Stepping up / down Questions

Hi, me again! Following a few struggles when i moved to Flutiform 125 from just a steriod preventer I had another consultation with the asthma nurse and we agreed to step up my dose to 4 puffs twice a day instead of 2 puffs twice a day so equivelent to the Flutiform 250 which the nurse was in two minds about giving me in the first place with a view to reducing the dose again when I felt things were under control. Anyway - the increase in dose has been fantatstic - I got my life back for the last 2 weeks :-) I felt so good and use my inhaler once, maybe twice in that whole time. I've also binned our old dog dander strewn, dusty bedroom carpet and pollen count has lowered so I thought it was time to step down again but within a day I'm back to the cough and tight chest as before. My asthma nurse is happy for me to step up and down as necessary but I was wondering when you know is the right time to step down as I've clearly done it too soon? I've seen people on here say they step up and down depending on the day and what triggers they have on any given day but it seems even though I have reduced exposure to my known triggers I'm still affected by the reduced dose. I'm stepping up again today to control my asthma so should I just keep with the increased dose again until everything is good then try stepping down again or is this a sign of being on the wrong dose in the first place?

2 Replies

  • This is a little difficult to give a clear answer to. In my case I just know. My peak flow is not reliable as an indicator for this as a rule. The only way I can describe it is how I feel first thing in the morning when I've just woken up (so before I've taken any medication). There comes a point in early summer when my lungs feel so good when I wake up that I know it's safe to lower the dose. If it's any consolation to you, I haven't reached that point yet this year.

    Sorry I can't be of more help on this one. Anyone else got a different, reliable way of telling the right time to lower the dose?

  • I think i've heard if you're stepping down you should wait until your symptoms have been good for about a week before you start adjusting.

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