

Thanks for info. I have been told that I'm on the highest meds they can give me. Have had heart and lung test at hospital and they agreed with this. I am managing. Just wanted medics to listen to me and let me have ventolin which, whatever they say, helps me more.

[Purpleotter]

I have had exactly the same problem, and it took a visit to the respiratory clinic to finally get it changed back. Hope you manage to get it sorted soon

[Bandstandlad]

I had the same problem but 'Ventolin' is now on my repeat prescription. Salamol is definitely not as good as Ventolin. I was not getting the same relief with Salamol and instead of using just one puff of Ventolin to get relief I needed probably 3 puffs of Salamol - and it still didn't give instant relief. When one needs that instant relief from an inhaler, you need something that works swiftly, I found Salamol does NOT give that relief. It is all well and good people saying they are exactly the same, they are not, they can't be. How came so many people complain and ask to go back on Ventolin? That surely proves the point.