Anybody been switched to Fostair?

I opened my repeat prescription collection today to find a completely different inhaler inside - Fostair instead of Seretide. I called the pharmacist thinking it was a mistake and he informed me I'd been switched by my GP and it's an equally effective medication. When I questioned the fact they were different active ingredients he said they were steroids of the same strength.

I just feel a bit disoriented by having this sudden change sprung on me from a medication plan which was working quite well for me. I'm also a bit puzzled my GP didn't feel the need to tell me.

Has anybody else switched to Fostair? What are your experiences?

12 Replies

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  • I was taken off Seretide and put on Qvar inhaler because he said Seretide had too many side effects. Whether that was true or not or down to the cost but I I feel my asthma is now not under control and I will be making a medication review appointment soon to discuss it.

  • They switched you from Seretide..to Qvar?! Do they realise they're not equivalent?

    You probably need the LABA component as well (the Serevent/Salmeterol in the Seretide) which isn't in Qvar (it's just the steroid, right..?) so why they switched you to just a steroid is beyond me!

  • Hi

    I'm not surprised you're a bit puzzled. Best practice in healthcare recommends collaborative care planning as a preference, but, this aside, there's still quite a fundamental matter of treatment consent.

    I hope you get on well with the Fostair. After an autumn of struggling with persistent symptoms, my GP switched to Fostair (Ok, there was also the small, temporary addition of antibiotics and prednisolone). I've been on Fostair for the past 2 years and I'm really quite happy with it. I'd been on symbicort before, but couldn't get on with the turbohaler thing

    Fostair certainly helps most of the year round, but it still doesn't stop the annual winter problem when viral infections get the better of my lungs.

    Hope it goes well :)

  • It's probably down to cost, the seretide inhaler is approx £60 each inhaler whereas Fostair is around £30. Often surgeries are pressurised by medicines management to make sure they are prescribing the most cost effective inhaler. This should be done face to face though.

  • Go back to your GP. I have never taken Fostair and it may ,or may not,be as good,better or worse for you. I was on Seretide but switched to Qvar which works well for me ( I understand the particles are finer which suits some people better) but may well not do for another person as Karjade has explained previously.m

    It is completely out of order ,in my opinion, to change without your consent. If it was a generic and was the same that might be O.K.( but still nice to be toad) But with different ingredients!

  • Hey,

    I can't comment on how well it works and I definitely think your doc should have spoken to you first, but I was recently hospitalised and the respiratory nurse there told me they're phasing out Seretide in the UK due to the increased risk of pneumonia and asthma-related deaths with its use.

    They were going to switch me to Fostair, too, but I ended up with Symbicort as I'm under 18 >:(

  • Firstly, you should contact your GP and query the switch. Certainly it should not have been done without consulting with you first, particularly if your asthma has been well controlled by the seretide. Secondly, it is my understanding that different steroids have different levels of potency, and that the steroid used in seretide (and flixotide as well), namely fluticazone, is one of the more potent. I'm not sure which steroid fostair uses. Thirdly, different medications work for different individuals because asthma is one of those medical conditions which does vary quite a bit from patient to patient.

    Last year, I had a discussion about different asthma medications with one of my GPs. It was an informed discussion (at his suggestion I had done a bit of research beforehand), resulting from the fact that I was having problems with a recurring fungal infection in my oesophagus and my asthma medication was suspected of being a contributory factor. The decision at the end of the session was that, yes, it might be a good idea to try something different (I am currently on a flixotide 250 accuhaler), but not until the circumstances are right. That meant doing the trial at at time when my asthma is relatively stable (so not in autumn, winter or early spring - it was winter at at the time). We were hoping to do it this summer, but that has had to be put on hold because of a colonoscopy scheduled for June which was then cancelled until August. Now we're in September, it's getting colder and already my asthma is a becoming a little unstable: dosages of flixotide are being adjusted to compensate. Not a good time for me to start experimenting with a new medication.

    This is the sort of discussion that should take place before any switch of medication for asthma occurs and I admit that it makes be angry when I hear of cases where this has not happened. So you should not be worried about going back to your GP and asking, at the very least, for an explanation.

  • Thanks everybody, I don't need to start the new inhaler for a couple of weeks so in the meantime I have booked a GP appointment and will query with him. Good to hear some positive experiences of Fostair and if there are concerns about Seretide side effects (though I have never had any troubles) then probably best to be off it. Always the concern when you are effectively taking something for life that you don't know what long-term effects are going to be.

  • I think you will find that all medications have some risk of side effects - including Fostair. I have been taking flixotide for almost twenty years; until this problem with the fungal infection I have had no problems with side effects at all and even now medical opinion is divided as to to whether the flixtotide is connected to it. At the very most it is suspected of being a contributory factor; I also suffer from reflux and was clinically underweight when the first diagnosis was made. About eight months ago I asked whether anyone else on the Forum had been diagnosed with oesophageal candidiasis (or thrush); thus far no-one has come back with a 'yes' response.

    Fostair was initially suggested for me when the first fungal infection happened and I refused point blank to switch; why would I want to when a) my asthma was so well controlled by the flixotide and b) opinion was divided as to the cause of the infection. A fungal infection is annoying and uncomfortable; asthma is life threatening. It was only when the fungal infection began to recur on a regular basis that I discussed the possibility of a switch. I might add that this year the recurrences have become rather more irregular and nothing like as bad. At the same time the reflux is better and my weight is up to acceptable levels. My asthma medication, on the other hand, has continued on as it always has.

    As Becks01 has said, I suspect that in your case the switch is down to cost.

  • Back in July I posted this in a message to the old forum:

    "For many years my asthma was well controlled by a combination of Serevent Accuhaler 50mcg 1xbd and Flixotide Accuhaler, 100mcg 1xbd (low season) and 250mcg 1xbd (high season). I also had, but almost never required, a Ventolin Accuhaler 200mcg. Two devices meant that I could tune the inhaled corticosteriod (ICS) while maintaining the long acting beta-2 agonist (LABA).

    I really liked the Accuhalers. The rounded design was comfortable in pockets, they were fully enclosed when not in use and had a counter so you knew exactly how many doses were left and were sure of a full dose each time.

    Last year I was switched to Fostair 100/6mcg (MDI), 1xbd (low season) and 2xbd (high season), with an Aerochamber Plus. So far, it seems to offer a similar level of control. Apparently, it has a shorter shelf life and the pharmacist has to store them in a refrigerator!

    My treatment is now the 1st choice for step 3 on Asthma Pathway June 2015 (http://www.cambsphn.nhs.uk/Libraries/Respiratory/Asthma-Pathway_June_2015.sflb.ashx) from Cambridgeshire and Peterborough Clinical Commissioning Group (C&PCCG)".

    The DPI version, the Fostair NEXThaler, had been designated NOT RECOMMENDED in a New Medicine Report by C&PCCG (http://www.cambsphn.nhs.uk/Libraries/Decision_Documents/FostairNEXThaler_for_asthma_-_Decision_May_2015.sflb.ashx). I assumed that this would stop it being prescribed on the NHS.

    When I saw my asthma nurse recently I asked nicely about the Fostair NEXThaler. This time it was on the computer so I had a temporary prescription for one to try. I have used it for a couple of days and already I much prefer it to the MDI. Really hope I can have it added to my repeat list.

    I suspect the major driving force behind prescribing Fostair MDI is cost. I don't have a problem with low cost or generic drugs if they are equally effective or have no worse side-effects than more expensive alternatives. The risk is that cost concerns might deny patients more effective treatments with fewer side-effects.

    However, as medicines come out of patent (eg. Seretide) there is pressure on the manufacturers to produce new products (eg. Relvar Ellipta) to maintain their income stream. Difficult for patients to know if any new asthma drug is a genuine improvement or a money-spinner.

  • Thanks John, good to know you've had a positive experience, I have had trouble in the past with MDIs actually triggering my asthma (!) so good that I've been given the DPI - I'll see how it goes.

  • Hi, the asthma UK nurse suggested the change to me, I was on qvar and salmeterol. I spoke to the doc and he was already considering the change. I cannot say I have noticed any difference in performance since changing and it if far more convenient and I find nicer to take.

    Hope that helps.

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