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child using corticosteroids for first time

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Hello! I am a newbie to this site. I would be grateful for some advice. My 11-year-old son has been prescribed Clenil Modulite preventer inhaler. I am worried because my son gets asthma quite rarely. He will go 2 - 3 months with no symptoms, even after major exertion. Then he will have a week or so of being wheezy at bedtime. It slows him down during physical activity then too a little, but doesn't stop him. So these attacks are thankfully not severe and managed well by Ventolin. He was going through one of these wheezy phases when we went for an asthma review, so the nurse scared us by saying he may have scar tissue, and corticosteroids are vital for healing/preventing this. But then, they recommend a steroid preventer whenever we go for a review (which we only do every few years) - even when his chest is clear and he hasn't had any symptoms for some time! I'm therefore finding it hard to believe they are necessary. I also find the starting dose high at 100 mcg, when 40 is recommended - even for adults - in the US for example. Sorry this is rather long! I'd be grateful for people to share their thoughts and experience. THANKS, Helen

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yaf_user681_30355

Hi Helen and welcome to the forum,

Have you looked at all of the info around the Asthma UK site? Regarding ventolin and steroid inhalers they are doing two different things in the lungs. The ventolin is relieving the symptoms and the steroid inhaler is treating the cause. If your son is having spells of using his ventolin more than twice a week this is usually regarded as a sign his asthma is uncontrolled.

Have you thought of ringing the Asthma UK nurses? Number at the top of the page. They will be able to explain this to you in detail and the reasons why it is necessary to have a preventer medication.

The introduction of Clenil may mean he does not have these symptoms every 2-3 months.

Edit: Just thought to add too, it is important to have an annual review also.

Hi Helen,

100mcg is not a particularly high dose, 200mcg tends to be the initial starting dose for a lot of patients.

I would agree with JF, give the AsthmaUK nurses a call.

Take Care.

Hello and welcome Helen!

There are people with all levels of asthma here including with what may seem like many with severe/brittle asthma - please don't be alarmed by some of this as in regards to overall number of people with asthma it is quite rare.

You will find a lot of useful information on the website in particular in the 'All about asthma' section on the green bar along the top of the site. Under 'How we can help > publications' there are many leaflets that can be ordered free of charge. The forum in particular the parents and carers section for you will answer many questions you may have.

The Clenil should help to reduce his symptoms and minimise use of ventolin. 100–200 micrograms twice daily is the usual starting dose for children under the age of 12. The adult starting dose is 200 micrograms twice daily. The maximum licensed dose can go up to 800mcg for children under 12 and 2000mcg for adults. Not sure where 40mcg is recommended as the minimum Clenil inhaler available is 50 mcg. You may have looked at Qvar information which has extra-fine particles and is approximately twice as potent as Clenil Modulite. There are different formulations of several inhalers that although similar sounding are not the same.

There are plenty of treatment options. Please go back to the asthma nurse/GP or call the Asthma UK nurse helpline.

Moved from General to Parents and carers forum, more appropriate as medical would also be

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