Stay on Seretide or switch to SMART

Hi everyone

I'm currently using Seretide and have 250mcg twice daily. I'm also on Montelukast and only rarely needing the Salbutamol. So far I've not had any Steroids this year, have an exacerbation at the moment, but that is because I have a cold.

This is in comparison with last year where I needed 4 courses in 9 months; although some of that was my fault as I was not very compliant!

I have an asthma nurse review soon and I know the team would like me to try SMART.

Just wondering what your experiences and thoughts of this are?

Thanks in advance.

10 Replies

  • I'd agree, don't fix what ain't broke!! I moved to Symbicort (not SMART) from Seretide due to leg cramps but I've lost the control I had on Seretide.

    Only the 100 and 200 mcg inhalers are licenced for SMART so you'd have to check you get a comparable dose i.e Seretide 250 * 2 = 500mcg.

    Also I thought Symbicort was more expensive than Seretide?

  • I would have a really good discussion with them about why they want you to change - do they think you'd get even better control if you change? I changed to Symbicort (not SMART though, I take 400/12 two puffs twice daily) from Seretide and can't say I've noticed much difference. If anything I am coughing more on Symbicort.

    I suppose the benefit of SMART is the flexibility it offers.

  • I was asked to change over from seretide to symbicort SMART regieme, a longtime ago when it first came in and in the end went back to the Seretide as do not get on with the dry turboinhalers.

  • I would go along with what others are saying and if the seretide is working for you, stick with it. It can be so hard to regain control when you lose it.

    I am a huge fan of Symbicort and Symbicort SMART, but would never recommend changing inhalers whilst you have control.


  • I would tend to agree with the 'if it ain't broke don't fix it'. That said it is worth listening to what your asthma nurse has to say.

    The only thing I can think of that hasn't been mentionned is that switching to the SMART regime may mean you can reduce the amount of inhaled steroids you are taking- this seems to be why some people like it.


  • I was changed the other way - from Symbicort to Seretide - for no reason other than the consultant whose clinic I went to preferred it. It gave me no control at all and I ended up after a week on Seretide having to call a paramedic for a ventolin neb on a saturday morning on the advise of NHS direct! I changed back to Symbicort and had a course of prednisolone to get me back on track but it took ages to get my level of control back.

    I suppose the SMART regime is an advantage with Symbicort (it didn't work for me but I need full dose all the time) but if you do decide to change my experience says be very watchful and go back if your asthma starts to deteriorate.


  • I'm also of the opinion if it's not broken don't fix it. I tried SMART for a while, but found turbohalers difficult to use when I was struggling and in the end was going through that many inhalers that it wasn't worth it and went to seretide.

  • I would agree - stay on Seretide if it's working for you, don't mess around with anything else! Speaking as someone who actually seems to have lost what control I had after starting on Symbicort and if possible feeling worse after increasing it.

  • I'm on seretide 250. 2 puffs twice a day. They were going to try me on symbicort but I absolutely hate dry powder inhalers and find hey irritate my throat, making my asthma worse. I'd maybe try it if they brought out a metered dose inhaler version but otherwise I'll stick with seretide. Oh, and seretide is a fab purple colour which I love!!!

  • Thanks for all your input; I'm still on Seretide. It's been doubled for almost 2 weeks as I've had an exacerbation after getting a cold! Im using the Accuhaler and have seen for myself how just doubling the dose has left me very very hoarse! Dont think I'll be switching to SMART, unless it comes as an MDI!

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