Side effects of Fostair ?

Hi there,

I am new to this forum, despite having had Asthma since I was 6 ....

I wanted to post on here, as I am hoping for some advice (apologies for long story)

I have had my asthma 'controlled' for many years, taking one puff day and night of my brown inhaler which was a Qvar (100 mgm Beclometasone Diproprionate, when needed a puff or two of my reliever, which is a Brycanyl Turbohaler.

I was overdue my asthma review, and they wouldn't vend my repeat prescription, so I made an appointment to see the nurse :-(

I was basically (bullied) for want of a better word, into taking a 'new' inhaler called Fostair...because I mentioned that occasionally I needed to take my reliever....

I have tried to give this new inhaler a fair crack of the whip (just over 5 weeks now), but today I have thrown it into the bin and will make another appointment at the docs asap to find out if I can go back onto the medication I was on.

I have had, and this has become worse and worse the following, which has resulted in me sat here today, with pains in my chest and being short of breath (which my reliever is not fixing )

1. Palpitations

2. Shaking of my hands (reminds me of when I used to have to take salbutamol tablets - those pink ones when I was little)

3. Strange rashes over my body

4. Pains in my chest (at the back)

4. Not sure if its related but I have had a really sore nose inside :-(

I just wondered, if this was like anything anyone else has had, and also wondered whether anyone else has been talked into taking this new combined inhaler ?

Thanks in advance

23 Replies

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  • Hi Colley1275

    I had the same problems with the fostair inhaler, it did not suit me at all. I have been asthmatic from the age of 19, I'm now 56 and have worked hard over the years to live a somewhat normal life and have also come to terms with my limiations. But my asthma has not been good since they took Becloforte off the market around 2007 because it could not be produced CFC free. I ask you, it makes me laugh with so much pollution flying around that a small inhaler would make the difference to global warming. So I am still trying to find a reliever that works for me.

    I have not tried the new combined inhaler so I can not comment on it. If something works for you do not let anyone bully you in to changing, it does not matter who they are. Remember lot of doctors try to get you to change due to the pressure of the costs of medical products and the government insist that cut backs are made. You can not be forced to change your asthma product or brand for a cheaper vision if you do not want to.

    Good luck

  • I was changed to fostair from seretide when I went to Papworth and saw my consultant there. He had a clear rationale for changing which made sense for my situation. I've been on it a good 18 months and haven't experienced any side effects, I use it with a spacer.

    Lynda :)

  • Hi Guys,

    Many thanks for your replies :-)

    Been to see the doctor today and he has put me back on my Qvar (preventer) so I will be able to continue as I was.

    I am going to just try and see how I manage on just one puff a day on my preventer....

    Would be nice not to have to use it all.

    Was thinking today if anyone has been able to move away from having to use the Steroid inhaler?

    I never used one before 2002....just used my reliever when needed, but since starting with the steriod, my asthma seems to be worse than it was before (when I dont use the steriod for a while)....or is it just old age creeping in ?

    Cheers all

  • Hi Guys,

    Been to see the doctor today and he has put me back on my Qvar (preventer) so I will be able to continue as I was.

    Im surprised he has swapped the fostair for qvar... qvar has only a steroid in it, whereas fostair also has a long acting beta agonist in it too, so the two inhalers do different things.

    I hope despite that, things have improved for you - luckily although the potential side effects where explained to me, I havent experienced any from the fostair.

    Lynda :)

  • I was on Becotide until 4 years ago. Was swapped to Seretide....was told it was better...,,developed palpitations and then a heart arrythmia. heart was treated with ablation successfully. Now off seretide,at my own request(insistence!) and on Qvar. Qvar certainly suits me as I rarely take ventolin now. I also take Mobtelukast,

    Different things for different asthmatics. Some people are no doubt fine on combination inhalers but not all of us.

  • In my teens I had a reliever inhaler to take when needed plus 3 inhalers to take everyday, one of which was a steroid at a highish dose. My asthma improved and I got to a point when I only had a reliever and only really had to take that when I had a cold. So, once on a steroid inhaler it is possible to get off it if symptoms improve. It's quite normal for asthma to go up and down over the years, so stick with the Qvar while you need it, you might find that you can stop taking it in the future. x

  • Hello sorry to hear of your experience it is truly awful to not have control of your own breath

    I too felt that my medication was changed rather quickly. From Symbicort; which was probably the most controlled my breathing had ever been, to Fostair. I was quite bewildered at the time, as I was not complaining it was just a yearly meds revue. From the very start of using Fostair my breathing worsened, I too have had heart palpitations that have got steadily worse to the point that I could not lie down. I finally twigged that it was the Fostair and have now been prescribed Clenil. This was despite my request for Symbicort.

    A quick Google and I discovered quite a lot of people with a similar story. This makes me wonder whether the side effects of this inhaler have been played down or under reported. I also began to wonder; why the apparent over keenness of G.Ps to prescribe? It didn’t take long to find out. You only have to Google “Fostair Switch” to find this is money driven. NHS trusts across the country are encouraging health care providers to switch from the more expensive meds to Fostair which is comparatively cheaper. On the face of it an admirable way of saving funds. But how much do they save by switching an asthmatic who feels their condition is controlled to any med let alone one that has some horrible side effects? The cost to the NHS of my ECG, full set of bloods, three G.P appointments and my loss of earnings, and therefore tax is quite shocking. If this happened to even 1 in 100 the cost would surely negate any saving on 1 inhaler?

    Ladies and gentlemen my rant is over.... but I would be very interested to hear if the figure is 1 in 100.

  • A quick Google and I discovered quite a lot of people with a similar story. This makes me wonder whether the side effects of this inhaler have been played down or under reported. I also began to wonder; why the apparent over keenness of G.Ps to prescribe? It didn’t take long to find out. You only have to Google “Fostair Switch” to find this is money driven.

    I think its worth remembering that most folk only take to the internet to complain when things arent going well - you are unlikely to find forums where people have taken the time to sing somethings praises, whatever it is! Thats life..

    I've been asthmatic all my life and had never heard of fostair, despite having plenty of GP's managing my asthma. It wasnt until I was referred to Papworth heart and lung hospital that I was changed to this drug, and he (consultant) clearly explained the clinical rationale to me.

    The cost argument simply doesn't bear out, and is frequently an assumption made by many - who have no basis on which to place that argument (ie they do not have access to the cost of medications!).

    I dont have an up to date BNF (British National Formulary), mine is 2011. But the costs then were as follows:

    QVAR (beclometasone diproprionate) 200 dose unit 100mcg £17.21

    Clenil (beclometasone diproprionate) 200 dose unit 100mcg £7.42

    Fostair (beclometasone diproprionate/formoterol fumarate) 120 dose unit 100mcg/6mcg £29.32 - less doses and a LOT more money.

    Do the maths ;)

  • I think its worth remembering that most folk only take to the internet to complain when things arent going well - you are unlikely to find forums where people have taken the time to sing somethings praises, whatever it is! Thats life..

    I've been asthmatic all my life and had never heard of fostair, despite having plenty of GP's managing my asthma. It wasnt until I was referred to Papworth heart and lung hospital that I was changed to this drug, and he (consultant) clearly explained the clinical rationale to me.

    The cost argument simply doesn't bear out, and is frequently an assumption made by many - who have no basis on which to place that argument (ie they do not have access to the cost of medications!).

    I dont have an up to date BNF (British National Formulary), mine is 2011. But the costs then were as follows:

    QVAR (beclometasone diproprionate) 200 dose unit 100mcg £17.21

    Clenil (beclometasone diproprionate) 200 dose unit 100mcg £7.42

    Fostair (beclometasone diproprionate/formoterol fumarate) 120 dose unit 100mcg/6mcg £29.32 - less doses and a LOT more money.

    Do the maths ;)

    I am not naive enough not to know that people complain more than praise. After all the only time I have ever commented on a forum was to complain! So I know that it is unlikely that a balanced view would be obtained from a forum. However, my GP told me that the side effects I suffered were “extremely rare”, so it was a surprise to find others who had suffered, so readily. I really am quite curious as to how these things are recorded, and if they really are as rare as we are led to believe.

    Fostair is being recommended for patients on a combined inhaler such as seretide & symbicort, so the comparisons you make are not relevant. Fostair is considerably cheaper than the most commonly prescribed low and moderate dose ICS / LABA combination inhalers, such as Seretide 125 Evohaler, Seretide 250 Accuhaler, and Symbicort 200/6.

    In my case, and here is where I did my maths; the Symbicort that I was prescribed had a 30 day cost of £38 compared to Fostair £29.32 a 22.84% reduction in cost.

    My asthma was controlled and now is not. I do think that saving money is a good reason for switching meds, but it should not be the overiding reason. I have also begun to wonder if my G.P just did not know enough about the medicine he was prescribing. I suppose I am curious as to whether the side effects I suffered may have been partly due to the increased effectiveness of the extra fine particle size and therefore it not being bioequivalent to same dose of another inhaler. Not information I was given at the time of prescribing.

  • NurseFurby,

    You can access BNF on line :-)

    And register for an account...

    Kate

  • Hi Kate

    I know, but I thought you needed an athens account? - and I dont have one anymore.. and Nick cant remember his password LOL!

    Lynda :)

  • nursefurby, you don't need an athens login etc anymore. You can register with any email address I believe.

    Also, if you work in the NHS it is free access at work with no registration needed.

    Think I've posted before on this but it is not as simple as your list - have to bear in mind steroid equivalent doses and how much of each a day and thus month costs to compare.

  • oooh I will have to try again then! Since I've left my NHS nursing post, I lost my athens registration, and you used to need one. :)

    I agree it is not 'as' simple, (I live with a doctor lol) but thats why I posted the same doses - it still gives an indication of the huge hike in cost per 100mcg. It grieves me when people assume everything is down to money and all docs prescribing is based on this. Its simply a massive generalisation. I was changed to fostair because it has a much smaller particle size than others, and my small airways are only functioning at 11% of predicted. Thus particle size of drug becomes important if its to get where it needs to.

    Lynda :)

  • Hiya Soph

    Apologies for the confusion - of course I know that I was comparing a combined inhaler with a non combined one. The reason I did this was because the issue being discussed was one of cost, and you stated you had been swapped from fostair (combined) to clenil (non combined). Another person in the thread had been swapped from fostair to Qvar. Both of which strike me as odd, because as you say in your post, they do different things - one being a combined inhaler and the other not.

    Can you go back to your GP to discuss? Is it worth asking for a referral, if you don't feel the surgery are managing to get your asthma under control?

    Lynda :)

  • Incidentally, I hadn't noticed this in the BNF before, but it bears out what my consultant said to me regarding it being clinically appropriate:

    ""Fostair is a combination beclometasone diproprionate and formoterol fumarate CFC free pressurised metered dose inhaler. Fostair has extra fine particles and is more potent that traditional beclometasone diproprionate CFC free inhalers""

    :)

  • I was prescribed fostair and found I had no nasty side effects, although the dose was too low and I got changed onto seretide.

  • Hi

    I personally don't like Fostair

    I got put onto Fostair from Seretide 250 and to be honest I would like to go back to the Seretide.... Fostair has a HORRIBLE taste... And hasn't really helped with controlling my asthma at all.

    I also take another preventer inhaler Ciclesonide.

    May this year I suffered quite a severe bout of pneumonia, which caused some damage to my lung.... Asthma hasn't been the same since.

    Thanks

    WHayleyOW

  • Hi,

    I've been on Fostair for two months now (was on Symbicort before, loved it but got side effects when my dose was raised) and have had some difficulties that I put down to a chest infection. However, infection is clearing up now and I'm still getting very dizzy with bad headaches and shaking hands etc. along with chest pain and cough - anyone else had similar issues?

    Thanks :)

  • Only been on Fostair for two days and definitely feeling dizzy - is this likely to go away or should I change to a Clenil?

  • I thought I would reply to this old post as it is still relevent. I had the same experience of being conned into using Fostair by the nurse after using occasional ventolin and Qvar. For the first few weeks I felt great, then gradually got worse and worse side effects, thrush, nose and throat problems and eventually it seemed to make my breathing worse. I looked at Bnf at the time and Fostair was slightly cheaper than separate inhalers, but they have made access to Bnf more difficult now if you are not in the health business. I got the impression that the GP had been nobbled by the drug reps.

    I went back to Qvar and ventolin, but I seemed to develop thrush and throat problems that I had never noticed before which I could not get rid of. I then asked to use Symbicort as I had tried it before and had no problems. It seems to be the least bad of the bunch now, with some thrush, but I can live with it. The experience with Fostair seems to have triggered reactions that I never previously noticed before. The snag is that Symbicort is more expensive than Fostair so I may have problems keeping it in future, but so far so good.

    Most of the reliever meds like ventolin or combined inhalers will cause some level of palpitations etc, but it is likely to be worse with the combinations as they use long term versions of relievers.

    I did not notice any rashes, but at various stages of use of Fostair I did have chest aches.

    Although researchers and fashion says that asthma is mostly under-controlled by patients, I think it is important to use the minimum amount of drugs possible especially once the situation is stabilised, to reduce side effects.

    Does anyone have any recent experience of accessing Bnf as a non healthcare insider?

  • I do sympathise with many people who suffers from breathing problems. It is a devastating health problem and if it also affects your oesophagus, it is a worse scenario to suffer COPD Chronic Obstructive Pulmonary Disease. I am not a medical person, but reports of my condition in 2008 to a Life Insurance policy of my GP devastated me at that time. A medical condition, not revealed to me in hundreds of appointments since I inherited this genetic condition from my parent. I suffered what I thought was Asthma, but a doctor told me in my late teens I suffered what he determines is Bronchial Asthma. This meant I had breathing health problem with my lungs as well as my oesophagus. Nevertheless, over the years with age, I also suffered several health problems. With serious asthma attacks and persistent violent coughs, my body suffered severe aches and pain.

    An almost fatal attack on a night in August 2008, and my chest was unable to take in air and I could not reach my inhaler, I clung on to dear life with a tight grip to the spindle of my pine headboard. I thought I was a 'goner' and kept my body from wriggling for air and calmed down. I then felt relief and air somewhat began to enter my lungs. The next night it happened again, and I did the same motion and again my body calmed down.

    I realised there was something Happening with my body to relief further attacks. Over the next few months, I went on to innovate further methods of bodycalming and realised I did not need to use my various types of strong inhaler to relieve my breathing problems. The activity is simple yet more effective than any physiotherapist recommended me over the years without success.

    Since my innovations for relief to my breathing problems I have never had an Asthma attack and other health problems contracted with age are completely relieved. I still suffer with my cough, but it no longer causes me any aches and pain in my body. Whenever, I cough I consider it as a 'jumpstarter' for my heart to remove any plagues from my arteries and other blood vessels.

    I named the therapy I still use almost daily, One Inch Therapy. It is so simple and easy and you perform the activity on the bed or floor without moving your body away from the spot. I'd say, there is no one in the world that performs this innovation I discovered and practice daily. I spent only 30 – 45 minutes almost daily on my bed in the morning. I am now 69 years old with a body shape more admirable than a person of 35 years old.

  • i have been using the fostair spray for the last 18 months. since then i have had serious palpitations, shaking of my knees and elbows and sometimes even my stomach. these are strange symptoms i never had. thank you for sharing your experience. now i know it is from fostair

  • Hi

    No Medicine is perfect and Long Term use of Steroid and Other Inhalers come with 'trade-off' risks for both Asthma and Other Health Issues. Having two separate Inhalers (one Steroid and the other for Breathlessness / Rescue) at least means that - with Doctor's agreement and guidance - you can periodically run short tests to see how well you can do without one or the other - otherwise, how will you ever discover whether you can cope without a particular drug?

    'Combo' Inhalers are, however, a useful way of preventing Patients from failing to follow a prescribed Regime, by - for example - deciding not to take their Dedicated Steroid Inhaler, or forgetting to do so.

    As always, 'Cost' also comes into the equation and - where Medication Cost is subsidized - Doctors are generally encouraged to move Patients onto the cheapest solutions, which may not always be the best ones. Some 'Combo' Inhalers offer Cost Savings when medicine costs are being subsidized by the State or some other Body.

    My understanding is that the objective with Asthma Inhalers is to 'step down' - as fast as your health will allow (to lower doses and fewer drug combinations). Also, to strive to 'reduce / restrict' your use of both 'combo' Inhalers and / or single drug inhalers to periods of your life when you can't do without them.

    Other than Patients who's condition 'severity / specifics' compel them to permanently remain on Inhalers, it's probably wise to view any Inhaler as a temporary-fix rather than a long-term solution, and to Review (at least every six months) with your Doctor / Nurse, irrespective of how well you're feeling.

    Note, I'm NOT a Medical Professional, so share your thoughts / intentions with a Doctor or Nurse before acting.

    Here's a couple of useful / related links:

    nlm.nih.gov/medlineplus/dru...

    medicines.org.uk/emc/medici...

    myhealthevolution.me.uk/201...

    jdrntruhs.org/article.asp?i...

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