Query in taking preventer

Hi - I am new to the forum after lurking for a while. Was suffering from bad leg cramps and have followed the advice to eat more bananas which seems to be helping.

I developed asthma about 20 years ago when I was about 40. So far it has not caused me too much bother but recently it has been slightly out of control following what the doctor thinks was a chest infection. I am on Symbicort Turbohaler 400/12 and my doctor has increased my dosage to 4 inhalations in the morning and evening + two inhalations of Brycanil four times per day and also as required. This is sort of keeping me under control however my PF is only averaging 370 down from 500.

I read on one of the recent topics that there should be a gap when taking individual inhalations - I checked my instruction leaflets and cannot see this written down and do not remember my doctor or asthma nurse mentioning it - is this correct or have I misunderstood. Does the way in which you take your inhalations increase the effectiveness.

10 Replies

  • Hi Springy,

    Welcome to the forum. I currently take Symbicort 400/12, 3 puffs twice a day and I always wait 5 mins between each puff. I can always feel it working by the 2nd and 3rd puff. The reason I do this, is because I used to be on the Symbicort SMART regime with the Symbicort 200/6 (using Symbicort for maintenance and reliever) and when my asthma started getting out of control again, NHS direct gave me the useful information they had written down somewhere that it takes a full 10 minutes for the reliever to work completely. By waiting the 5 minutes I feel I am able to absorb more of the 2nd and 3rd puff than I would otherwise.


  • Hi Jac - thank you for this advice. Will try leaving five minutes between puffs and see if any improvement.

  • As a young kid, I was taught to leave it 10 minutes and to always take inhalers standing up (does that make any difference or do I have a wierd habity?). When things are a bit grumpy I might take the reliever and some tea before taking the preventer. The clearer my lungs are the better it works.

    I hope it goes well for you

  • Oh what an interesting post! I also take Symbicort 400/12 and I don't remember ever been given that advice, JF. Something to ask at my next review I think! :)

  • I wasn't given any advice when I was prescribed the higher dose inhaler either Glitterdust but, because I was on the Symbicort SMART regime for over 3 years and for nearly all of that had no need for ventolin as a reliever, I knew the long acting reliever does start working quite quickly and when NHS direct gave me that information too it just seemed to make more sense to space it a bit. I'd be interested to see if it makes any difference for yourself and Springy.

    TS it does remind me of when years ago you had to take the reliever 10 - 15 minutes before the preventer.


  • I remember way back in the mid-80s being taught to wait for 60 seconds before taking a second puff of the inhaler, but the reason for that was that the propellant and drug needed time to remix, otherwise the second dose would be mostly just CFCs!

    Now that so many inhalers are dry powder, I guess that doesn't apply! I'm interested by the thought that it would be worth waiting for the reliever to kick in before taking prevented inhaler (or waiting for the first dose before taking the second). I tend to take my two 'reliever' nebs before I nebulise steroids, but I hadn't thought that much about it until just now. I'll make sure I keep doing it in that order!

  • PS. Welcome to the forum! I'm still new myself, but have found it hugely informative, supportive and fun already, and hope that you will find the same.

  • Sorry for not getting back sooner but thought that I would let everyone know the results of my trying to space out the inhalations of my reliever and preventer. Following a chest infection I was on 4 inhalations of Symbicort in the morning and evening + two inhalations of Brycanil four times per day and also as required but I was not really improving. I started to take the Brycanil first and leave a gap of about 15 minutes before taking the Symbicort. This really seemed to help and I have managed to get back to my normal dosage of Symbicort - two in the morning and two at night - and I only need the Brycanil when the weather is very hot/humid. So thanks for the advice everyone.

  • That is really good to hear Springy!! Thanks for letting us know as it is good to have our own theories put to the test and to see a good result.


  • Think about it, if you use a reliever inhaler like Bricanyl or Ventolin which opens up your airways, then more of your preventer inhaler will go down into the airways, therefore having a higher chance of it being more effective. Though not everyone will be prescribed Bricanyl or ventolin as a reliever to be used 4 days a day and will therefore use their preventer on its own. If anyone does find they have increased useage of reliever inhalers despite using preventer inhaler get advice from a medic.

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