seretide for the under 2's

My little girl (aged 14 months) has been diagnosed as having chronic asthma.

At present she is on Ventolin, Clenil and Montelukast. Her condition is not controlled and she has pred every month due to asthma attacks.

Her consultant called today to check how she is doing and is keen to stop the Montelukast and start her on Seretide. However he stated that the Seretide is not licensed for children under 2yrs of age at the moment so he's going to have to investigate it.

Does anyone have any experience of this?

Do any of your little ones take Seretide instead of clenil and Montelukast?

My concerns are the reasons why it isnt licensed for under 2's? Also on googling (which i know is naughty!) i have read it isnt licensed for under 4's!!!!

Anyone?.......

7 Replies

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  • Seretide isn't listed for use under 4, but that's probably down to the salmeterol as that's also stated as 4+, along with Formoterol, where's the flixotide, just like the clenil has no lower age spec.

    May be better in the long run though as montelukast is for 6+, no data for accolate (other Leukotrine modifier) so that's not prescribed for children under 12

  • Hi My Son was on serevent and Flixotide together as well as atrivent from about 18 months old, and oral steroids for nearly a year. I may be wrong but i think seretide is a mix of them both, please correct me if I'm wrong. He was on such high doses (flixotide 250 x2 am + pm,when well doubled when ill!) the consultant thought it was safer to combine the dose, also it used to take us an extra half hour to get out the house in the morning because of spacing the medication!Back then it wasn't licensed for under 12's and only used to be able to get it from the hospital pharmacy and they always rang the consultant before we could have it. Matty is now quite tall now which is such a surprise as he's still on lots of meds, (stopped the atrivent last year, been on montelucast 10mg for as long as I can remember) He tends to lose weight quickly but his height is fine, he is 10 next month.

    I know it's heartbreaking worrying about the side affects of medication but I know without it our story would be so very different. My Son is a happy child and nothing stops him loving life.I hope you manage to get the meds sorted. It does gets easier when they can tell you how they feel but sometimes my Son tries it on not to go to school, then I feel guilty when I do send him!That's another emotional nightmare!!

    Take care

    Kate

  • Thank you both for your replies. It so hard to make decisions about meds when its all still so new for our little girl. ( although my husband has asthma and is on a multitude of drugs for control)

    Rattles, Im glad your son is doing well and all is under control. Has his asthma got better with age? We're hoping to see this although one consultant said not to expect improvement as my husband has it so bad and therefore its probably genetic.

    As for the side effects, it is a concern as she's so tiny. I wouldnt want to give her anything she didnt need especially as there could well be a better alternative out there...somewhere!

    The consultant mentioned a home nebuliser too as an option but also said that they arent totally recommended for children as it keeps them out of hospital for too long. Which way that one is going to go i dont know! One minute he was praising them, the next, back tracking!

    Well, her hospital appointment is on the 19th so guess will find out more then.

    Thanks once again.

  • One thing I should have said, and sorry forgot, is don't actually worry if something isn't stated for use under a certain age, it may be that like Accolate, no clinical data is available, or is in such small numbers that no realistic decision can be made. Many have specialist consultants who will frequently prescribe outside of the license guidelines in difficult cases.

  • Hiya Emily, so sorry you and your daughter are having such a rough time. Gosh, it's such a worry.

    If it's any help, it might be worth asking the consultant about the specifics of the prescribing information (the SPC) - according to the EMC website (electronic medicines compendium) the SPCs for seretide do not state an age range in the indication section (which is the usual point of reference for whether a consultant is prescribing off or on label), but the SPCs do state that it doesn't have dosing recommendations for under 2s. This might be helpful to your consultant. If I want to talk over any aspect of a new drug, I always look on the EMC website for the latest SPC, print it off and take it with me to appointments!! I know it seems a bit cheeky - a patient showing a doctor the latest SPC, but sometimes there are changes made to a drug and doctors just haven't heard about it - they are only human and there are so many drugs to work with after all! I used to write SPCs and patient leaflets and it's really valuable experience now that my little boy has asthma. Good luck!

  • Hi Emily my Son still has severe and difficult asthma but it's better controlled now. When Matty was 18 months old we had no control and it was awful.We do have a portable nebuliser at home and a hospital nebuliser at school, but as Matty's asthma gets severe without any warning. He can have fantastic peakflow reading (started doing when 5) and collapse or have an asthma attack. He had a row with a school friend a few months back in class and ended up on his nebuliser.We have a parimed portable one which is fantastic and smallish, it goes with us everywhere. It's knowing when enough is enough, we have a set procedure with our consultant and now my Son is older he just says oxy and I know it's ambulance time.We have done alternative too. We see a chiropractor as my Son's uncontrolled asthma had given him scoliosis (curved spine) which has straightened out now but has to be checked regularly at the hospital. The chiropractor works on the area around the ribcage to give him more room to breath. We have eat healthily and I breastfed my Son until he was nine months.

    I hope you get some answers. Take care

    Kate

  • wow, thank you so much Woody-som and wheels for your input, will definately keep those points in mind.

    Rattles, you really have had a tough time havent you! Your poor son and poor you. This asthma can be sooo awful.

    Thanks for the advice about the nebs. Our consultant mentioned some are based with oxygen and some not and that we need one with oxygen. Guess its all new and that we'll learn but it all seems so alien at present. Im still breastfeeding and as yet havent really introduced any dairy.

    Wishing you all a very healthy and happy 2010

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