Steroid inhaler reduction

Hello, Would like to know how anyone's found this? I know there is a lot here on pred. reduction. I've been on max dose Seretide 250 i.e. 2 puffs twice a day. If no better on reducing to previous usual dose and have to go back up more regularly, what would happen then? Consider more pred. short course...?

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are you on montelukast? or aminophylline? maybe docs would consider those before putting you on long term pred..

look at BTS guidelines.

but if you symptomatic and no improvement on increasing steroid inh, then defo short course pred may help you

good luck

x x

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Thanks Snowygirl, have been on montelukast for years. Aminophylline is theophylline? Haven't been on that.

I get the feeling that I'm on the most they can or have managed before. G.P. not keen on me on max dose Seretide but nurse suggested it. I am better on this dose just wondering what'll happen when I reduce it. Waiting for ENT appt next week for sinusitis. Seem reluctant to do much else asthma wise as waiting to see how I am once that's sorted. Asthma referral then if lungs don't behave and will look at other options.

I did say there must be more i could try i.e. theophylline. Will go back to see them if feeling rough again on normal inhaler dose. Have had a couple short courses pred. this year and have some at home if needed.

Edited. Have read the BTS guidelines, there is a new 2011 revision out now

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yes aminophylline/theophylline is same thing. its oral version of the iv drug given in costa.

when you are on that you start ona low dose, then they check your aminophylline levels regularly as it has a narrow therapeutic range, then if levels are okay then you stay on that dose, or if need be, to control symptoms you can increase the dose.

NB; if need costa and need iv aminophylline remember to tell them u are on iv aminophylline as they need to omit the loading dose and start you on the infusion and of course check your levels

are there other inhalers you tried? rather than seretide? maybe smart regime, which is symbicort. maybe suggest that one. that contains a long acting bronchodilator and steroid too. there are posts on here bout it. i used to be on it and worked for a short while in reducing few attacks, but not enough, so had to be changed as needed more steroid dose...

re; bts guidelines, didnt know new guidelines, better look at them myself lol

re; pred, next step after trying aminophylline and regular courses of pred, would be long term pred

discuss such with your asthma nurse

x x x

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I am having problems with reducing my seretide 250 I normally fluctuate between on 3 or 4 puffs of seretide twice a day depending on stroppy my asthma is to try and get some control and consultant added in spiriva resmat (2 puffs a day) and Alvesco 160 (2 puffs twice a day) and put me down to Seretide 250 (two puffs twice daily), which my lungs hated so increased back to Seretide 250 (3 puffs twice a day plus 40mg pred on step down program). Just been back to consultant and now trying spiriva resmat (2 puffs a day) and Alvesco 160 (3 puffs twice a day) and Seretide 250 (2 puffs twice a day) to see if this is any better. Basically I have not been able to successfully step down (not sure if that is technically correct as other inhalers added) to Seretide 250 (two puffs twice daily). As only just started new regime I will have to wait a while to see if lungs will mis-behave themselves... Also on a number of other meds as well including maintence pred. I hope you get your medication sorted out...

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My sense is that the doctors will always try to reduce your meds to see if it works, but for me it's never worked well. If you find you feel better at the higher dose and it's working, I think my asthma doc. would be O.K. with that. Some years I have managed with a lower dose, and then other years needed the higher dose. Asthma does and can change.

Bee