Follow up -back to Fostair - hooray.

[Shirazmataz]

I wrote about this two months ago, where a group pharmacist who i have never seen or spoken to changed my Fostair to Fobumix powder and just sent a text to tell me about the change. I was pretty annoyed about this at the time. I had wondered about Fostair MART regime, but never had a chance to discuss it.

Anyway i have given the Fobumix a go, it has been ok but peak flows down a little and have finally rang the pharmacist but had to wait a week for an appointment to speak to him on the phone. Success though. I am to try Fostair MART. I wish he had just rung me in the first place though and it appears bad practice and cutting corners, i guess because they are so busy.

He did agree that my being able to breath with Fostair inhaler was preferable than worrying about impact on global warming. I must say using a spacer with Fostair allows me to get maximum benefit, i just found trying to breath in the Fobumix powder with one huge inhalation meant I was getting powder caught in my mouth. Some people might manage it - but i have found using a spacer much more effective. Fingers crossed that the Fostair MART is going to be effective.

Does anyone here use Fostair MART, i would be interested to hear about your experiences?

thanks Sally 😀👍

[Mellywelly]

Hi chook, I don't understand how the pharmacist changed your medication and not a doctor? I would go nuts on my pharmacist if they did that. 🤔

[Shirazmataz in reply to Mellywelly]

Hi Mellywelly, i dont either. Our surgery merged a few years ago with a bigger one and since a third one has merged in too. So they are now a big group, with what looks like a lot of staff, but it is a huge rural area. Our village practice has a pharmacy attached with their own pharmacist and i know he wouldnt prescribe. But the guy that changed my meds works for the group practices as a whole and probably is more senior and looks like he can prescribe. He may have done additional training like nurses can train to become nurse practitioners. Maybe his role is as a senior pharmacy advisor for the GPs. I am assuming. That is all i can think of. I shall do some feretting about and find out. But i think unacceptable to change meds without talking to the patient and sending a text!!!! He has never seen me ever either. Must have just looked at my med notes. I saw a GP a couple of weeks later about something else and said i was cross about it, and she just said Fobumix was good as you dont need a spacer and didnt pick up on the lack of consultation. So i am glad to have handled it and got what i wanted in the end. Takes a lot of energy though.

[Dottie11 in reply to Mellywelly]

We have pharmacists at our Gp practice that can change our meds but pharmacists at the chemist cannot.

[soppysokes in reply to Dottie11]

Same here. as I understand it they are there to process repeat meds,prescriptions etc to take that load from gp’s. In many cases it can pick up where a person was issued a med years ago and although no longer needed is still being used, cuts down on potential problems also cuts and waste,that is a great idea imho but it should not be reasoned in the case of a current medication thats needed.Certainly not without an explanation/discussion with the patient first, but it is happening unfortunately. The change can be refused and then referred to GP or consultant if necessary apparently!

[Ern007 in reply to Mellywelly]

When we have a med review, I don't anymore, it is a pharmacist that conducts the review, I never liked that.

[Shirazmataz in reply to Ern007]

Ern that means that you cant discuss anything else that you might want to at an anual review other than medication. Its like just a service these days thst deals in drugs and very little other health advice and discission!

[Ern007 in reply to Shirazmataz]

Mind you medication review is just that, Anne my wife has to have one with a Pharmacist - Your GP may work different, our neck of woods it the same.

If you have problems after the review, you can see your GP. or better still your Asthma Nurse, I liked the old system better, although the last review I had, I said I did not want a pharmacist. so I got the GP or nurse, I forgot. old system was better, try your GP and see if you can avoid a pharmacist review.

[Shirazmataz in reply to Ern007]

I had a nurse for the asthma check at my surgery, but she was not a respiritory nurse so was unable to answer my questions. I would have to drive a 50 mile or so there and back to one of the other practices to see a teained respiratory nurse. Just shows the constraints in the NHS these days. When you look on the practice staff info to see who is a resp nurse it doesnt say. It just gives christian names for the nurses not even surnames which i think is diabolical. Treat them as professionals please and identify their skills so we as patients know who we need to see!

[Ern007 in reply to Shirazmataz]

A good point - you could have 2xSaras's without surnames - pointless.

50 mile round trip. wow - Mine in just 200 yards away down the lane. I hope you get a proper review and the right medications.

[Homely2]

I have fostair 100 mart for my asthma. I have always liked it as it suits my asthma.

My asthma is very variable so my need for my inhaler changes from a lot to a little and back again. Fostair 100 mart gives me more control.

My asthma nurse talked to me pre mart re changing my fostair to a dry powder version as part of their push away from fostair inhalers. She said that they were not allowed to change it unless the patients asthma was stable and the patient consented.

[Shirazmataz]

Thats interesting Homely2. Thanks for your comments. My asthma is worse in wet weather and had too much of that in the last year, but i hope to have the flexibility that the MART regime can offer.

[Dottie11]

I dont sorry but good luck. I love my spacers though. xx

[peege]

Morning! Yes, I've used Fostair MART since an excellent respiratory nurse changed me from Seretide in 2018. I find it utterly brilliant. I was taught to use Seretide this way many years ago by London respiratory nurse as part of teaching me to manage my own lung health (she also sent me to PR to help prevent future deterioration. It's been very difficult since moving to Gloucestershire and a poorly rated GP practice in 2015 . Until that is this great nurse in '18 who said 'let's get you on Fostair which is designed to use as & when as well as being a preventer . I rarely need ventolin. When 1st prescribed it i was given a handy little booklet plus when collecting at the pharmacy I had to read a form then sign to confirm I understood what Fostair 100 is licensed for MART use.

I'm similar to you Shirazmataz, asthma is much worse when wet/damp out, winter & at night. In summer I can ease off the two puffs twice daily.

To me it's the best thing since sliced bread although I realise we're all different. Good luck 🙂

[Mavary]

Hi! Like you I was on Fostair. I have 200/6 four puffs a day. My surgery decides one day to change me to Luforbec 100/6. Of course I started to go down hill. I had to ask for steroids as I was getting I couldn’t breathe in the morning. I had a fuss about that. I spoke to the practice nurse. I said I had asked advice from Health Unlocked. She said who are these people and I haven’t got any paperwork. She was really funny. I said well this is what I had last time I was in hospital and I don’t want to be in again. She must have looked at my notes because she said oh yes I can see you did. She was perfectly fine after. The last time I couldn’t breathe in the morning I passed out. Anyway I was asked if I’d like to see the Asthma nurse and I said yes. She asked if I would like to see the consultant and I said I would. In the meantime they managed to get me Fostair. The Consultant looked at the Luforbec and said it is exactly the same medication. So I’m now on the Luforbec with no side effects on the full dose as before. The only difference with it is you have to keep it in the fridge until you start using it.

[Shirazmataz in reply to Mavary]

Hi Mavary. The lack of discussion with patients before changing such crucial medication for breathing is very unprofessional, and it set you back. Ive not heard of Luforbec but wondering if it is a powder medication as pharmacies have been told to change from the gas inhalers to powder if possible. We need to be assertive with them to get back to something which works for us, and not accept something less effective. If it works thats ok! I would be careful about quoting us patients on health unlocked though, as we are pretty well informed as a group but not medics!! They wont like it!

[Mavary in reply to Shirazmataz]

It’s exactly the same as Fostair. The only difference is you keep it in the fridge till you use it.

[janedivney in reply to Mavary]

Hi Mavary. I’m sceptical when pharmacists etc say “it’s exactly the same”. Look at salamol vs ventolin. Luforbec & Fostair might have the same ingredients but that doesn’t mean their manufacturing process is the identical. It takes many years for drug companies to develop a drug, and once the patent expires other companies can only get a list of the ingredients, not the exact manufacturing process. It’s always a good idea to try the generic tho, as you’ve found

[Shirazmataz in reply to janedivney]

There is a price difference, Fostair ranges from £43.99 to £46.99 depending on the website and doseage, and Luforbec is £33.33 (UK Meds) You can understand why practices are changing to a cheaper version if they are the same medication. Agree Janedivney that Salamol is certainly not as effective as Ventolin so to keep an open mind when told they are the same thing.

Fobumix which i have just come off is £21.50 so half the price of Fostair which i am now back on.

[Mavary in reply to janedivney]

Hi my Drs told me it was the same and when I saw the consultant he said it is the same. I could only go by that. The only difference is you have to put Luforbec in the fridge before using it.

[janedivney in reply to Mavary]

Oh yes, of course you have to go by that and try it. I’m pleased it works for you.