How many puffs 'normal'?

How many puffs of blue reliever per day/week would you consider 'normal', that is, normal for a well balanced asthma? I've read different figures on this... and how many puffs taken regularly migh be bad, even in a more severe asthma?

One of the figures I've seen is that 5 puffs per week would be normal.

Well, I've felt this past week so healthy, been able to do everything as normally etc - and still seeing my figures of taking reliever makes me laugh. This 'healthy' week I've taken now 18 puffs alltogether, raging between 1 and 6 puffs per day.. which is better than before pred, when I took some 32 puffs a week. During my previous pred course I took only 16 puffs a week.. Which is still much more than 5! So is there any other figures than this little five to give some guideline on using a reliever?

-Niccia

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I got told By my asthma nurse that 1-2 puffs a day is balanced enough. But It depends on the severity of your asthma. I know people who are going through whole inhalers a week, and are severe/brittle.

Hope this helps!

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Hi Niccia,

This is a difficult question, because there is no 'normal', really, and no absolute 'safe' limit - everyone is different. Those of us with severe/brittle asthma are going to have very different levels of acceptable reliever inhaler use than those people with well controlled asthma.

The British Thoracic Society guidelines for the management of asthma suggest that use of your reliever inhaler more than three times a day (probably two puffs each time, so a total of six puffs) is an indication to 'step up' to the next level of treatment, ie, to start inhaled steroids if not on them, or to start one of the add-on therapies if already on inhaled steroids. Of course, use of your reliever inhaler is not the only criterion for stepping up treatment - daytime symptoms more than three times a week, waking one night a week, or asthma attack in the last two years are also factors which should prompt consideration of increasing treatment. The BTS guidelines also comment that use of two or more cannisters of reliever inhaler a month or more than 10 - 12 puffs a day is a marker of poorly controlled asthma.

As Vicky has pointed out, you don't have to read the boards for long to realise that many of the severe and brittle asthmatics on here regularly exceed these limits by a long way, particularly if they are on nebulisers, which are many times stronger than inhalers. This is usually done with the agreement of the person's medical team, and with the knowledge that the person is already on all the preventer medication that it is possible for him or her to take. Taking large doses of these medications is not without its dangers and side effects, as well as the worry that having to take large doses can imply that your asthma is dangerously poorly controlled.

Your own personal limit for reliever inhaler use should be discussed with your GP or consultant, preferably as part of a personalised asthma management plan. If you are concerned about the amount of reliever you are using, please do go and visit your doctor and discuss whether additional treatment is necessary. The goal for the vast majority of asthmatics should be control with minimal or no symptoms and minimal need for your reliever.

Hope this helps

Em H

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Thank you for answers! I'll contact my doctor, of course. This is just a good place to get answers and ideas to such questions that you don't remember to ask your doc.. So thanks!