Fostair and montelukast experiences

[Jeb2012]

Hi all,I have recently been diagnosed with asthma and possible bronchiectasis.

Consultant switched my inhalers to fostair 100/6, both as prevent and rescue and was given montelukast 10mg

Had an awful week since. Constant headache, which turned into a migraine, and had to have a day off work. So stopped montelukast as suspected it was that.

Then just felt very tired, and unwell since being on it. Still short of breath, even though obs ok and chest clear.

I personally feel I was better on the brown and blue inhalers.

Anyone else had a similar experience?

[peege]

Not a similar experience. I've found that Fostair 100/6 changed my life, I find it brilliant. Do you use a spacer with it ? - doing so gets a fair bit more of the medication to where it's needed. Have you checked that your inhaling technique is correct? And do you wait at least 30 seconds between each puff? Very important. Also, it usually takes up to 3 or so weeks for a new inhaler to fully take effect (sorry, I know it's a nuisance but they don't work instantly). I think my change took about two weeks, someone else I know took three weeks. Check the manufacturer's website for the technique - or youtube with & without spacer. Because its a MART inhaler (Maintenance And Reliever Therapy) you can take up to 8 puffs in total in 24 hours if you're breathless.....but don't forgetto wait 30 to 60 seconds between puffs! Good luck ×

[Jeb2012 in reply to peege]

I can't imagine taking 8 puffs in a day. I get bad trembling in my hands with it and palpitations. And that's after 2 puffs in the morning, then 2 puffs 90 mins later as a rescue inhaler. Takes a few hours for the trembling to calm. I even shake holding my tea and spilt it today.

Any thoughts on this?

I'm new to all of this and didn't think to ask the consultant at the time as he seemed so confident it would work.

[peege in reply to Jeb2012]

Can you stagger the puffs a bit perhaps? Now its cold I've upped to 2 puffs at night but i often leave half an hour between puffs. I'm absolutely expert I'm afraid and I've never had the shakes with an inhaler. I know what it must feel like as that's how I feel with prednisolone and I cannot even tolerate caffeine . You need to talk to a professional, your hp, asthma nurse or....Definitely give the helpline a call to see what they suggest - 0300 222 5800 between 09.15 to 5pm weekdays

[Jeb2012 in reply to peege]

Thankyou so much for your help and sharing your experience. I did stagger the 2 puffs this evening, by about 15 minutes, and that helped.

I think the issue is that if I need to use fostair as a reliever, a short while after using it for maintenance, it gives me tremors.

I'm sensitive to caffeine as well and always have decaf products and then I struggle to tolerate prednisolone.

I will call the helpline on Monday afternoon and speak to them. This is all still so new to me and feels quite daunting, as only diagnosed a week ago and all of a sudden they changed my inhalers and placed me on montelukast, and think I just needed to do one change at a time.

Thanks again. Just nice to hear a friendly voice of someone who understands

[Getfitok in reply to Jeb2012]

this happened to me too, so I went back on clenil which I was on originally.

[Jeb2012 in reply to Getfitok]

Yes I think I was alot better on clenil. And then used salbutamol as rescue.It's hard as I feel it's sometimes just having the confidence to say that you feel something isn't working for you.

Thanks so much for this reply x

[blackmememe in reply to peege]

I use Fostair and was given a spacer to use with it by my GP but a few weeks later the asthma nurse rang me to tell me to stop using the spacer as its a powder inhaler and a spacer stops it working ? I have read a few posts about this on here but I am still not sure if I should use a spacer or not.

[Poobah in reply to blackmememe]

Spacers can only be used with a gas propelled inhaler. Dry powder inhalers depend on breath activation. Here's information on inhaler technique for various types of inhaler that you may find useful. asthmaandlung.org.uk/living...

[blackmememe in reply to Poobah]

Thank you x

[peege in reply to blackmememe]

It always pays to read every word of the leaflets supplied with each medication blackmememe. Personally I keep one of each in my medication box & swap with newer ones annually. P

[Hil101 in reply to peege]

Hi, please can you tell me why it should be 30 secs between puffs? I take the stronger Fostair (200) and am plagued with thrush which gets on my vocal cords despite best gargling and rinsing technique and using a spacer. So I keep the time between the puffs minimal and get to the rinsing stage as fast as poss after holding it in lungs for barely 10 secs

[peege in reply to Hil101]

Gosh, horrible for you.

When I did the Pulmonary Rehabilitation course the Respiratory Nurse educator said it was because it takes time for the medication to drop through the propellant (this is MDI spray type only (powdered ones gave me thrush years ago regardless of rinse and gargle)). I've no idea if this is the correct reason however MDI inhaler instructions also say to wait 30 to 60 seconds. I checked the other day.

I don't know if this helps....years ago I was treated for Candida. One of the recommendations was to eliminate sugar (because it feeds candida/thrush I was told) and to eat plenty of live yogurt. I was so desperate at the time I'd take a mouthful of it, throw it to the back of my throat, attempting to gargle with it and holding it there at long as poss. To this day I eat plain live yogurt daily and have very little sugar.

[Hil101 in reply to peege]

Thanks for that. I’ll give it some thought

[peege in reply to Hil101]

I'm so vigilant about avoiding thrush I even rinse and gargle before I do inhalers. At night I'll do one inhalation then floss my teeth or something to ensure I do the wait. I've tge notion (right or wrong) that by rinse n gargle first tge medication won't stick to my soft tissue so easily, sort of diluting it. Probably mad ocd but it's total habit now. (I'm not old in anything else 🤣

[Collienut]

I had the shakes every time I took Fostair, it faded off after a couple of months. It was worth it as my breathing is the best it's been for years and no more swollen legs. The shakes were the same as when I first had Ventolin. I also found it was worse if I took Fostair right after my Spiriva, I leave a half hour gap between the two now and that helped stop the shakes.

I also take Montelukast, only problem I get is disturbed sleep, but again it stopped the coughing fits by night so I still get more sleep than before.

I still use a different reliever inhaler as I'm not on the MART regime like you appear to be.

Maybe speak to your consultant,asthma nurse/gp and see what they say about the headaches?

[Heaven20]

Exactly as you said, couldn't get on with Fostair. After a few weeks requested to go back to brown and blue inhalers, felt a lot better since.

[Jeb2012 in reply to Heaven20]

Thankyou so much. I am going to speak to the asthma nurses tomorrow and also book a GP appt

[Heaven20 in reply to Jeb2012]

I was a bit sad it didn't work for me ( i have bronchiectasis and asthma) as my adult son who suffers with asthma found it much better, but it shows we are all different.

[Jeb2012 in reply to Heaven20]

I have asthma with suspected bronchiectasis. And yes I feel sad too! I tried the montelukast as well, and my breathing was alot better, but the side effects were awful. Was off work with migraine after days of headaches.So had a rough week on montelukast and fostair! I felt under pressure to persevere and keep trying cause I feel the expectation is that they work for most, and didn't want the consultant saying I should have stayed on it a bit longer. But I know I felt alot better on brown and blue

[SuziElley]

Fostair 100/6 works well for me, paired with Spiriva which I take two puffs in the morning. Fostair I take tow puffs morning and then evening and can take up to another four puffs during the day if needed. I also take montelukast once a day. This seems to be the best regime for me. I think you need to give these things two or three weeks to really see if they’re working. Maybe talk to your asthma nurse about it.

[Meerykat]

I also experienced hand tremors, palpitations and felt generally unwell on Fostair. I persevered for one month but the side effects continued and it didn’t improve my asthma symptoms, in any case. The asthma nurse therefore reverted me back to clenil and salbutamol but, although I don’t have any adverse side effects now, it hasn’t helped with my main symptom which is excess mucous, which doesn’t shift by coughing or Monteleukast and feels like a permanent blanket of mucous sitting in my upper chest. The asthma nurse has now changed my inhaler to the higher strength of Relvar but on reading the instruction leaflet it states 1 in 10 may suffer pneumonia and 1 in 10 may get weakened bones leading to fractures! I’m too scared to try it.

[Jeb2012 in reply to Meerykat]

I would feel exactly the same as yourself re the relvar.I am going to try the two previous inhalers again this week.

I've had sinus pain, migraine, runny nose, tiredness and worse breathlessness since being on fostair.

It's frustrating when you have to try things to see if they work and then having to put up with the side effects if it's not right.

I started both the fostair and montelukast at the same time (as was advised too) and I think I'd rather have tried one, then the othe, because i couldn't tell which one was causing side effects and so it got very messy.

Stopped montelukast and going back to previous. I've been on fostair just over a week, which doesn't sound long, but it's a long week when it doesn't feel like its relieving and causing side effects bad enough to impact my work, energy levels and general feeling of wellbeing.

I think I'll ring the helpline tomorrow and see what they say. It's all new to me and feels abit overwhelming at the moment.

[Asthmasince2yrsold]

My experience was similar to you. I was using blue inhaler before brown inhaler. I was told this was an outdated method. I was changed to symbicort. Had a severe asthma attack and changed to Fostair. Now on antibiotics , prednisolone and doubled Fostair. Can't seem to breathe as well as I used too. I'm considering going back to my old routine of blue inhaler followed by brown inhaler.

Has anyone else done this?

[Jeb2012 in reply to Asthmasince2yrsold]

I spoke to asthma nurse at asthma + lung UK yesterday and they were brilliant.They said that it's likely the additional ingredient in fostair (formoterol) that caused me to feel unwell and that combi inhaler may not work for me.

Saw GP, and they have put me back on blue and brown inhalers and feel alot better in myself.

Probs will get reviewed and poss changes again to it, but for now, feel more like myself again.

[Asthmasince2yrsold]

Wow! I was so pleased to hear about that. Thank you so much. I'm going to follow your example.

[Jeb2012 in reply to Asthmasince2yrsold]

I don't think my asthma is controlled yet, but I was only diagnosed just over a week ago.Consultant changed my meds, and I felt worse.

Was off work for a day I felt so bad. Felt more breathless, had tremors in hands, headaches, migraine, palpitations.

I'm not there yet. But I don't think fostair was the right inhaler for me. Just felt like it worsened everything

[Asthmasince2yrsold]

I spoke to the Asthma Helpline Nurse and she identified that Fostair may not suit as I had cramps headache and racing heart. She thought that I also had a problem with Fomerol.I saw GP and was prescribed Relvar and told to take the Prednisolone and Montelukast. Early days as my Sats still <95% but slow improvement. I'm due to have CT Scan in November, Allergy prick test December and Respiratory Consultant in January. I'm also seeing my Asthma Nurse in a few weeks time to see how I'm getting on.

All very strange as I've had such good controlled Asthma for decades. Yet, a bizarre Asthma attack that came from nowhere that hospitalised me. Now trying to get back where I was.

I do hope your journey to getting good controlled Asthma is with you now.