Fostair during pregnancy?

[Durhamlark]

Hi all

Lifelong asthmatic, now 20 weeks pregnant. Have been generally fine taking Beclometasone (Clenil) and Salbutamol when needed.

I had an asthma review last week and the nurse wants to swap me to Fostair because I ordered more than two salbutamol inhalers in the last year and it’s now their policy that needing more than 2 means asthma is not well controlled (news to me!).

I’ve been doing some reading and am not particularly comfortable with using the Formoterol present in the Fostair inhaler because it is apparently tocolytic (causes uterus to relax) and shouldn’t therefore be used in the run up to delivery and labour. In addition the potential effects on unborn babies are not well studied so it’s a gamble.

My midwife is trying to find out more but says she can’t find many studies.

Does anyone have experience of Fostair in pregnancy? Or do you know of any studies I can read? Or can anyone suggest any alternatives?

[peege]

I can totally understand your need to do what's right for your baby - thank goodness I didn't use any drugs to worry about in my three (navy years ago). I think this one could be a query for the helpline, call 0300 222 5800 between 09.15 and 5pm Mon to Friday to speak to a professional

[Lysistrata Administrator Community Ambassador]

I agree with asking the helpline. Just FYI, the general guide for control is that if you need reliever more than about 2-3 times a week, you're not well controlled and are likely to need an increase in preventer medication. Though if the reason you ordered two in the last year was because you wanted a spare or one expired or something, then it's not really saying anything about how often you need it - they should really have asked how often you feel you need the Ventolin.

I'm not a healthcare professional and I don't know if it's a particular issue with Fostair or formoterol, but I know that there are smooth muscles in the uterus as well as round the airways (ie muscles that you can't control). Inhalers that act on the smooth muscles round your airways should be mostly localised to the lungs/airways, but I guess it's possible they could affect your uterus? I know magnesium sulphate which is used for acute severe asthma attacks is also used to stop premature labour by relaxing the uterus, but that's an IV medication rather than an inhaled one so would be expected to have a systemic effect. (And I don't know if the doses are the same - just that magnesium sulphate relaxes smooth muscle but in a different way from the way that the inhalers do it.)

As I said, it's definitely worth asking the helpline. I do know that it's considered best for the unborn baby to have the mother's asthma be as well controlled as possible, so that should also be taken into account with any treatment you may need for asthma while you're pregnant.

[Patk1]

Sorry I can't help but I'd suggest you don't change to anything you aren't happy with - don't be afraid to speak up + say so.x