Going to see the asthma doctor on Friday again




I'm going to see the asthma doctor for the fourth time since April on Friday as my asthma has been uncontroled for quite some time, this time he may be changing my medication to symbicort or to fostair to see if it will improve my asthma.

My current medications are:

Here is a list of my current medication as I am not just not on meds for asthma.

Salbutamol Breath- Actuated Inhaler -2 puffs as required

Fluticasone and Salmeterol Cfc- Free Inhaler 250 - two puffs twice a day

I take this inhaler with a spacer

Montelukast Sodium Tablets 10mg

One to be taken daily

Prednisolone when needed

Epilim Chrono M/R Tablets 500mg

One to be taken at night

Epilim Chrono M/R Tablets 200mg

One to be taken each morning

Fexofenadine HCL 120mg tablets

one to be taken in the morning

Azelastine 0.05% Eye Drops

Put one drop three times a day

I do have an asthma management plan which I stick to it is as follows:

My action plan:

Zone 1

If you are feeling well and your peak reading is above 380 you should take: 2 puffs of your sere tide inhaler twice a day 1 micrograms of montelukast tablets once a day. Take your blue, reliever inhaler (salbutamol) for unexpected coughing, wheezing or breathlessness.

Zone 2

Zone 3

If you are becoming increasingly breathless and having to use your blue reliever inhaler every 4 to 6 hours or more often or peak flow is between 220 and 380, you should take: 6 prednisolone tablets (5mg strength) immediately and every morning until your symptoms are better and your peak flow is above 380 for two days, then take 3 tablets every morning for the same number of days that it took you to get better and then stop the tablets. Let your doctor or nurse know within 24 to 36 hours that you have started a course of tablets. Also take 2 puffs of your seretide inhaler twice per day.

Zone 4

It is a medical emergency if your symptoms continue to get worse and your peak flow reading have fallen below 220. Get help immediately by telephoning your doctor or calling for an ambulance by dialling 999 or 911. You should take 8 prednisolone (steroid) tablets immediately (5mg strength). Under these circumstances it's fine to use you reliever inhaler every 5 - 10 minutes until you receive medical attention.

My peak flow is very up and down most of the days and not many days go by without the need for my reliever. Since December I have had at least one course of pred every month in the winter I get quite a few chest infections which need antibiotics.

So I am really hoping the doctor can get my asthma under control without the need to see a consultant at the hospital.

I do know what the inhaler are like that he has recommended for me to try but I am willing to try anything that may help.

What other treatments are their available to try?

What treatments work best?

I am really worried what he might say but all I want is for my asthma to be under control again.

Thank you for reading my post sorry its so long.

Thank you for your support.


10 Replies

  • Hi,

    first of all, is this your GP or an asthma/respiratory cons? (i wasnt quite sure from your post. also i recommend having a chat with one of the AUK nurses as they can be really helpful. and when you go to your appointment, having a list of questions works quite well so you dont forget anything.

    again i'm not an expert but i've been through most of the asthma medications and i have my likes and dislikes but these tend to vary between people, and everyone is different so what works for one person may not work for another.

    your treatment/action plan seems quite solid, but obviously if your needing regular courses of oral steroids then something probably needs to be changed. i know you mentioned that you dont want to be referred to a hospital for your asthma care however if things are uncontrolled and its better to get a specialist involved (this often isnt forever as once you have good asthma control you can be discharged from the clinic).

    both symbicort and fostiar have different long acting beta-agonists called formoterol(s.p) which can be more effective in some people than salmeterol.

    also symbicort and fostair can be used as a 'smart' treatment plan, where you use your preventer fostair/symbicort as a reliever (but there is a limit on the amount of doses that you can take) and you would have to ask your doctor about this, as i was on the treatment two years ago and it may have changed (also it is only licensed in over 18's, but even if your younger if your treated in a chest clinic at a hospital your this is allowed)

    there is also an inhaler called 'alvesco' ciclesonide it is a new medication, but it doesnt have the long acting beta-agonist combination like the other preventer inhalers so you would need to take the formoterol or salmeterol in a separate inhaler.

    there is also an alternative to montelukast called Zafirlukast (Accolate) which may work better, it is two tablets a day instead of one but i personally found it more effective than the singulair.

    you said that your peak flow is variable from a day to day basis but you seem to get by without using your blue? is it possible your technique isnt great? (personally speaking mine is awful) do you have an asthma nurse to check your inahler/peak flow monitor technique? if not you could always ask your GP.

    anyway that's definitely not a complete summary of asthma medications by any means but its the ones i thought most related to you and your current treatment, and the post was starting to get quite long.

    but i hope it goes well at your doctors appointment

  • Thank you Sarah 93,

    Your message was really helpful. I see the asthma doctor at my local surgery on a regular basis. I will ring and speak to the asthma uk nurses later today and will have a list of questions prepared for tomorrow. I will talk to him and the other treatment available and see where I go from there. Rachel

  • Hi,

    Dont worry about going to the asthma consultant, i find mine is much better than my gp if I have any problems now I go to my consultant or asthma nurse at my chest clinic becauss the gps just sent me to the hospital when I am struggling. I found that the chest clinic were the only people who would try different meds on me not even the hospital drs would try different inhalers until I kicked up a fuss & pointed out that I was being rushed in every 2 weeks so obviously my inhalers wernt working & needed to be changed because I was taking 4 puffs of steratide twice a day & still needing alot of ventolin.

    I was refered to the chest clinic & they did alot of tests & started me on different meds & I was up there once a week until they found the medication that was starting to work. The add on therapies they have given me are montelukast & uniphyllin I have also been put on azithromicyn which is a long tearm antibiotic because my I had reoccurring chest infections & if I dropped my pred down to 30mg I was back in hospital or struggling 2 breathe again. Ive. Been on all this for about 4 months now & was able to come off the pred & get back to work after 6 long months off ill. In the time ive been back in work ive only had 1 chest infection which is fantastic because I work with kids, I was struggling to breathe because of it but this time it didnt land me in hospital a week of high dose antibiotics & 3 weeks on pred & ive had no problems since.

    I always say this because of personal experience, If your asthma is uncontrolled Then see your asthma nurse or consultant, they are the specialists and know more about different meds to try. Good luck

  • Hi,

    Just being to the doctors today and he has added uniphyllin Continus 200mg tablets one tablet twice a day to my list of asthma medications to see if this will help to improve things.

    Salbutamol Breath- Actuated Inhaler -2 puffs as required

    Fluticasone and Salmeterol Cfc- Free Inhaler 250 - two puffs twice a day

    I take this inhaler with a spacer

    Montelukast Sodium Tablets 10mg

    One to be taken daily

    Prednisolone when needed

    I have been told I will need a blood test in 4 weeks time 4 - 6 hours after taking my morning tablet. Does anyone know why this is?

    Does anyone else take this and has it improved things?

    I have another review in 6 weeks time.

    Thanking you in advance for any information.


  • You need the blood test to check the theophylline levels in your blood because there is a thin line between it being non therapeutic, therapeutic & toxic. Ive been on this for 6 months now & was gradually put up to 400mg twice a day because this is my therapeutic dose, you might find your dose is changed according to the results of your bloods. You will also need regular blood tests to check it is sti in the therapeutic zone.

    I hope this helps

  • Thank you for the information Sarz,

    I started on my uniphyllin 200mg this morning will take another one later on.

    The doctor has said that I need a blood test in one month and will adjust the tablets accordingly.

    I am hoping these blood tests will not course any problems with work as he I have to have the blood test 4 -6 hours after I have taken the Uniphyllin. It takes me an hour travel time to and from work each day I work Monday to Friday 8.30 - 4pm I work in a college with adult with severe and complexed special needs they will just be returning from their summer break. So I don't know with the time it take me to get to work how I will get round the issue of my blood test being taken between 11.45am and 12.45pm.

    Is there anyway a blood test can be done at a hospitals walk in clinic and the results be sent to my doctors surgery?

    Thank you for any information.


  • Hello Rachel, to answer your question Is there anyway a blood test can be done at a hospitals walk in clinic and the results be sent to my doctors surgery? it depends on your area. Here for example, all results from most hospitals and GPs are on the one system all can access. However, the hospital policy is to not do routine bloods from GP. You may be able to but best to check first that you can, how it will be requested i.e. you may need a form from your GP and that the GP can check the result easily.

    In any case, hope it helps. It is not something I have tried, GPs here (as many round the country) do not prescribe theophylline (of which uniphyllin is a brand).

  • I am on 200mg uniphyllin twice a day and it made a big difference to my asthma symptoms the first day I took it! I have never been offered a blood test but I assumed it was because I am taking the starting dose.

  • I can't say for definite JF re the blood test but here is Asthma UK information under All about asthma > Medicines & treatments > other treatments and add on therapiesTheophylline works by relaxing the muscles that surround the airways. It is usually prescribed as a tablet and is generally taken twice a day. It is important that your doctor gives you the dose of this medicine that is exactly right for you, so you should have regular blood tests to monitor the levels of theophylline in your blood. If your blood level of theophylline is too low the medicine won't work, but if it is too high it can cause unpleasant side effects. If you are taking other medicines, these can affect how well theophylline works. Smoking can also stop theophylline from working the way it should.

    Ensure you tell your doctor if you are taking prescribed, complementary or over the counter medicines or if you are exposed to cigarette smoke. Different brands of theophylline may provide different doses so it is important to check that your pharmacist gives you the exact brand that you have been prescribed. You should continue to take the same brand unless your doctor discusses a change with you.

  • Thanks for that TJ, I have just had my annual medication review with my GP but will mention it next time I see him.

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