Qvar 100 vs Clenil Modulite 200

[ZeroThePidge]

I have just been prescribed Qvar 100 after I had to stop taking Seretide 125 due to side effects. I was prescribed the Seretide a week ago as the Clenil inhaler wasn't doing much to control my asthma (waking up several times a night, needing my ventolin inhaler multiple times a day etc). The Seretide was helping to a certain extent, but I can't live with a permanent headache (I had the same issue with Symbicort 200/6). Now, from what I can see, the steroid in both Qvar and Clenil are exactly the same, so why would I be prescribed Qvar if the active ingredient is the same in both inhalers?

[Chip_y2kuk]

Qvar is finer particles, so higher and better absorption... it also goes "deeper" into the airways. ...But yes it's the same steroid in both

[Kurty2]

I've found that most of the doctors or nurses hardly know what's in what, they don't seem half as 'with it' as I always thought they were.Was it just the headaches you had with Seretide? I've just stopped taking it myself after a month of use as I've been getting a painful stomach and a sensation of a 'stiff' throat.

I've not looked at the ingredients of the one you mentioned but have you tried fostair (nexthaler)? Might be one to try.

[Kurty2 in reply to Kurty2]

Just looked and looks like fostair has the same steroid as the qvar, do you take cetirizine or loratadine? If you're dust allergic, that could help, don't expect the doctors or nurses to mention it as mine never have.

[ZeroThePidge in reply to Kurty2]

I honestly don't know if I had any other side effects from the Seretide. I struggle to work out what's going on with my body (like, I will accidentally burn myself and not realise for days). It took me the better part of week to realise I'd had a bad headache since I started the Seretide inhaler, and as that was the thing that was upsetting me that was the only thing I noticed.

I am not willing to try combined inhalers again as both of the ones I have tried have given me bad headaches so I don't feel comfortable trying Fostair.

Despite the fact I have had asthma for nearly 20 years, I don't actually know for sure what triggers my asthma apart from having a cold so I don't take antihistamines unless I absolutely have to.

[Kurty2 in reply to ZeroThePidge]

I also struggle wondering which medication or food is causing which side effect. I too am thinking to stop using the combined inhalers, the last nurse I spoke to had asthma herself and she doesn't use the 'mart' method combing steroid preventer and reliever at the same time regardless wether you might need one or the other at any given time.

[ZeroThePidge in reply to Kurty2]

I don't understand the logic behind the push to have everyone on MART inhalers. My last asthma nurse changed me to a MART inhaler without asking me what I thought about it, and then refused to change me back to my old inhalers when I said I was having issues.

I'm sure it works great for some people, but not everyone.

[Kurty2 in reply to ZeroThePidge]

Absolutely, no doctor or nurse has ever been able to explain to me why we should be taking long lasting relievers every single morning and night.. even when breathing is completely fine and controlled by the steroid element.

[Lysistrata Administrator Community Ambassador in reply to Kurty2]

I appreciate it's not working for you and I agree it doesn't work for everyone, but the idea with MART is to deal with inflammation as well as symptoms at the same time, rather than just using reliever alone which doesn't tackle inflammation. They are linked but not the same, and it is possible to have a lot of inflammation without noticing.

What your nurse uses for her own asthma shouldn't influence what she gives anyone else for theirs, as people's asthma is not all the same. Her job is to work out what 's best for each patient - which may be MART for some and not for others.

[Xedoc]

So sorry to hear of your side effects. I think it is a matter of trial and error and trying different ones until you find one that suits you. I had terrible issues with my throat and voice which I attributed to seretide but never headaches and which has improved since I’ve reduced the dosage. Now down to 100mg. I also sough alternative medicine avenues and practice buteyko breathing which helps. I did get severe headaches a few days after being prescribed uniphylin, so much so they were affecting my sleep. I stopped after a week and the headaches disappeared.

Have you tried looking at your diet? I went dairy and gluten free in Jan of this year and have since have had no need to use my ventolin which I would have taken almost every day before that.

Mine was a 2 year struggle with various side effects as a result of the medications I was prescribed and am now in a better place thankfully. Hope you find a solution soon .

[ZeroThePidge in reply to Xedoc]

I think it's the LABA component of combined inhalers that causes issues for me. I had the same issue when I was on Symbicort. I am currently on a relatively high dose of Qvar (2 puffs 3 times a day for the next 2 weeks) and I am not having issues with it so far.

What alternative therapies are there?

I haven't looked at my diet. To be perfectly honest, I don't have the ability to cut things out of my diet as it's already extremely limited and I can't try new foods.

I'm pretty much done with trying new medication. I am at a point where I am genuinely contemplating stopping my preventer inhalers as they do nothing anyway and just using ventolin. Dealing with it is ruining my quality of life as it's causing more stress than not treating it.

[Kurty2 in reply to ZeroThePidge]

I'm the same, I've stopped taking everything 5 days ago, I think there's a stress element to my breathlessness, like a spiral of panic, I have relievers at hand if things get bad like ventolin and the ones in the mart inhalers, but I think the steroid inhalation isn't helping me, I've been on them long term and they have quite serious long term side effects so I'd rather be off them if possible. Regarding food I suspect but it's only a suspicion that peanuts, sardines, and maybe milk may not be good for me, but it's so vague it's hard to tell for sure. I did happen upon being tested without even knowing it and not even being told by my doctors that I had a tree allergy. So they do allergy tests apparently which can be helpful of course, if only they had the thought to tell me and discuss it with me, no such luck it seems, health care seems to be on its knees.

[Lysistrata Administrator Community Ambassador in reply to Kurty2]

HI Kurty2, probably a long shot but can you ask to see a respiratory physio? They may be able to help with the stress breathing. If not and you have the funds for it (not assuming either way), it is possible to see private respiratory physios.

I appreciate that your medications need to be tolerable. However, if you're concerned about the long-term effects of inhaled steroids vs whether you can tolerate the ones you're on day to day, I feel I should say that not controlling inflammation in asthma and relying on reliever alone can be really dangerous. And oral steroids have a lot more side effects in the long and short term compared with inhaled ones. If your asthma is uncontrolled due to being undermedicated, you will be much more likely to need courses of oral steroids.

I'm not scaremongering, but I don't think enough people know this and from what you've said about them I don't know if your GP or asthma nurse will have said it clearly.

Apologies if you're aware of this already but I can't assume you are, and uncontrolled asthma is dangerous enough that I want to repeat this for others reading too:

*Stopping all your medication without medical advice is dangerous*.

[Lysistrata Administrator Community Ambassador in reply to ZeroThePidge]

Hi ZeroThePidge, sorry to hear you're struggling with finding the right medication.

When you say the preventers are doing nothing, they do need some time to build up - it is a slow process unfortunately. I would give the Qvar some time - more than two weeks - to see if it helps as it doesn't sound like you've been on it long enough to help yet. And you said it is ok from a side effect point of view so hopefully should be doable to stay on it.

You said the Seretide was helping the asthma a bit but obviously it wasn't possible to stay on to see how that developed. I totally agree that if it gives you a headache all the time it's not suitable for you, but from an asthma point of view the Qvar may well help if you give it a bit longer. As Chip_y2kuk said, it is the same steroid as Clenil but has finer particles.

There are other options besides long-acting reliever, if you haven't tried them yet. I would give the nurses on the helpline a call and chat through your situation and options. They can't prescribe but can advise what to discuss with your GP/asthma nurse: 0300 2225800 or WhatsApp on 07999 377 775 Monday-Friday 0915-5pm

Re natural remedies, have a look at this page before trying anything: asthmaandlung.org.uk/sympto... Also worth being aware some natural remedies can interact with medication (for asthma or anything else) and some can trigger asthma.

[ZeroThePidge in reply to Lysistrata]

I have been prescribed Qvar 50 in the past (2 puffs twice a day) which didn't do a whole lot for me. I didn't get side effects, it just doesn't do much. I have been told to take 2 puffs 3 times a day of the Qvar 100, which may be helping in as much as I am not waking up needing my inhaler as much at night, but it's only a temporary increase and it's definitely not one I feel comfortable taking forever.

The only other option I have been offered in Montelukast, which I will not take.

[Kurty2]

Thank you for sharing, that's a lot of medication. My story is I was on just one steroid inhaler 14 years ago (budesonide - for a year or so) but then it seemed to stop being helpful, so they gave me symbicort and it worked instantly and I found that I just had to use it as a long lasting reliever once or twice now and then, this went on for about 10 years, using about one symbicort inhaler every 3 month. But 4 or 5 years ago it stopped working so well for me and I'm struggling a bit to find out what's happening - pretty much on my own. By the by, do you know why they don't do just a long acting bronchodilator inhaler on its own?

[Lysistrata Administrator Community Ambassador in reply to Kurty2]

Sorry to hear you're struggling on your own - is changing GP an option? Have you tried all the GPs in the practice in case one is better than the others? I know some surgeries are great and others not so much...

They tried using long-acting reliever alone and it increased asthma deaths. In asthma, it's not safe to use alone (it may be for some people with COPD but that's a different situation), The steroid is what reduces inflammation, not the reliever. Having a reliever without addressing that isn't effective or safe in asthma. And symptoms and inflammation are not the same, though they are linked. You can have minimal symptoms day to day and a lot of inflammation - that's why you keep on taking the medication even when you feel ok.

You may find it helpful to chat through your situation with the asthma nurses on the helpline, as they have a lot more time to listen and can give you some ideas to take to your GP/asthma nurse. They're also good on 'strategic' advice if your GP isn't listening. 0300 2225800 or WhatsApp on 07999 377 775 Monday-Friday 0915-5pm.

[Lysistrata Administrator Community Ambassador]

See the answer above starting 'Sorry you're struggling' - everything is in there now.

Apologies for the confusion!