multiple doses of Symbicort

[Lynneypin]

So I’m having a bad exacerbation of asthma and have been advised by GP to use up to TEN extra doses a day until it subsides…. So that’s TWELVE in one day. That’s a lot. Would love feedback from anyone who’s done this please. Freaking me out a bit. x

[Poobah]

I assume you're on Symbicort 100/6? It's advised that a daily dose of more than 8 puffs is not normally needed; however a total daily dose of up to 12 puffs can be used for a limited period. But if that doesn't appear to be helping control your exacerbated asthma symptoms, phone 111 for further advice. But if symptoms are worsening despite additional Symbicort and you have difficulty talking, call 999.

For reassurance, have a chat with the very helpful Asthma UK nurses on the helpline, 0300 222 5800, M-F, office hours.

[Lynneypin in reply to Poobah]

I’m on 200/6

[Poobah in reply to Lynneypin]

In that case I would telephone the Asthma UK nurses on the helpline in order to discuss, as 12 x 200 inhaled steroid appears to be excessive. But the experts are the Asthma nurses.

[Hidden]

That is the maximum dose of Symbicort 200/6. It can be used for flare ups and some people are on it permanently. I was on it for 10 years, (6 puffs of 400/12) until 2020, when I was finally diagnosed with a dysfunctional breathing pattern, that affected my asthma badly.

I'm not sure about the MART asthma plan maximum, as I have not spoken to my asthma nurse about it yet. (I have only just come across it and I am on Symbicort MART now ) Edit: I think this last paragraph may be confusing. I know for me it is 12 puffs in a day. I mean for a severe asthma attack. I have a ventolin and spacer for my own plan.

[TrevorE in reply to Hidden]

Out of interest, how have things changed after the dysfunctional breathing pattern diagnosis?

[Hidden in reply to TrevorE]

Hi, I still have to correct my breathing pattern every day and if it's not obvious to me whether my shortness of breath is that or asthma, before reaching for my inhaler.

It has been life changing for me. My quality of life has had a 180' change for the better. I feel my asthma doesn't dominate all of the time. I had to have a portable nebuliser with me during late spring and summer or if I caught a cold. I was on multiple courses of prednisolone each year. This is the first year since I started the breathing exercises in 2020, that I have needed prednisolone. And my nebulisers at home are redundant.

[TrevorE in reply to Hidden]

So glad to hear. Thanks for the reply.

[My_fairy in reply to Hidden]

Hi

Would like to know how did you get the diagnosis of dysfunctional breathing and if you didn’t need the puffs why did doctors prescribe you.

I have the opposite issue the exercises make no difference to her except when she takes the inhaler it improves her tightness/wheeze. I need someone good to check her breathing.

I would appreciate your help.

[Hidden in reply to My_fairy]

Hi, if it's asthma causing my symptoms (if they are more severe, then I know right away) then my breathing exercises don't work, until I use my inhaler. If I am having an asthma exacerbation, then my breathing pattern is affected, until my asthma calms down.

I'm hoping that explains it clearly. It is like a vicious circle for me, asthma causes the dysfunctional breathing and the dysfunctional breathing mimics asthma, but also triggers my asthma.

The last Consultant I saw, had the Respiratory Physiotherapist in his team assess my breathing pattern and she taught me how to breathe correctly. Then, over the next 2 years, I was able to slowly reduce my meds. it was only then in 2021/2, the Consultant diagnosed me. There are a percentage of people in the general population who can have a dysfunctional pattern, but there is a higher percentage in the population of people with asthma.

I needed the medication before, as the way I was breathing all of the time meant I was inhaling more allergens into my lungs and the pattern of breathing was keeping my airways inflamed.

This is just my experience, I have never completely fitted in the 'typical asthma box.'

[My_fairy in reply to Hidden]

thanks for the reply yes it makes sense..

[Homely2 Administrator]

Talk to asthma UK on 0300 2225800, not just about the maximum level dose. Also ask them about, what to do if it does not improve, when should you be asking for prednisone from Gp. Also ask them about reducing the dose if it starts to improve, do you reduce quickly, or slowly etc.

Remember if in doubt ring 111 or 999.

[Lynneypin]

GP has prescribed pred to take just in case. I’ll ring this afternoon. Thanks.

[Poobah in reply to Lynneypin]

Hope you recover well. Keep us posted.

[peege]

Check the leaflet to see if its a MART inhaler (Maintenance And Reliever Therapy). Several are but as Poobah says, call the helpline tomorrow if you haven't already. P

[Lynneypin]

I spoke to the helpline. Recommended to try 2x 200/6 morning and night with up to 4 doses in between. Up to 12 doses can be used if in real trouble but she was surprised my GP hadn’t seen me in person. I have an open appointment with the respiratory team at the hospital (last there 2.5 years ago) so if I’m still this bad tomorrow I will contact them.

[Patk1 in reply to Lynneypin]

Hope the mart regime suggested helps settle yfr asthma

[Hidden in reply to Lynneypin]

I hope you feel better very soon Lynneypin.

[Lynneypin in reply to Hidden]

Thank you x

[My_fairy]

yes my daughter has been on the symbicort for nearly three years for her severe persistent symptoms and daily usage can go up in acute exacerbations when we know she needs the steroid tabs. Symbicort is a good inhaler has been helping her and she also has Ventolin, atrovent and tiotropium in her plan to use daily as required for Ventolin up to 10 puffs, atrovent 2-3 times and tiotrpium once a day.

Her asthma is very severe and sometime even with these she still needs preds and nebs on top so you can imagine how we are struggling especially as she’s just turned 16 being so young. Hope it makes you feel bet tea en10 puffs a day aren’t bad for exacerbation for you if it means you are avoiding tablets in the long run and saving yourself from bad side effects inhaled isn’t as bad as far as I know.

Good luck

[Lynneypin in reply to My_fairy]

Thank you. The extra doses are helping.

I’m so sorry about your daughter. How awful to be struggling so much. Bless her - such a worry.

[My_fairy in reply to Lynneypin]

Yes with time getting used to it but definitely a worry all the time

[Birthday60]

that is exactly what it’s for - combined inhaler which reduces inflammation and relieves restriction causing attack. If you don’t understand what your doctor or asthma nurse has advised it’s best to ask them .. maybe if you struggle with this take a friend or relative with you to the appointment to support you