Toddler given Qvar 100

Hello

I have a 2 1/2 year old who has had a persistent cough since her viral infection in February, however no chest infection but lots of coughing at night etc. The Doctor referred us to the Asthma nurse and she prescribed Qvar 100, two puffs twice a day, plus Salbutamol when required. The inhaler worked immediatly, no coughing from the second day of use, so brilliant. I have however been worried about the use of corticosteroids and note that the dosage my little girl is on seems rather high for her age. Is this dosage normal for a two year old just starting out on inhalers?

Also, I have another daughter who has just developed Chicken Pox, should we discontinue use of the Qvar?

Thanks for reading, any advice would be greatly appreciated.

5 Replies

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  • Just wanted to say hi and welcome, I noticed you're a newbie. I'm afraid I can't help with your questions but I'm sure someone will be along soon with some advice. (My daughter also has a persistent cough, worst first thing in morning and after exercise, she is currently trialling medication, but no diagnosis of asthma at this stage)

  • Hey and welcome! really sorry but I can't comment on the dose they have given, but they must have a reason for this :-)

    With asthma the salbutamol should work within a few minutes, but the QVAR will take a few weeks. I'd imagine they want to gain control and then reduce.

    Long term ics issues are pretty rare from what I've heard and its better to have asthma controlled than risk a severe exacerbation.

    I *think* the chickenpox advice is when on high doses of steroids for a long period of time, such as maintenance oral steroids.

    If you have any concerns though, I'd advise contacting gp, writing a list of questions and writing down the answers.

    L x

  • I just wanted to say that there's a big difference between pressing the pump and the drug being in the body - generally with small children the amount of the drug that reaches the lungs is much smaller than the official dose written on the inhaler. I've known toddlers who were on ""a higher dose"" than their six or seven year old siblings (who could use the inhaler more effectively so needed fewer squirts or a weaker drug).

    As Lollie says, there are major differences between inhaled steroids and oral steroids - the inhaler will be a tiny dose compared to an oral steroid.

    You should make sure to rinse her mouth and ideally brush her teeth after using the steroid inhaler.

    However, the fact that things are much better after just 2 days might be a sign that the Qvar isn't needed. I'd give your asthma nurse a ring - as others have said it typically takes weeks to have an effect. Are you using the blue inhaler as well? If so then they will probably want you to carry on with the Qvar anyway as the aim of the preventer is to stop you from having to use the reliever other than very occasionally.

    You really should be free to discuss these concerns with your asthma nurse as well - and the asthma uk helpline is great for specific advice.

    Cx

  • Like lollie said, I'd also suggest that they're starting with a high dose to gain control and then reduce the dose at your next review. If you've not got a scheduled review then I'd suggest making another appointment with the nurse.

  • The Doctor referred us to the Asthma nurse and she prescribed Qvar 100, two puffs twice a day, plus Salbutamol when required. The inhaler worked immediatly, no coughing from the second day of use, so brilliant. I have however been worried about the use of corticosteroids and note that the dosage my little girl is on seems rather high for her age. .

    Qvar takes between 2 weeks and 6 weeks to work so I doubt it could work in two days. Perhaps you should go back to the asthma nurse and tell her this as you don't want a toddler to be taking a medication that she doesn't need so much of and that she could step down to a lower dose. As well, I too would be concerned about a toddler on that high a dose if the toddler were mine. There are a number of precautions to take note of with Qvar and it says in the leaflet it can affect a child's growth. I too am on Qvar and although I am not a toddler I am having my bone density checked as I already have osteoporosis and it can cause loss of bone density. Saying that, it is much safer than oral steroids.

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