Possible next steps?

I'm planning to see my GP next week, so just looking for some advice so I can be prepared for what she might suggest.

I'm currently on 2 puffs seretide 250 twice a day, fexofenadine and nasonex. Tried singulair last year and it didn't work. Have had a few courses of prednisolone and antibiotics over the last year. My main trigger definitely seems to be hayfever and possibly mould spores, as well as the usual colds.

Having had really good control over the winter, I've started needing more ventolin over the past month, and waking up in the night several times a week. Know I'm not bad enough for pred but don't really know what else could be done to improve general control. GP has already mentioned that additional tablets might not be worth it because of side effects. Does that mean I'll just have to put up with symptoms during hayfever season?

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Obviously I don't know anything about your medical history or asthma control. From my past experiences and looking at the meds you are on a couple of things spring to mind...

1) Instead of using singulair have you tried zafirlukast which is in the same family of drugs.

2) Your GP may increase your dose of seretide 250 from 2 puffs twice a day to three or four puffs twice a day.

3) Changing your nasal spray.

4) Adding in a different inhaler(s).

5) Adding in a second antishistamine or increasing the dose of the one you are on or changing to new antihistamine.

These may have to be prescribed by a consultant rather than your GP:

6) Intraconazole or other antifungal agent for keeping the mould spore reactions under control.

7)Adding in theophylline tablets.

Hopefully these ideas may give you some idea of possible options for your next appointment.