When seeing the asthma nurse last week I asked if a side effect of any of the inhalers I take was cramp as I had started to experience quite a lot of this. She said no it was probably just a result of my breathing and asthma. As I am breathing fairly normally I am a little confused. Anyone got any idea what she was talking about! Going back next week so might mention it again if still no wiser.

20 Replies

  • hey allegro

    i often get cramp have you had your potassium levels checked as low potassium can cause cramp, taking lots of salbutamol can cause it too. also being dehydrated can give you cramp. im not sure wat your asthma nurse meant by it was due to your breathing! anyway hope you get it sorted soon.

    clare x

  • Hi Allegro

    I too suffer from cramp (feet normally). No identified cause, except that it happens especially when when my feet get cold. I have also previously read the suggestion that Salbutamol can make it worse. I have been taking more than usual recently as I have been going through a bit of a flaky time, and have just put 2 and 2 together with this post - I've been getting more cramp than usual and with warm feet!


  • I was getting cramp every night but now take 200mg Quinine sulphate at bed time and have no problems.

  • Hi, Thanks for you posts. Have just spoken to a friend in nursing who suggested the whole potassium thing. Have now found that the simple act of eating 1 banana can seem to ease it so thought I would share this info in case it works for you. If only chocolate biscuits worked as well!

  • I too have started to get major leg cramps in the last year since being on inhaler for asthma.

    GP gave me quinine tablets but I think they gave me stomach pains so stopped. I have also researched online re the possiblities of mineral deficiencies so now have a banana a day too, a small one as I am also looking into the effects of excess weight and the efects of this on asthma.

    I am also doing calf stretches throughout the day to see if this helps. So far so good, no cramps for over two weeks

  • Allegro

    I swapped yesterday to Seretide and, being a good boy, have read the leaflet in the box from cover to cover. I thought you may be interested to read the following that I found under the heading ""Side Effects"":-

    ""There have been common reports of muscle cramps and occasional reports of aching joints and muscle pain.""

    Just to prove the point, as I started to write this, I suddenly got awful cramp in my left foot. Aaargh.


  • Some common foods high in potassium are:

    Apricots (fresh), Avocado, Banana, Cantaloupe, Honeydew, Kiwi, Milk, Oranges (and orange juice), Potatoes, Prunes, Spinach, Tomatoes (and tomato juice).


  • Thanks for all your ideas. I too have discovered that a banana a day helps though am researching the chocolate biscuits in the hope of discovering a new cure. Will keep you posted on this. Now I am on seretide it doesn't seem quite as bad as some of the other drugs, but could just be the amount of bananas I am eating.

  • My cramp is staring to diminish now as well. Don't know if due to getting used to change to Seretide now, or also following banana advice. Certainly noticeable improvement.

    Am also trying chocolates. Hotel Chocolat Chilli Truffles are my prescription. Having some very nice effects, but dont think on the cramp. ;)

    Hope your chocolate biscuits work as well for you, Allegro!


  • Serevent! - my asthma nurse says cramp is a known side-effect.

  • Am taking this research very seriously and not sure if the chilli truffles are the best idea. Have you tried the dipping chocolate? (ps just in case don't stop the bananas!)

  • Muscle cramp is a recognised side effect of beta-2 agonists - ie salbutamol, turbutaline, formoterol, salmeterol. Cramps can occur at the usual sort of inhaled doses, but are more common with higher doses, for example by nebuliser or subcut infusion. These are very well known for causing painful cramps, particularly in the feet and legs, but potentially anywhere in the body. They can cause cramps even if your potassium is normal.

    As others have said, cramp can also be due to low potassium, or indeed due to imbalances of some of the other electrolytes (salts) in the body - low sodium, potassium and calcium and high magnesium can all cause severe muscle cramps. Potassium is the most relevent one for us lot, as beta-2 agonists, theophylline/aminophylline and steroids all cause low potassium. It’s worth getting a blood test to check potassium levels, and also theophylline levels, if you’re on it, if these haven’t been done recently. It's also worth trying to eat potassium rich foods, provided there is no reason that you can't eat a high potassium diet (for example, kidney problems). A banana dipped in dark chocolate (also high in potassium) and then put in the freezer makes a lovely 'choc ice' which is a good way to eat bananas if you’re getting a bit sick of them!

    Electrolyte disturbances can also be caused by other factors such as kidney disease, severe diarrhoea and other drugs like diuretics (eg furosemide, bendroflumethiazide).

    Dehydration can also be a major contributor to cramps - so make sure you are drinking plenty throughout the day and has water by your bed at night. Obviously very sugary and carbonated drinks like coke are not the best for preventing dehydration. If you're drinking orange juice, for the potassium, it's best to have it with a meal, I believe, to minimise the effects of the acid on the teeth.

    Caffeine is another contributor to cramps – so trying to cut down on your caffeine intake, particularly last thing at night if it’s night-time when the cramps bother you, is often a good idea. If you are a confirmed coffee addict and drink instant coffee, a good way to start cutting down is to buy some de-caff and mix the two together, so that each cup is half as strong.

    In terms of dealing with the cramps - massaging the affected area, pulling back on the foot to stretch the hamstring, and walking around can all help to ease the cramps off more quickly. A warm wheat bag over your foot can help as well.

    If you're having frequent severe cramps, or cramps in odd areas (eg other than your feet and legs) it's probably worth getting checked out by your doctor to check that you don't have any of these electrolyte imbalances and to rule out other rarer causes for muscle cramps. If the cramps are severe, your doctor may prescribe quinine tablets to be taken at night – these will not produce instant results, they do take a few weeks to build up in the system, but they can be useful. In extreme cases the doctor might prescribe muscle relaxants like diazepam (Valium) to help, although most doctors will be pretty keen to avoid these, as they can be addictive and can cause respiratory depression.

    Allegro - I'm not sure what the nurse was thinking of when she said that the cramps could be due to your breathing and asthma. Asthma per se shouldn't cause cramps. Inappropriate hyperventilation, such as during a panic attack, can cause spasms and cramps of the hands and feet if it is severe, as well as pins and needles in the hands, feet, and around the lips, but it's usually pretty obvious that this is what's happening, and it doesn't seem to fit with what you're describing.

    Hope this helps,

    Em H

  • Em you got in there first.... Seriously though if the cramps are bad get it checked out by your GP. And note I have yet to find a muscle in the body that does not cramp, the tongue and cheeks be in vogue again here as well as chest if I cough or laugh which tends to panic everyone cos people don't half panic when you suddenly clutch your chest and it really hurts and it is hard to hide cos it hurts a lot. You know it cramp cos you can feel the muscles are tight and it does wear down quite quickly.


  • Hi Ventolin inhaler and singular tablets can lower your potassium levels if taken more than normal dose, get her to check this out.


  • Actually montelukast (Singulair) is one of very few asthma medications which has not been shown to lower potassium. As already mentioned, beta agonists (eg salbutamol, terbutaline, formoterol, salmeterol), theophylline/aminophylline and steroids can all lower potassium. It is more likely to be a problem at higher doses, eg nebulised or subcut beta agonists, but different people have varying sensitivities to these drugs and some may find that they need potassium supplementation at 'normal' doses.

    If you are also taking other medication that can lower potassium, obviously you are even more at risk of running into problems. Other medications that can lower potassium are diuretics such as furosemide and bendroflumethazide and laxatives. Severe diarrhoea can also cause low potasssium.

    Em H

  • Montelukast can cause cramps but not from lowing of potassium. I have been and had my pot levels done more than once convinced that was why I was getting cramps and my levels were ""normal"" so it does not always follow cramps are due to low potassiums, it is worth checking ouy but there can be other causes.


  • Oh gods who started the cramp thread, there I was shamelessly lazing on the sofa when in both feet the muscle at the top and bottom of the foot, which way do I stretch first, cos I can't con any of the kids into giving me a good foot massage!


  • in halers

    All inhalers ues saline witch is salt and salt will give you cramp . As I take all sorts of inhaled meds I can talk for hours about cramp

  • Which inhalers contain saline????? None as far as I know. Nebules contain saline though.

    Salt does not cause cramp it can solve cramp problems! When you sweat too much and loose salt from your body you get cramp!

    Some inhalers do indeed cause cramps in some people but often is is caused by a lowering of another chemical in the body - Potassium!


  • Indeed... what Kate said!

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