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This might sound like a daft quetion, but what exactly do they mean by control? My main problem is tight chest and coughing. Thankfully i'm rarely affected by sleep, but that might be cus I take anti depressants and they knock me out at night time. Anyway, how many times could I use my reliever in a week for example before Asthma is classed as 'being out of control'?


7 Replies

The British Thoracic Society, in their Guidelines for the Management of Asthma, define control as

- minimal symptoms during the day and night

- minimal need for reliever inhaler

- no exacerbations

- no limitation of physical activity

- normal lung function - FEV1 and/or PEF >80% of predicted or best

They also say that using two or more cannisters of your reliever inhaler per month or >10 - 12 puffs per day is indicative of poor control.

It sounds from what you're saying as though you are having more than 'minimal' symptoms and therefore your asthma might not be optimally controlled. You might want to go back to your doctor to see if you need to be 'stepped up' in terms of treatment (the BTS guidelines have five steps, starting out with just salbutamol as needed and adding in more drugs on each step).

Despite what you might think from reading on here(!), the goal of asthma treatment is usually complete control and that is obtainable in 90 - 95% of patients, so if you are having symptoms and you are not already on full whack of treatment you should definately go and see your GP.

Hope this helps

Take care

Em H


Thanks Emily.

Sort of. I'm currently on Symbicort 400/12, 1 puff twice a day and singulair at night as well as my salbutamol.

I was on 2 puffs of the Symbicort but dr put me down to 1 puff on Nov 1st. She told me to go down to the 200/6 if i am stable. Since I stepped down I have needed my reliever 23 times and only 2 days where I haven't taken it at all.

Does this mean it's out of control? I half wonder if i should make appointment to see asthma nurse rather than bother dr (again!)?



Hi Christine,

If I'm reading it rightly you've used 23 puffs of ventolin since your Symbicort was decreased on 1st Nov, which is less than 2 a day. That's certainly not the sort of level of use that most doctors would be concerned about (>10 - 12 puffs a day), so I wouldn't worry you are using it too much.

However, you did mention that you are getting symptoms of tight chest and coughing... the goal of treatment would usually be to more or less totally get rid of symptoms in most people (apart from some of us awkward ones!). It might be worth going back to your doctor or your asthma nurse to see if you do need your treatment stepping up. The asthma nurse should be able to handle it just as well as the GP at this stage.

It doesn't sound like you're on anything like maximum treatment (sounds like about step 3 out of 5) so there's plenty of room for stepping up if the doctor/nurse thinks it's needed.

Hope this helps

Em H


emilyh can i just clarify something with you please. when you are talking about puffs of salbutamol are you counting each puff as 1 or 2 puffs as one. just when i record mine i record 2 puffs as 1 dose therefore if as it is at mo i am having 7-8 doses a day that is 2 puffs at a time should i actally be thinking that i am having twice that amount. made worse at mo by fact am hoppping about on crutches still and chest not too happy.


katharine x


Ine puff one dose, get back to clinic misses

love Andrea xx


um, for me, it's 2 puffs one dose, always has been :o/

Anyway, good news. about a week or two ago, just suddenly felt much better. Still have tight chest and coughing but it's not constant thru the day and i don't need my reliever every day, have even managed to go into the gym, work out properly.

I know it'll sound daft but this year has been bad (for me anyway) as it's normally so well behaved and i was starting to think I was never gonna get a grip on it, but, fingers crossed, i think i'm finally getting there :o)

Altho my trigger list has got longer, when I come in contact, i don't feel like i'm reacting as bad as i was before, think i might do a merry dance around my front room hehe :oD



Glad am nnot alone there with my puffs christine. well done on managing proper workout at gym - seems ages since i could do that. prob is ages like begin of sept. oh well best keepon with ventolin in hope that pfs soon decide to behave. get going with that dance.



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