Fostair and coughing

Hi, I'm new to the forum. I've had mild asthma from childhood, characterised by repeated bronchial infections which have diminished with age. Some years ago I was prescribed "Seretide" which had the strange effect of changing my "wheezing" to coughing. I didn't take too much notice at the time. More recently I was prescribed "Fostair" which I thought increased my coughing. I spoke to the "asthma nurse" about this but she convinced me to persevere with it, which I dutifully did. Six weeks ago I developed a nasty cold with a cough so severe that I pulled all my intercostal muscles and self-medicated with codeine to try and suppress the cough. (There was no bacterial infection and phlegm was clear.) So, six weeks go by with no let up in the cough and I decided to stop taking the Fostair. My cough all but disappeared within 24 hours. I'm convinced that Fostair was the culprit. Has anyone else experienced this effect? Also, it's almost impossible to clean off the spacer that I use.

17 Replies

  • Hi Butterlover,

    Very interesting, I had exactly the same reaction to Fostair. Constant coughing fits all day from the moment I started it. Stopped after a week as the coughing caused a major attack, which then turned into two months of prednisolone, pneumonia and pleurisy which I'm just getting over. I've seen others mention this side effect too, I don't think it's common though.

    I'd be interested to see what experience others have had :)

  • Hi, thanks for your response. It's interesting isn't it? The asthma nurse I saw hadn't come across it either.

  • Hi i took all those inhalers, I think the coughing comes from the bronchodilating effect, like if you have mucus and you take an expectorant you will cough..when I was well I didn't cough, although they do irritate your vocal cords and now I have a problem with that so herbal teas and honey help a lot.

    How are coping without a preventer?

  • Hi Happy London, I did reply to your post but it seems to have disappeared. Both Seretide and Fostair have more or less eliminated mucus from my lungs, which does have a downside, making coughs dry and painful. I'm lucky so far that Ventolin has kept me breathing although I haven't checked my peak flow yet.

  • I understand..I have a lot of thyme herbal tea with honey to soothe my throat. I think you need to get in touch with your doctor or ask for help from the Asthma UK see the preventer has a long term anti inflammatory effect so if you are only relying on the ventolin it is not a good solution for your lungs but I know they all have side effects which you have to work around. Take care xx

  • Hi Happylondon

    I wondered if it was exactly this. It was the dry powder one I took, when I'm better i'm starting Foster inhaler instead so I'll let you know, still think I prefer Seretide but apparently it doesn't get into the small airways.

  • yes dry powder is a killer for the throat..we have to go for the inhaler that suits us best, it is such an individual reaction..

  • I was prescribed Fostair and Clenil to replace Flixotide last hospital visit. I feel sick and cough but put the coughing down to cold weather. I was told to reduce my steroids 5mg every 3 days - I told them from past experience this was not possible but they said I wasn't taking it seriously. I've been asthmatic since 1967 and they tell me I'm not taking it seriously. Am fed up with being patronised and used as a guinea pig. I am persevering with the new inhalers but titrating down at a level I know my body can take, even so I've had to increase oral steroids a few times as I couldn't walk around my own home

  • Month on sickly feeling slightly better but cough is still present, indoors or outdoors plus constant wheezing. The only way I got through xmas was to up steroids again. Am fed up but sticking with it till I go back to hospital. Have kept diary but they most probably won't take any notice of it or even believe me. Wonder sometimes whether it's worth bothering with them as it's always a random doctor who has his own theory on my asthma

  • While Fostair helped greatly for a while when I first started taking it, I have since attributed lung irritation to it's use (but that attribution may be an error on my part).

    I found - when I took myself off Fostair and tried to rely on Clenil plus Ventolin Only - within a few weeks I needed to request reinstatement of Fostair as (for me at least) it does seem to deal with asthma exacerbation better than Ventolin alone.

    One issue I have with Fostair is that I don't like the idea of taking a Long Acting Beta-Agonist (LABA) 'every day' as there should be periods of time (days, weeks etc) when I can breath reasonably well without needing 'meds' other than Inhaled Steroids to assist me. I don't want to become LABA Dependent as well as being hooked on Inhaled Steroids (which, by the way, I have heard it said can also be source of Lung Irritation).

    As you'll probably know, Fostair contains both a Steroid and a LABA. There's been quite a few negative comments about LABA's in general online, in articles written by Professional Medics (not joe public) - including the fact that Combo Inhalers (presumably the LABA Component in them) can irritate the respiratory system. You could envisage a scenario whereby one of the reasons you needed an Inhaler was simply because one of the drugs in it was contributing to your respiratory issues.

    I've just switched from a Clenil Steroid Inhaler to a Qvar Steroid Inhaler. I'm still taking a single does of Fostair AM and PM but I'm hoping the Qvar will - at some point - prove more beneficial than the Clenil, and allow me to ditch the Fostair (or only ask for a fresh Fostair Script when I get a severe exacerbation - as it seems to work well for my exacerbations in combo with Ventolin when I get very poorly).

    It's a trial and error game with all the Inhalers, plus - after a while - your constitution seems to modify / adapt it's response to a med it's got used to, which can necessitate a permanent or temporary change of meds.

  • Hi Matman, thanks for your informative post.

    "Combo Inhalers (presumably the LABA Component in them) can irritate the respiratory system." Can you give me a link to this info? I think I need to do more research :)

  • The last section of the 'fourth' Comment / Response to a Post on a page (of this Forum) that I've provided a web link to - at the end of this reply - has been 'extracted' from an - admittedly - very old Online Article (as the Post itself is 6 years old). While I haven't had the time to track down and review the original source article, if you 'copy and past' into Google, a line or two of (say) the last paragraph of that old Comment referred to above, you should find the original source.

    Big 'BUT' - while the info I've referred you too seems 'very scary' on face value, it's essential to delve deeper into the 'benefits v risks' arguments. Lots of people (me included) feel that LABA's can help you through an exacerbation period. For me, at least, the issue is not wanting to remain on a LABA for a prolonged period 'if' I can get by without one.

    Also, there are well know 'risks', often severe ones, associated with loads of commonly used meds (you've only got to read the Patient Info Leaflet supplied with them, or Online Versions of the same) . However, the alternative - where asthma is concerned - is the danger of an untreated, or poorly treated respiratory illness known to cause a number of deaths each year.

    The reply to 'your' Post (from HappyLondon, above ) is also highly relevant in my view and the point she makes could easily account for coughing issues, irrespective of what inhaler is being used.

  • Thanks Matman, I have in fact followed up with a Google search. I'm not an alarmist when it comes to pharmaceutical use. In this case, however, I feel that I may be over-medicated as the symptoms of my asthma seem to be an order of magnitude less than others I've seen described here. I will discuss my treatment at the asthma clinic. :)

  • Hi . I've been on fostair 2times daily for 3 weeks now(I was previously on qvar 2 times daily plus ventolin when required )since a recent viral infection causing coughing and my worse bout of asthma since diagnosis 10 years ago . Prednisolone for a week helped initially but the cough returned once the dose was reduced and stopped although I was using ventolin inhaler 4 hourly and also as needed. My peak flow increased slowly over a week and has remained consistent with my exercise tolerance increasing dramatically, hardly needing my ventolin at all since ( only in extreme cold ) . I'm due a review of inhalers by GP in 2 weeks . So far I'm happy with Fostair but I'm hoping to revert to my previous regime once I've fully recovered from my recent exacerbation (and the weather warms up!)

    Hope this helps.

    Ps. By the way ,I use a spacer and always rinse my mouth after Fostair use (a tip picked up here) which seems to stop a hoarse voice and dry throat.

    Thanks everyone for all your helpful comments and tips ...a great resource!

  • Hi,

    I developed a very mucusy cough after 5 bouts of pneumonia, I was changed from seretide to Fostair and was fine foe about 6 months. My cough returned in September and I've been quite ill since. My x-ray's are clear and spirometry was normal. I'm now coming off steroids and my cough has started again, I also find my Fostair loses its effectiveness in its last week or so of life!!

  • Hi, I also have had a continuous cough whilst on fostair and now am on the 200/6 one which I've noticed I get muffled hearing and almost tinnitus after taking along with the annoying cough I'm seriously considering coming off it altogether as I feel it's making no difference to my asthma. I had a severe allergic reaction and asthma attack last October and since then numerous doctors trying to find an inhaler mix that works! I started on fostair pink one 4 puffs twice a day for first two months and I often ended up on Prednisolone or using nebulizer or both along with Salbutomol. Then they tried giving me a powder inhaler siymbicort and that gave me awful muscle cramps and still wheezing and coughing which also ended up with me taking antibiotics for a later discovered phantom chest infection three times in 6 months! Then they gave me Spiriva to try for 8 weeks which made no difference! Seeing the specialist last week I asked if I could come off the fostair and he advised against it suggesting this other fostair 200/6 2 puffs twice a day instead. Since taking it last Wednesday I've developed more coughing and cold like symptoms similar to my allergies so wondering if I'm allergic to it! I seriously want to come off it but am a little worried but thinking maybe taking a course of Prednisolone as I come off it gradually and see if the coughing stops. I'm going to see a herbalist next week so might do it after that

  • Ps also tried montelukast which made me nauseous, abdominal pain and diarrhoea! Tried lowest dose and still same reaction!

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