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Hydro vs pred

Hiya. My asthma has been going downhill over the past few days after quite a good stint. Although peak flow is not a good indicator for me, the GP (and AUK nurse) have recommended a course of oral steroids. A couple of years ago I was put on pred and had awful side effects. After that the specialist asthma nurse mentioned that should I ever need it again I could try hydro. So I have a course of hydro with me and I'm a bit concerned about taking it because of possible side effects- have any of you taken it? Have you found it to cause fewer side effects than pred?

A bit of background: currently on symbicort SMART 200/6 (around 8-9 inhalations total a day for the past 3 days), montelukast 10mg, fexofenadine, mometasone/beconase. In fact I think it was a worsening of my rhinitis and changing nasal steroid that caused this exacerbation.

Peak flows are always around 400-450 - I have small airway disease and not managed to get an FEV1 recently, which would reassure me.


9 Replies

Thanks but I don't think there's any question this is an exacerbation. It's just whether is bad enough to take hydro. GP did listen to my chest, which was clear. Other than a runny nose (rhinitis) and cough (asthma), I don't have any other cold/flu symptoms. What I'm really wondering is if hydro really does have fewer side-effects than pred. I got a call from surgery nurse this morning and she's agreed to give me an FEV1, after some discussion. Hopefully she'll be able to interpret the results and reassure me one way or another.


I use a duo reps spiromax inhaler which is the same as the symbicort in conjunction with a Salomon inhaler I am just wondering why you are taking the symbicort so many times iwas told by my G P that each time its used it last for 12 hours


Symbicort is an unusual inhaler in that it can be used as both a preventer and reliever (as part of the SMART regime, which not everyone who is prescribed it is on). As a preventer, I take two puffs in the morning and two in the evening, the other puffs right now are reliever.


Hi Aylanrida,

Sorry I haven't tried hydro before so can't advise.

Can I ask What type of side effects were you getting with the pred?


I went a bit crazy... I felt quite paranoid, depressed, aggressive. Not a place I want to be in again!


Hydrocortisone does have a lot less side effects and it is better than prednisolone because hydrocortisone is like cortisol which your body naturally produces!

How have you been told to take the course of hydrocortisone ? It is just it has a shorter half life than prednisolone so taking it once a day like prednisolone may not work.

I have recently changed from prednisolone to hydrocortisone so you want any information ask as I think I read tons on the differences.

I would say go for the hydrocortisone it is better on your body in the long run!


Well, based on the results of my spyro yesterday, they recommended not to take it. I think this might be the end of this flare up as I had a better day yesterday. I have the tablets anyway in case I need them. The GP had never prescribed hydro for asthma and from what you're saying what he'd advised might not have done it anyway. I have 80mg/day for 5 days to be taken in the morning (equivalent to 20mg pred, so I'm told). How do you take yours? Thank you for reassuring me.


I take 10mg at 6am, then 2.5mg at noon and 2.5mg at 3pm.

I am not sure about taking it once a day as it only has a short half life so it would wear off before bedtime each day.


That is really good to know, thank you. I'm glad to report that I feel a lot better today, so I'm relieved I didn't start the hydro in the end. I can see light at the end of the tunnel now...


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