Chronic Side Effects of Asthma Medications

[Clemenzaa]

I joined this group some two months ago, soon after being been diagnosed with underlying asthma. At that time, I had been prescribed Forstair 100/6 and have tried the pressurised inhaler and NEXThaler fine powder options, both of which evoked horrendous side effects of hoarseness, dry mouth ulcers and mucus overproduction. The responses I received from forum members were reassuring and most welcome.

I met with my respiratory Consultant for the first time at the end of February. In addition to confirming my diagnosis to be late onset asthma (I am 63) my prescription was changed to Relvar Ellipter 92/22 in an attempt to address the side effects issue. I was also allocated a Respiratory Nurse to provide support in monitoring the inhaler, given my reaction thus far.

Since then, I have been prescribed Fobumix Easyhaler and Combisal 25-125, both of which have evoked the same constellation of side effects that I have experienced from the outset, particularly inflammation of the mouth and throat and severe hoarseness, such that I can hardly speak.

Clearly, I am concerned at the situation in which I find myself, not only at the onset of asthma, coming as it has so late in my life, but more particularly at the chronic side effects of the medications that have been prescribed to control the condition. The medications I have used thus far, comprised of 2 active components, a bronchodilator to relax the muscles in my airways and a corticosteroid to reduce and prevent swelling and inflammation in my lungs. I fear that as I have already tried four different types of such medication, it is likely that my response to others will be the same. In absolute terms, the side effects I have suffered are far worse than the breathing difficulties linked to the asthma itself.

I would welcome any observations linked to my experience thus far.

[HungryHufflepuff]

I’m sorry you’re having such bad problems with inhalers. Do you use a spacer with the aerosol ones. It can help reduce side effects. I had Fostair for 6 months and the side effects were terrible. Since then I’ve had several inhalers and none are great. I did have one that worked for many years, before then, but was changed from that to Clenil which didn’t work and since then the ever changing inhalers. There are lots of inhalers out there. Hopefully you’ll find one that works for you with minimal side effects.

[Kristicats]

Could you talk/ contact your respiratory nurse Re your side effects or better still speak to your resp consultants secretary and pass on a message direct to the consultant . I’m afraid GPS don’t have an in-depth understanding Re lungs as a respiratory physician and tend to think one size fits all so to speak.

[hypercat54]

There is a site specifically for asthma on here. Why not put your post in there as well. They are very knowledgeable there too.

[Clemenzaa in reply to hypercat54]

Thanks for that, I will seek it out.

[knitter]

There are a number of asthma inhalers that don’t work for me , some make my chest tighter . I tried Fostair , that didn’t suit .

Combined preventer and reliever inhalers don’t work well for me , but other people are fine with them.

Single preventers help me best, I use Qvar with spacer and a reliever when needed. But I very rarely need a reliever now, before I used one every day.

I also practice gentle gentle nose breathing as much as I can, being aware when my breath pattern changes.

I also practice meditation to help with anxiety and to help relax my muscles and slow my breathing rate.

I have tried alternate nostril breathing at my yoga class....videos on you tube.

Gentle exercise too, gentle yoga in my case ....coordinating breath with mindful movement . Walking if you can .....I count laps backwards and forwards around my house, goodness knows what the neighbours think . My cousin does laps of her garden , mine is too small .

The BLF has a good graded exercise CD available.

[Clemenzaa in reply to knitter]

Thanks for your response, I also ty to keep active.

[Hidden]

I’m not remotely medically qualified, and this is not my neck of the patient woods, so I may be way off, but it almost sounds like an over-reaction driven by the meds. Mast cells in the lungs are involved in asthma as well as in allergic reactions, and I know with my daughter (who, in addition to cystic fibrosis, has an autoimmune driven mast cell problem), when her lung mast cells first became problematic, the symptoms were massively increased sputum production, wheezing, and shortness of breath. We were fortunate to have a very experienced local consultant who agreed with me quite early doors that it wasn’t an infection but something else entirely going on, and he also had the foresight to look beyond it being related to her cf. The solution in Bod’s case - and it’s also an add-on treatment for those with asthma in its own right - was an oral medication called montelukast. It’s a leukotriene receptor antagonist, with leukotriene being a type of mast cell found in the lungs. Within days it settled her lungs back to normal baseline, and she’s now been taking it for almost 3 years. We’ve stopped it a couple of times, but quickly find she starts reverting back, so it’s now a long term part of her treatment plan. As I said, it may not be remotely appropriate to your situation, but it could be something to bring up with your medical team to explore.

Regarding the ulcers, do you rinse your mouth after using a steroid/combined inhaler? The advice isn’t consistently given when prescribing inhalers, but it’s very much necessary. In my daughter’s case, she had quite extreme hoarseness with starting symbicort, and again with relvar, but it does generally ease with time. I think it took about a month to 6 weeks to settle for her.

[Clemenzaa in reply to Hidden]

Thanks for your response. when taking my medication, be they powder based or pressurised inhaler with spacer, I ensure my technique is conducted correctly. I also ensure that I gargle and rinse my mouth out after I have administered the required dose/s. Irrespective of what I do, the symptoms occur, severe hoarseness being the most the most worrying for me, given its impact upon my ability to talk.

I am pleased that you have a good support system for your daughter and it seems responsive to her heath needs.

[ChilledoutNana]

I have bronchiectasis, and mild asthma too which is usually well under control. We are all very different. I was taken off Qvar and have taken Fostair for several years. Yes, I too have a hoarse voice and dry mouth. Lung specialist started me on Montelukast which I took for about four years but stopped as my symptoms have improved. I also use a spacer and gargle with water after inhaling. I never use mouthwash too as was having an adverse affect. Since first lockdown I’ve been static cycling. Initially very difficult. Managed 90 seconds first day but have gradually extended this to 45 mins on a good day. I’ve walked more and (touch wood) my lung capacity has improved immensely.

[Clemenzaa in reply to ChilledoutNana]

Thanks for your response.

[Hidden]

Hi ClemenzaaI can sympathise with your problem. It’s very uncomfortable having a sore mouth and distressing when you need to talk but feel hoarse.

I ended up with fungal laryngitis diagnosed with a vocal cord biopsy. The high dose steroid inhaler had caused this along with acid reflux.

I was treated with Itraconazole antifungal medication for one week. I also use Daktarin oral gel if I get oral thrush.

I was advised to use steam inhalation in addition to rinsing the mouth and gargling after inhaler use. So far, the infection hasn’t returned. Gargling on its own doesn’t reach the vocal cords.

The speech therapist told me that steam from having a shower or bath is also beneficial. I usually take my inhaler prior to morning shower and use steam from a bowl of hot water later in the evening, for just a few minutes. I did buy a steamer but the bowl is just as good .

Hope this helps and hope you are feeling better soon.

J

[Clemenzaa in reply to Hidden]

Many thanks for your comments

[Suzie42]

My husband was diagnosed with late onset asthma when he was 68, 2 yrs ago he was put on Fostairnext inhaler like you, but unlike you it was like a Miracle cure the very 1st time he took it his symptoms disappeared, he had hoarseness and some mucus, but with a cup of coffee afterward had been fine. He is just finding that this is now not enough and has to use the reliever so is being seen by consultant soon. I hope you get yours sorted out soon. Good luck.

[Clemenzaa in reply to Suzie42]

Thanks for your response

[katieoxo60]

Sorry to hear your going through an aweful time, most of the info given is good but may not work for everyone. But anything is worth a try, nothing worse than trying to get a symptom under control and side effects taking over. I personally had a problem with one that you mentioned and ended up in hospital on a nebuliser . Inhalers often do cause hoarseness ect, I use a bacterial mouthwash and spacers do help too. It took me two years to get my illness under control after they changed me from combivent to others. I hope yours is sorted as soon as possible, inhalers are constantly being changed so there should be one that suits you, but it is about finding which one does suit. Most definately try Asthma Uk site for help. Every best wish for a speedy solution.

[Clemenzaa in reply to katieoxo60]

Thank you so much for much for your response.

[Patk1]

Iv not read other rries,so hope not repeating this - have u b told to gargle after using puffers and swill mouth out.also,ru using a spacer or aerochamber with thm