difficult method (but works) to control difficult asthma but did everyone else do this?

hi

Im currently on a high dose of everything to keep my chronic asthma and chronic rhinitis in control. I just curious to know if anyone else had to do this to get their asthma under control.

Im currently on seretide 500 twice a day plus flixotide 250 three times a day (booster at mid day) now i have flixonase nasules too twice a day, instead of a spray. I ditched the singulair as i couldnt take it anymore with all the side effects but i seem to be ok (but then im on antibiotics again! so cant tell).

Is it common to be put on a really high dose for a long period even after there is signs of complete control? I've just taken over my lungs again and i dont want to drop down how did you wait till you dropped doses?

14 Replies

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  • Yes many dr's will prefer you to be on high dose inhaled steriod rather than oral steriods as less likely for side effects to occur. Will reduce once asthma has been stable Currently I'm on

    symbicort 400/12 2 puffs twice daily

    Budesonide 400 mcg 2 puffs twice daily

    Some sort of nasal spray

    And a daily dose of prednisolone .... Currently 40mg to reduce to 20mg for maintenance....

  • Be careful of reducing meds, I kept doing this for 4 weeks with my nebuliser meds, have given in now as I know as soon as feel better it's not time to reduce. I need to give my lungs time to recover. My Son is on high doses of serevent every day but needs it (has been for over 6 years), every time they reduce he ends up ill and on steroids.Not allowed to reduce now.

  • need to compensate singulair going.

    Hi

    i know what you mean. i've had to drop singulair but now my bizarre throat spasm and choking issue is back i'm going to give it a week or two to see if it goes down or i'm going to have to find an alternative.

  • need to compensate singulair going.

    Hi

    i know what you mean. i've had to drop singulair but now my bizarre throat spasm and choking issue is back i'm going to give it a week or two to see if it goes down or i'm going to have to find an alternative.

  • Hi,

    After I saw the dr in the hospital last time she wanted to reduce my seretide by two puffs a day and take flixotide instead but I'm still taking my 3 puffs twice a day of seretide because I'm so scared because my asthma has got worse lately and I'm afraid that if I reduce the dose something really bad will happen. They won't give me pred because I'm on hydrocortisone tablets for my adrenal gland which packed in because of too many inhaled steroids, ironic isn't it! xxxxxx

  • Hi,

    I also get throat spasms and feel as if I am choking, how many others get this? xxxxx

  • Confused, that is one high dose of ICS, but would be preferable to taking an oral steroid, less side effects but do try the singulair, or swap for accolate and try reducing the ICS if you can. The max licensed dose for Fluticasone is 1000mcg daily and your over that, long term high use for ICS can result in adrenal gland failure.

    I tried reducing Seretide last year and got no where with it, few days and I'd give up. This year i have the separate inhalers and managed a month on half dose ICS until Sunday when the cool and damp weather caught up with me. Grrr I want the hot dry sunny weather back.

  • That's the thing its working and a part of me wants to drop the doses but i'm reluctant its taken me a year to whip my asthma into line.

    i'd do anything to get rid of the throat spasms!

  • hi - I know none of us want to take pred but as far as your asthma's concerned, mightn't you have better control if you had a maintenance dose of pred for a while?

    also, if you're asthma gives you a lot of grief why don't you ask your gp about getting ventolin nebules?

    I can understand you wanting to come off the singulair - that excessive thirst sounded horrible

  • hi polly,

    it is, it still hasnt cleared and im dashing to the loo constantly! Im think my kidneys are getting a work out though. I was given flixonase nasules at the emergency clinic as i only have one nostril to breathe out of and this is a wonder drug but as is a also increasing my already high dose of steroids im a little concerned about this. It not my regular doc who gave this but he was actually better so im not sure how to go about it but i fancy getting a second opinion now.

    Im getting all the withdrawal problems not too from not having it ie. dizzy spells and rapid heart beat excessive thirst is still there but i also get hot and cold flushes too! I wish i was never that serious to have to resort to such a strong medication. Im going to have to find something to compensate the singulair going but what more can i add.

    woody, have you found the flixotide and serevent combination better than seretide?

    At the moment im pretty sure ive past that 1000 mark as im taking one of seretide 500 twice a day and using the flixotide 250 (as a booster/top up 2 time with the seretide back to back and have the third dose at that precisely before that 6pm asthma attack!) 3 times a day,

    Im wondering if id be better off using serevent in the morning as a booster or top up..this way I can try and ditch the seretide on the good days! (mind you the rate im going at if i did that i'd end up on preds again!)

  • Hiya, I am really pleased to hear your asthma is finally under control, albeit with very high doses of inhaled steroids. I think I read somewhere that if it stays controlled for at least 3 months then the GP should consider reducing the meds.

    I am not sure I understand the logic of taking Flixotide 3 times a day as this is only a steroid inhaler and works over a period of time and has no immediate effect. It would be equally effective if you took 2 additional puffs in the morning and 1 at night with your Seretide.

    My son is on Symbicort 400/12 and although he takes the maximum dose of 4 puffs a day, when he is unwell his consultant has increased this to an additional 2 puffs at lunchtime at it gives him extra steroid for long term control but also an extra dose of long acting Bricanyl in the middle of the day which definately helps him. He also takes additional Oxis (the equivelent to Serevent) twice a day on top of his Symbicort. This was done as he has no side effects from increasing the long acting bronchodilator and it gives him a booster to get through the day.

    I would rather he took higher than prescribed doses of these drugs than needing to be on long term Pred. His adrenal glands have stopped working due to Pred use, he has a lower bone density, has fluctuating blood sugar and has weight problems which have caused bullying at school all due to Prednisolone.

  • Hi i agreed to this idea as pred makes my joints swell up. i'm probably going to go in for a check up a lot later this time as i want to keep an eye on it. would a rhinitis infection symbolize poor asthma control?

    its such a good feeling being ten steps ahead of my asthma!

  • Hi i agreed to this idea as pred makes my joints swell up. i'm probably going to go in for a check up a lot later this time as i want to keep an eye on it. would a rhinitis infection symbolize poor asthma control?

    its such a good feeling being ten steps ahead of my asthma!

  • An asthma nurse once said to me that is a good idea to try reducing your meds at your best time of year. For example don't try reducing your meds in hayfever season if you are a hayfever sufferer.

    If it makes you feel better I have been on a really high dose of ICS for 4 years now- I take 6 puffs of symbicourt 400/12 and 4 puffs of pulmicourt 400 each day.

    Glad it is working for you, don't be too keen to reduce the meds, it is better to have good control.

    Bryony

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