Stepping down after infections/colds etc.

My GP told me to up my Symbicort from 2 to 3 puffs twice a day 'for a few days' during this weird infection.

Problem is, I forgot to ask for more details. Something's working whether it's this or the antibiotics - lungs are definitely improving, slowly, though whatever it is is still leaving me very tired and not feeling great. But I'm not sure when I should go back down to 2 puffs like I was on before!

How do you judge this? I was planning a fixed number of days but this feels like something where you should go on symptoms etc and I'm honestly not sure.

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  • I also had my symbicort increased to 4 puffs 3 times a day for 1 week then was told to reduce it back to 4 puffs twice a day and then reduce it back to 3 puffs twice a day and so on 4 weeks later I settled on 4 puffs twice a day and I seem to cope any less and I start to struggle again I think you need to find what works I believe you can take symbicort up to 12 times in 1day if needed.

  • Thanks Nigel! Wow 4 puffs twice a day seems quite a lot - is that the 400/12 or 200/6? Are you on the SMART regime? Not sure whether the 12 times a day applies to the higher strength as well - if it's the lower strength I am now on that as 6 puffs of 400/12 would be the same as 12 of 200/6. However I believe at least some people on here are on more (presumably as advised by a consultant) so I imagine that short term it's not a problem.

    Lungs are complaining a bit this evening so perhaps I should leave it a bit longer.

  • I've forgotten to ask too so just rang gp surgery and asked receptionist to find out from gp for me or get gp to call me.

    Might be worth asking the gp to call you to give you some guidance?

    Hope you start to feel better soon. X

  • Thanks - I can email him and will eventually. I was going to wait and see ie drop down to 2 and see what happens, then I'll know.

    I feel like I'm doing better on 3 though so very reluctant to drop down and maybe get worse! Maybe I'll leave it a couple more days and see how I get on, then email the GP. I guess it would be nice to have something concrete to show at my cons appt too ie 'when I increased Symbicort my symptoms improved so it is helping'. Dreading it...

    Hope you sort yours out and feel better soon as well Angelica!

  • I have been told recently by my asthma nurse if you have been ill for a week or over you need to step your inhaler up for each day you are ill plus a week, anything under a week its to be stepped up just each day you are ill (eg if you have been ill for 3 days it needs to stay stepped up for 6 days)

  • Thanks Sarz! So just being dim here - if you're ill for a week then is it for the week you're ill, plus seven days ie one for each day you're ill, plus another week?

    Seems like a good rule of thumb - now just need to work out how it applies for me, as I'm not sure when all this started. I suspect I will be on the stepped-up for a while longer but it would be good to give it a chance to work!

  • Yes so if your ill for a week ull end up stepping up for 3 weeks in total. That was like me I had no idea when I got ill & kept it stepped it up but ended up in hospital anyway but after my asthma nurse things started to get better. Im still on my stepped up dose & 10 tablets for at least a year its soo nice to be able to breathe at last. :)

    If you get reoccuring infections ask your asthma dr or nurse about Azithromycin its a long term antibiotic that also reduces the swelling in your airways. This has changed my life I went from being on 80mg of steroids and still struggling to breathe taking my ventiolin constantly & still not being able to do anythin to being back in work & slowly getting my life back after 6 long months & only using my ventolin on rare occassions when I over do it.

    Hope you get better soon x

  • Ah I get it thanks!

    Really glad you seem to be getting things back on track and able to go back to work - you must be really pleased. I'm nowhere near that bad, not on pred all the time or anything, just have moderately bad lungs that are determined to be rebellious lol!

  • I really am, I was so fed up of daytime tv lol. The only reason im able to get my life back on track & be steroid free is all thanks to my asthma nurse & consultant at the chest clinic I was getting nowhere when I was an inpatient they didnt listen to me when I asked for my inhaler to be changed the Drs wouldn't listen to me until my asthma nurse came to see me and had a word with the drs. Ive been back to work for 2 full weeks now & I havn't picked upp any germs from the kids which is a miricle so fingers crossed its going to stay that way.

    I hope your lungs start to behave themselves soon

  • Thanks! Go your asthma nurse. s/he sounds amazing! It's so frustrating when they don't listen to you isn't it? Hoping you manage to stay germ-free.

    I was getting better but today has been pretty terrible lung-wise - good otherwise, but I have completely lost count of how much reliever I've been taking! No idea why...guess it answers my question for the moment about stepping down ie not yet (but then according to your scheme, and I think your asthma nurse sounds like an excellent person to trust on this, I should be stepped up a while longer anyway.)

    Think I might have to email the GP though...am hoping today was just a random one-off.

  • She is amazing she really knows what she's talking about (my GPs didnt have a clue & they have admitted that to me) she really seems to care & worry about me when im bad & always seems to have time for me she also understands whats normal for me isnt the same as what the guidelines say is normal for my age & height. Yeah it is I was in MAU & had a dr saying to me I don't want to change your medication when your bad. I said iv'e been asthmatic for 16 years so I know when my medication needs to be changed & thats when i'm struggling!! Im on Azithromycin & thats worked really well to keep the germs away & are strengthening my immune system after a lot of steroids & kids giving me their germs lol.

    I hate it when you think youv'e turned a corner & then it comes back. i hate being attached to the Ventiolin coz it gives you the shakes, sometimes you think what's the point in using it if its not working!! I hope you get things sorted its really not nice when your struggling because it effects everythin. Make sure you don't step down too early & if it goes on for too long see if your asthma nurse or specialist can be more help.

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