rationing Ventolin

Hi, I have a very supportive GP practice but have found that,of late, the asthma nurses have become really judgemental about my asking for more ventolin. they say they have been to various conferences which inform their judgement of prescribing ventolin. they say I should only have 1 prescription a year. and seem unable to listen to me and what it is actually like to be asthmatic. I was diagnosed with asthma as a toddler 48 years ago. I get panicky if I don't have a ventolin with me. so I need to have more than one available to me.

I understand that it is better to get prevention correct so reducing the need for ventolin.

However, I also know that 1 ventolin prescription a year is not going to work even if I didn't need it.because If I use an inhaler and then leave it untouched ( because it's lost in a coat or something) for a few months, it stops working. has anyone else found that?

If I order more, I get told to come for an asthma review where I get patronised and told off.

has anyone else had this experience. with the rationing of ventolin?



17 Replies

  • I forgot to mention, that I use ventolin most days! I know, I need to get my preventers better.!!

  • Your prescription is it once a year ie. one blue ventolin inhaler. My practice usually give me two at a time. Really wasteful in my opinion as I currently got 5 inhaler in date. I keep two with each spacer (adult blue type). At the moment i have used one inhaler last week when my chest wasn't happy after having a bad cold. Yesterday I did use it alot as I got a very bad chest resulting in an asthma attack late evening and finished off using rescue steroid tablets.

    I find this too with my preventer I get two every time I ask so that last two months. This month I only asked for one as I having my asthma review on the 12th October. i did this because I thought if they change my medication then the second one would be wasted. I hate the idea of the NHS wasted money by over prescribing.

    I never know my inhaler to stop working I keep keep one set in my hand bag and one in my rucksack which I use every day. The dates on the inhalers are very long usually 18 months and you can take them back to a pharamcy for recycling but I still don't like wasting it. I was brought up by ww2 child who was told not to waste things as they wasn't an endless supply.

    Thoughts folks

  • My surgery, which also dispenses, is very rural and a 10 mile round trip. When we get bad winters we get VERY bad winters, and no, only one item at a time. Something about budgets. Well, how about budgeting so your patients don't need emergency care!

  • Yes I agree budgets must rule the prescribing medication. Rural practise may not have the same budget as a surban one like mine. My Gp surgery has at less 8 GPs asthma nurse and nurse practioners. They joined with two other practises two. So to share there staff around. Does any one know roughly how many puffs are in a ventolin inhaler? I using my alot at moment recovering from an asthma attack on wednesday night. So far today 3 lots of doses 4 puffs ago.Trying tp use only one at a time. I label mine with a use me first written on the label.

  • In brighton Boots used to have a 'midnight' pharmacy but when I ran out of meds earlier this year, during a bad spell when I realised I needed to go back on symbicort, I found that had finished and the latest option is now a late drop-in clinic that shuts at 8pm.

    I went in to Boots at 9am that morning hardly able to speak and told them what I needed, I spoke to my surgery on the boots phone, they said boots have to fax a request, so boots said they would. I came back at 6:30pm still in a bad way and was kept waiting half an hour only to be told they have no record of my morning visit! I was seething - the symbicort was just behind the counter and I thought of just taking one and throwing the experts a tenner but kept myself together and only just made it at the late clinic for a script then back to boots and boy, I'd forgotten how good symbicort is!!!

    I have friends who get their meds, incl. antibiotics and even worse things sent over from Bulgaria and Turkey! blah blah bla....

  • I was told this a few years ago. Like you I also live in a very rural area (though actually only a mile and a half away from my GP practice, which, like yours, has a dispensary attached - next nearest pharmacy is six miles away). I successfully argued my corner over it. However, I have been with that practice for a long time, and they do know my asthma well (they also respect the fact that I know my asthma well). The point was brought home fairly recently when I needed a repeat prescription for a different medication (one which I was getting on a singleton basis), requested it in good time (a week out) was delayed in collecting it, and when I went to get it (the day before my last available dose) they hadn't got it in (apparently their usual supplier hadn't had it). Fortunately the medication was not critical (not for asthma). As a general rule I request the next two preventer inhalers when I begin my last one.

    Try talking to your GP about this one - that's what I did.

  • They referred me to the Pract Manager, he who apparently makes the Big Decisions. I'll try again next time I'm in p- I'm too old to drive over icy snow-clad hills - ...watch this space! And hope for a mild winter.

  • I have never known an inhaler not to work no matter how long I have them in a bag . X

  • Ask your GP or another doc to specify two inhalers on the prescription, say you need the security of having one with you when out and another at home as a spare or in case you lose one. Or say it's because you require one to stay elsewhere (workplace drawer; car; emergency bag etc..).

    Or, if you pay then say you need better value for money!

    I haven't been to an asthma nurse since about 2007 because I have an anxious temperament and the last time I was told I need to get a job and that if I can't breathe through my nose (a lifelong problem that I cured myself of eventually) then I must make a horrible sound when I eat (there are various impolite terms for that kind of person, I'll stick with 'asthma nurse' here).

    However much worsened I was in my self-image from seeing said specialist, I was given good advice about my inhaler use: she said I should wait a little before using my inhaler (Ventolin) to see if my symptoms really warranted it - she had recognised that I was taking a puff at the slightest sign and that my 10+ a day use was bad. I had previously had Bricanyl daily from about seven or eight years old until about 28 when it was changed to Ventolin, a change that reduced a lifetime of jitteriness.

    I was given the above inhaler advice a couple of years prior to a long period of very bad daily symptoms through half my 30s, when I was then on max symbicort and Ventolin all the time but through it all I remembered the advice and understand now since I've recovered how much allergens and irritants influence my symptoms, now I am careful to limit triggers.

    Another actually helpful comment when I was bad was from a doc who said that my airways are very inflamed. Just that comment opened my eyes to what I had been suffering and allowed me to reconceive of certain types of symptoms as being analogous to my eczema, or to a sore patch of skin that needs time free of irritation to heal.

    I empathise with the sense of security that possession of an inhaler brings, and with the fear/need at the slightest feeling of a symptom, and also with the various panic that accompanies the condition. It's important that we are helped to manage our asthma and given as much info as possible. It is utterly ridiculous to 'ration' meds, we only need to be told why, how and how much to use. When I was a very young child I was perfectly responsible and capable of treating myself with what was then a Ventolin 'RotaHaler' (with little capsules of sweet tasting powder that the device broke when I twisted it). Indeed, a kid in primary school with his own medicine is safer than one who has to ask an (usually ignorant and inept) adult for it.

    Cheers, Ollie.

  • I was told the same thing that if you have asthma your airways are always inflammed. That was asthma uk when recovering from my first ever asthma attack called 999 for myself. I must admit to being very shocked when told this. I was awake up call. I hadnt given much thought to my

    asthma had been mild since diganosis ten years previously. I think that getting your head around your asthma condition except it and being sensible. I must admit to not carry it always with me before last years asthma attack treated it too lightly. Not a thing to be taken lightly but to be sensible. For me knowledge is key. Its is there but doesnt rule your life.

  • Yes, I keep inhalers just in case too, and I'm glad not to have been over-confident about it on some occasions. Though since my symptoms became so much less frequent it has been a joy not to have that mortifying panic at the fearful thought I haven't an inhaler with me! Foolhardy I know, and not to be recommended. I would say we have to judge things ourselves, whilst being well informed and cautious.

  • I always request two ventolin inhalers even though I rarely need to use them. The reason I like having two is that it reduces the risk of going out without one. With two I can keep one at home and have the other in my bag. I've never had a problem getting two at a time from my local surgery, though they are aware of why I like having two. My advice would be to talk to your GP about this if you are having a problem with the asthma nurse and explain why you have had to do so.

    I've never had a problem with my ventolin inhalers not working if they haven't been used for a while, but that might be down to the type of inhaler. I use accuhalers.

    And yes, if you are needing to take ventolin every day you need to talk to your GP about whether your preventer inhaler is doing its job properly. I really do recommend that you do not put this off any longer. The fact you are needing to use ventolin as often as you are is an indication that your asthma is not under control. You might be getting away with that and coping at the moment, but if you pick up an infection things could get nasty very quickly. That happened to me twenty five odd years ago - I ended up in hospital as a result.

  • One a year? .... I would find another asthma nurse. I'm nearly through my second one in two months and have another two still in the box waiting to go. My asthma nurse stated the ashma UK advice about using salbutamol (something about using more than 2 doses a week or something)

    I once had a crap asthma nurse and we had a right row and after that she wouldn't see me and I saw the other asthma nurse instead (for years)

  • one a year!! well yeah maybe if your asthma is well controlled and you have very few symptoms, but not if you regularly suffer symptoms. I am on my fourth/fifth one this year as I am currently using two kinds both acuhaler and evohaler in tandum depending on my need.

  • They are not rationing anything. All the reports about asthma desths say that gold standard care is that patients requesting repeats of ventolin frequently should be reviewed to check their asthma. You are lucky to have such a switched on Primary Care team.

  • I get 2 Ventolin each prescription but I order my repeat prescription online when I need to. As far as cost is concerned Ventolin is relatively inexpensive when compared to Sereteide and some other inhalers.

  • Hi why not ring one of asthma nurses on Asthma UK? Google it. x

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