Stomach cramps on fostair 100/6

[Covidgavemeasthma]

Hi

I was diagnosed with asthma last spring following COVID. I have tried a few steroids inhalers such as Clenil, Fostair Nexthaler and Relvar . Clenil wasn't affective enough but didn't cause any side effects. Both the powder inhalers caused severe shakes lasting hours or very sore mouth symptoms. 3 weeks ago after a chest infection my asthma nurse prescribed fostair 100/6 to be used twice per day with a spacer. This was going fine until about one week ago when I started to get cramps down both sides of my abdomen ( from ribs) down and in my mind to lower back. This has been getting progressively worse lasting for hours each day. I am due a review with the asthma nurse tomorrow but just wondered if anyone else had experienced similar or is this just a coincidence. I have read of others suffering from leg cramps but not this. As a new asthma sufferer I would be grateful to hear of your experiences with this inhaler. Thank you.

[Homely2 Administrator]

All my family are suffering from stomach cramps at the moment, due to some form of stomach bug, I presume.

[Covidgavemeasthma in reply to Homely2]

Hi, thanks for the reply. The cramps I have are not in the location I would normally have for stomach bug etc. it's more down both sides of my ribs and mid back. It normally wears off later in the day until I take my second dose at around 8pm.

[JumpJiving]

Covidgavemeasthma Ask for an early morning (8-9am) cortisol blood test to be done. Hopefully not a cortisol issue, but when on steroid-based inhalers it is worth checking when exhibiting flank pain (which can show as lower back too)

[Covidgavemeasthma in reply to JumpJiving]

Hi, thank you for your reply. What would this indicate please?

[JumpJiving in reply to Covidgavemeasthma]

Covidgavemeasthma Low cortisol can occur (amongst other reasons) if steroids suppress the HPA (hypothalamus, pituitary, adrenal) axis. If that is the case, you would need to take medication to support your cortisol levels alongside using your inhaler(s). It is rare, so hopefully not what you are having, but can happen

[Covidgavemeasthma in reply to JumpJiving]

Hi, thank you also for your reply. I am taking on board everyday people are replying and will mention to the nurse tomorrow.

[Poobah]

Muscle pain is a listed side effect of Fostair and other similar inhalers containing steroids and long acting bronchodilators. You could ask for a potassium check to see if that's the issue (low potassium is a listed side effect and can cause cramps and/or muscle pain). But don't be surprised if they just change your medication. Even if they do change your inhaler, you could eat a more potassium rich diet. And there are a range of foods higher in potassium than bananas.

I'm on Fostair, but it was Symbicort that gave me very low potassium levels and fortunately the hospital picked up on it and started treatment. I now have to keep my potassium intake up by diet, in order to counteract the effects of my inhaler.

[Covidgavemeasthma in reply to Poobah]

Hi Poobah, thank you for taking the time to reply. I will mention everything you said when I see the nurse tomorrow. Would symptoms start 2 weeks after starting Fostair?

[Poobah in reply to Covidgavemeasthma]

Fostair isn't your first combination inhaler and they all have the same side effect. But Fostair has very fine particles and can't be tolerated by some because of this. So Fostair may have tipped you over into lower potassium levels after a period of time on other similar inhalers.

OR it's just that you don't tolerate Fostair and your potassium is OK. But they should check your potassium levels as it's highlighted in the patient leaflet that "your doctor may want you to have regular blood tests to keep an eye on your blood potassium levels". If you have your Fostair patient leaflet that came with the inhaler then take it to your appointment so you can highlight that with your asthma nurse.

I've had varied responses from nurses and doctors when raising the subject of side effects, so having the patient leaflet is a good way of supporting your concerns about side effects, especially as they're listed.

Good luck with your appointment, I hope they can resolve things for you.

[Covidgavemeasthma in reply to Poobah]

Thank you so much for your reply. I really appreciate it.

[Allbranuser]

Hi CGMA

Your background story on acquiring asthma is interesting. You didn’t mention whether you are taking other meds, secondly before diagnosis were you tested FeNo and/or spirometry?

I have been using Fostair 100/6 with spacer for 6/7 years on a MART and it has been pretty good at preventing exacerbations until I caught Whooping Cough. Slowly recovering.

I have not had any flank pains etc. Welcome to our hotel, you can check out but never leave.

[Covidgavemeasthma in reply to Allbranuser]

Good morning, to give a bit more information I caught COVID for the first time in November 2023 but the coughing never stopped. After going to my GP and having a chest x-ray I was given antibiotics and told to come back afterwards. The medication made no difference so I was put on a high dose of clenil and given a reliever inhaler. I continued to have some exasperation of symptoms so also tried the fostair nextair inhaler but that gave me terrible mouth ulcers. Then tried relvar/ relvar but the shakes were too severe to be able to drive or use a computer keyboard. I was put back on clenil. I then ended up with a chest infection in November 2024 so was given Doxycycline but still had 2 asthma episodes. The nurse changed me to Fostair 100/6 about 3 weeks ago which has improved my asthma symptoms hugely, however in the last 7 or so days I have started to experience the pain in the whole of my rib cage and down my sides. I'm seeing the asthma nurse for a review later today so will mention all of the replies I have received here. I hope that explains things a bit better

[Stclements47]

hi, can I ask if you are on aerosol or powder Fostair? I was moved from aerosol (which was amazing for me) to powder Fostair (via Luforbec which was a nightmare for me!) and now I'm having weird crackly pain in my flanks too! Not muscle pain, hard to describe- it's like an intermittent rippling crackle...

[Covidgavemeasthma in reply to Stclements47]

Hi, I'm on the aerosol Fostair with a spacer.

[Viewpoint]

I had the exact same experience of Fostair 100/6 which was prescribed for me as my normally well controlled asthma using Budesonide became uncontrolled after testing positive for Covid. The asthma breathlessness has been successfully dealt with but the side effects for me from taking Fostair after two weeks were extreme - stomach upset, awful lower abdominal muscle pain, heart palpitations and feeling my body was not coping at all with Fostair. It's two weeks since I took it and have reverted back to Budesonide but I still feel my stomach is not back to being 100%, not feeling as hungry and still have occasional abdominal muscle pain but no where near as bad. A sharp drop in Potassium levels is noted as a side effect on the patient leaflet however, my potassium levels increased. I've got an appointment with my asthma nurse next week to discuss. I think I am so very sensitive to the steroids in asthma medication (ectopic /skipped heartbeats from starting on asthma meds a few years ago after diagnosis) and need to have a good discussion next week with my asthma nurse as my U&E blood tests are all in the normal range but I feel my body was rejecting the Fostair medication.

[Covidgavemeasthma in reply to Viewpoint]

Hi, just a quick update. I've seen the asthma nurse who is very pleased with improvement in my asthma symptoms since starting the fostair. I explained the strange pain symptoms I have been getting and also the advice given here in regards to potassium levels but she was not concerned. Having previously been on landoprazole for GERD she feels that I should restart this as the symptoms appear to be more gastric related than medication. I've got to try the landoprazole for 2 weeks and if no improvement go back in 2 weeks. I'll see what happens. Thank you to all of you who have taken the time to read my post and have given very informative answers.

[Poobah in reply to Covidgavemeasthma]

I'm glad you now have a plan. I know we feel like a nuisance sometimes because it takes several appointments to get on top of things, but never hesitate to go back to see your doctor or asthma nurse until you're satisfied that things have been resolved. All the best.

[JumpJiving in reply to Covidgavemeasthma]

Covidgavemeasthma Did you ask about the early morning cortisol blood test? Although, TBH, it's more of a question for the respiratory consultant rather than the asthma nurse. If you didn't ask, email/phone the respiratory consultant to ask about it. As I said before, it's rare, but asthma inhalers can cause adrenal insufficiency (they are thought to have caused mine). It's not a condition to ignore, so worth the follow-up

[Covidgavemeasthma]

Thank you Poobah. I'll see how it goes for the next 2 weeks.