Fostair 200/6 (pink inhaler green cap)

Hi everyone. So recently (well over the last few months) my asthma got really bad so I went to the Dr. She said I sounded ghastly and upped my dose from fostair 100/6 to fostair 200/6 and twice a day, two puffs, with a reliever inhaler. This was on Tuesday. My coughing is a bit less deep and horrible and doesn't last as long but my lungs are still ever so "twitchy". The slightest trigger and they start feeling tight. Earlier I went to the supermarket and walked past two guys sitting smoking. Even though I held my breath and walked past them it still set it off as I started to breath again. At the moment I need to use my reliever at least once a day sometimes three times. It is driving me mad. Has anyone else been prescribed this and how long does it take to work and to bring the symptoms down, or if it doesn't when should I go back to the Dr. She also said after two weeks bring the dose down to one puff twice a day and hopefully one puff once a day and come back and see me in a month.

thanks guys!

Emilyeagleowl

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  • Hi Emily, sorry to hear you're not doing to well ATM

    I'm on Fostair Nexthaler 200/6 (DPI) 2x2 daily. From what I remember it took a couple of weeks to 'kick in' properly (initially went from a different steroid based inhaler to fostair 100/6 (MDI) 2x2 and a week later 200/6 (MDI) 2x2 cause the 100 wasn't doing anything). The 200/6 very slowly improved my breathing, tho not completely (have since had the words brittle, severe and difficult thrown about to describe my asthma and went to DPI cause I have issues with MDIs in general).

    If you're not feeling/doing better the day or so before you're meant to downgrade, I'd speak to the doc and tell her, though from the sounds of it she's hoping that this is just a short term flare up (which is possibly why you find you're reaching for your blue more!). Personally I wouldn't downgrade if you're still feeling your lungs react to everything, just make sure you let your doc/asthma nurse know the situation asap (better before than after the downgrade day but we all know how difficult it can be to get appts sometimes).

    Also see her if you find you're needing to use your blue more and more each day or that it's not lasting as long as usual (usual advice I know but it can be tempting to just try and carry on and ignore it) as you may need a short course of steroids just to get everything back under control.

    Don't be worried to speak to someone if you're worried (GP/asthma uk/asthma nurse/pharmacist etc -phone or in person) and don't be scared to go to hosp if it really gets bad and nothing is helping (better a short time in a&e, than a long time in a ward/a box in the ground!!!)

    Do you know what caused the flare up in the first place? (Plus I'm assuming that you were on 100/6 for awhile before hand and that it was working well for you previously!)

    Hope this helps and that you feel better soon x

  • Hi, thank you so much for your reply! I don't know what caused the flare up. If I'm honest it was probably terribly controlled for years before if I think about it rationally. My asthma was missed for a long time (from the age of about 6 or 7 to 16) as my parents just said I was unfit and needed to do more exercise when my chest felt tight and I was always coughing, until one day I had an asthma attack in the swimming pool and my mum finally believed me. I was on 100/6 for about 5 years and I think this flare up or whatever it might be is because I think I had forgotten what is was like to be able to breathe and not have symptoms; that the symptoms I did have were better than previously. So I didn't notice it was getting steadily worse. I only went to the Drs because I kept pulling muscles coughing like I did before I was diagnosed, and someone told me I sounded terrible. I think I supposed to downgrade after a week to two weeks she wasn't specific, but at the moment that's not going to happen. My flatmate opened a window about two hours ago and we live in an area with lots of pollution boy did my lungs feel it.

  • If you're still at that stage go back sooner! What other drugs are you on and do you have a PF meter that you use regularly? Plus if there isn't a known trigger that started this all off then it could be that you have just been uncontrolled for so long that your lungs are starting to rebel!!

    I was exactly the same, and just kept trying to push through, and now I don't 'recognise' a moderate attack cause I've been at that stage every day for months, and until recently I would just try and push myself through severe attacks, usually ending up with me having attacks classed as 'life-threatening' (from the top of my head I think I've had between 6-8 of these in the last 18 or so months πŸ€¦β€β™€οΈπŸ˜³). Think I've been 'told off' by various people for this, but I didn't want to make a fuss over nothing πŸ˜•, tho I deal better with it now.

    Now I have a GP surgery and consultant who understands me and who I get on well with, who have set me 'rules' of when to seek help and who from and when I can just manage on my own (regarding PF, symptoms and med use and can use to tract progess [good and bad] over time) in a diary as well as an action plan to follow (tho I usually sit in yellow zone so I think I've basically seen my Gp once a week for almost 3 months and had 3 a&e/hosp admissions in the last 5/6 weeks...)

    Do you keep a diary and if so what do you record? It may be worth booking in ASAP with your asthma nurse to get yourself sorted and get some advice. Don't struggle on through when there are thing out there that you haven't tried that may help! I have recently been put on a new med and almost cried the first morning I slept through the night/not woken early cause that hadn't happened for months but although I'm feeling a lot better I am still getting symptoms during the day so still not really controlled (although to me I feel absolutely perfect 😏)

    Sorry you had such a hard time as a kid (it's probs where you've picked all the bad habits from ignoring your asthma!!!)

  • I do indeed have a peak flow meter. Most of the time its at the normal range for my height (400-420) and age but sometimes it drops to 250-200 and then goes back up again a little while later. They are tight again at the moment and have been feeling cranky for most of the evening. I think you are right about probably booking a drs appointment or something, I don't know if we have asthma nurses here, we might do. It probably is where it all started it not being controlled properly or even acknowledged for about a decade. When I got diagnosed no one mentioned it could be fatal if you have a bad attack. I think its badly downplayed as a illness. Most people and I did at the beginning think its just a case of being wheezy and having an inhaler but its not. I didn't take it seriously because of the whole downplaying it thing, so perhaps the lungs are fed up and rebelling after all these years. When you say you have asthma people just shrug.

    I'm really sorry to hear about your bad lungs, its not good the whole thing, and I hope it gets (I was going to say better but nope chronic disease), but feels better soon.

  • Thanks ☺️

    I think there was an time when all and sundry (and every other child) was diagnosed (wrongly) with asthma (usually a bad case of bronchitis where the blue helped short term and was never needed again) and we are now suffering from there being a lot of 'asthmatics' who aren't.

    I think we need to give these mild 'I had asthma as a child, and I have a blue inhaler which I have never used, and I've never been to hospital' asthmatics a different name, to those who are more severe, as people just don't realise that it's a spectrum, that we are all different and have different triggers and responses and just cause one person can do something does mean everyone can (as a teen was told by 2 different people - a primary school headteacher, and a gymnastics coach - that I was making a big deal out of nothing, just wanted attention, there were kids out there dying of cancer etc, when I was bad and reaching for my spacer and pump [again struggle with MDIs so always have a spacer on me] also had a PE get cross at me when I stopped 1/2 way through a 1500m athletic lesson cause I didn't feel too good - was made to sit by myself under a tree unsupervised for just over a hour during which I now realise was a severe attack - had no knowledge of asthma then! πŸ˜’)

    We could call ourselves something that makes our condition sound more serious (bronchial constricting pulmonary disease - BCPD for short?πŸ˜…)

    Get yourself seen too soon (I hope your surgery has an AN tho they can double up as diabetic nurses too so have less clinic time. They can be a god send as you usually have a longer appt with them compared to a GP and they specialise/have an interest in asthma). It may help to write a brief(ish) summary of when everything kicked off, how you've been feeling, how often you're getting symptoms etc, so you don't forget anything esp if you end up seeing your GP!

    Fingers crossed that you get under control soon - don't be an idiot (like me!) and ignore your body telling you that it needs help cause something's wrong!

    X

  • Thank you! I will make an appointment as soon as possible! I really don't think using a blue inhaler sometimes 3 times a day after a fair few days on the medication sometimes taking an extra two doses (it says its ok in the medicine booklet) is healthy thing to do and will tell them that.

    I completely agree with you there! The bronchitis thing is a definite. I know lots of people who have a blue inhaler prescribed and never use it. I understand there are people who have allergy induced asthma and only need a blue inhaler in spring or whatever but they still need it occasionally. These people never do.My brownies have asked me when they saw me using my preventer inhaler on brownie holiday, what's that. When I said I have asthma and this is the inhaler I take every day to stop my attacks happening they said you don't have asthma as that's not an asthma inhaler as they are blue and brown and thats pink. This happens occasionally with adults.

    When I went to the Dr the first time and said I have had these symptoms and have looked them up I think I might have asthma he rolled his eyes and said you probably don't as your not wheezing its probably bronchitis but I will send you to the asthma nurse for a spirometry just to check, but I doubt it. And sure enough it was asthma.

    Those coaches sound like ignorant fools. Not being able to breathe is not good even if you don't understand how serious asthma can be! That must have been incredibly frustrating! I believe because you can't see how gunked and inflamed our airways are it doesn't seem real to many people. I remember my older cousin (who was a proper adult in her 30's when I was 16) scolding me because I had forgotten my blue inhaler saying you could die. Now I know she was right.

    We should indeed. It sounds like a childish disease when your an adult because of the whole nerdy kid stereotype.

    x

  • I work with kids at the weekend (coaching gymnastics to kids/teens with disabilities of various types as well as the development squad girls aged 4-8). They now all have a good education on asthma and know where I keep my emergency pack (I keep all my meds in a butterfly pencil case/make up bag that is easy to spot and they recognise cause I'm usually doing something I can't step away from aka catching a kid, when I start to get symptoms πŸ™ƒ), and I'm always happy to answer any questions they have about pumps, meds, asthma in general. In fact they often feel special when they are the one I call on to get my pack cause it means they are trustworthy and important and if a younger one doesn't remember an older one will fight to be the one to go with her and show her πŸ˜„.

    I've been doing this job for years now so almost every girl in squad understands asthma as a serious condition, and when one of 'my' 7 year olds had her first (v severe) attack 2 weeks ago (having never been diagnosed with asthma before she had 2/3 days in hospital) her mum felt better for 1 talking to my mum (getting parental support for the stress of the situation - my mum also coaches disability with me) and 2 leaving her in my care as she knows I know exactly what to do and how bad it can be (had this comment a few time now from parents of severely asthmatic kids)!

    It also means that whilst there is a 0 tolerance of bullying, kids can be kids but none of them ever even think about using asthma as a pressure point!

    I've learnt to take the rough with the smooth, and most around me know how bad I've been so they help me build my thick skin for the idiots out there who don't understand!

    Get yourself sorted soon, and feel free to message me if you just want to chat/moan/rant about anything! (It can be a great stress decompressor!!!)

    If you're getting nowhere ring asthma uk! They are lovely and can help you talk through options and any worries/concerns you have 😊

    X

  • Thank you very much I might do just that because I know it takes a long time to get anywhere with them even though you know your own body and can tell them there is something wrong.

    I went out shopping earlier and I was in town for two hours and as soon as inhaled the smallest amount of cigarette smoke the gunky lungs were back, the horrible gasping cough and the tight chest. I have been staying in and away from people so I thought it was getting better but nope. I may call asthma UK tomorrow to ask them what I should do, as I'm away from home at uni and I have never tried to get anything serious done here at the medical centre.

    And that sounds like such a good thing to do. I bet those kids are really grateful to you and your knowledge :).

    x

  • πŸ˜” sorry you've had a bad day! It's horrid when you kid yourself into feeling like you're getting better, then you just look at a trigger and your bodies is just like 'ha! You're still not well!'

    Defo go and see/speak to someone tomorrow (and if it gets really bad hospital today) its really important to get help (a&e) if you keep swinging into 50% and below PF or can't talk/eat/sleep etc! Don't wait and put yourself at risk, for just wanting to not make a fuss (could also be a shortcut to a specialist if you end up being admitted [how I got my referral after my initial GP practice refused!])

    Do you have a GP at uni? If not ask around for a good one/read surgery reviews online, I think it's important you register in one near you (you can temporarily register at home when you return, or vice versa as it's almost summer and you may be going back home!) If you don't you can have an emergency registration for an on the day appt to see someone tomorrow!

    Fingerscrossed for you tomorrow! X

  • Thanks :). I was pretty upset when I thought I was getting better and then it happened again. We do have a GP on campus and they are the ones who suggested the increase in fostair 200/6 (which reading the reports and the medical reports that are out on it should have helped a bit by now).

    I keep blowing 250-200 pf when my estimated pf 420 but then it goes up again. It's really odd, and painful.

    I am going home soonish but I did register here when I was a fresher, so I was a useful fresher :P.

    x

  • Good girl!!! I completely understand how frustrating it feels when what you want and what your body does doesn't match up!

    If it's happening before 4 hours is up after taking your blue head down to a&e. It does sound like you need something more (aka pred). If you're worried and your in yellow (between 50/75%) head down there too (they will not be upset with you for seeking help!). You could also try ringing 111 today and get their advice (tho it is usually go to a&e tho so...).

    Is 420 your best or just your predicted, and if it's your best did you get it when well controlled with no symptoms? My best is almost 2x my predicted (630-350) but I usually only get it when I'm well/had a lot of treatment. on my first attack I only got treatment cause I had a wheeze then got 'over treated' until they could prove that my PF wasn't still increasing (I had never done a PF before). I have since improved my best from 500- 630 so...

    Hopefully you'll be able to see the GP tomorrow and get some more help!

  • My predicted is 420 and my best is 420- 400 depends what day it is, it might be when it was well controlled. I'm at 370, thats not too bad, at the moment.

    I might ring 111 as my gp surgery is really irritating sometimes, if you don't ring and get an emergency appointment at 8 when they fill up within 5 minutes they don't care if you are dying.

    All I know I can't go out without my pf dropping to 250- 300 which is no fun.

    x

  • Completely understand appt making issues. Try physically going to the building when they first open. If you are bad and they are full and won't let you see anyone, ask them what to do. If they haven't got any (useful) advice ask them to ring you an ambulance/tell them you're gonna go to hospital cause you need to be seen that day asap.

    This happened to me last week. My new GP practice is usually brilliant (this was my first issue), they do daily walk in appt in the morning, and stop taking on patients at 11. I got there at 11.05 (hadn't felt too bad but asthma uk advised me to go, it's a 5 min walk, left at 10 to, took me 15 mins to get there), and they refused to add me to a docs list (I've had multiple docs tell me to just come down regardless of time). Because of the walk I couldn't talk and it took me a few mins to realise they were turning me away. I looked at them, gasping and my eyes started to leak (wasn't really crying, just couldn't stop them) they asked me what I do when I'm like this, I said come here or go hospital. They frowned and begrudgingly added me to a list. I had other patients offering me their places in the queue (which made the eye situation worse), but got myself back into my red zone (above 33%) whilst waiting to see doc. 1 1/2 hrs later see my doc, having a severe attack, emergency meds in the clinic, and he really didn't mind/care that I had been an add on cause it was an emergency and he rolled his eyes at the 5min thing! (Ended up in a&e anyway later that day but at least I could say I had done everything to try and control it!)

    Sometimes being physically present enforces they situation to them so they can't just ignore you, and it looks really bad if you go to hosp and say GP was full and wouldn't see you!

    If you're not doing too bad tho just keep ringing them til they have a space! Good luck x

  • Thank you. I might have to call 111. I took my blue inhalers at 17;40 because my chest felt tight and the reading was 410. I did it at 18:00 and its dropped to 375. Which is annoying.

    That doesn't sound good. When you feel dreadful and someone won't help you.

    x

  • Ask for a referral to see a respiratory physician. Your asthma is obviously not controlled as well as it could be. Take care of yourself. Xxx

  • Thank you for your reply. I think you are right. I went shopping earlier in town and one whiff of cigarette smoke and the gunk in the lungs is back and the coughing like I have smoked 50 a day for 50 years. It's being triggered by absolutely everything out of the ordinary. xxx

  • Definitely ask, in fact - INSIST. I used Fostair for 2 years and during that time had 2 bouts of pneumonia and eventually had to be hospitalised. I now use Relvar Ellipta - already there is great improvement after only 2 weeks. Good luck x

  • Thank you for your support :). I'm going to insist they do something. Its wrecking my life and it hurts! I'm glad you're feeling better now too! x

  • I have been on it for a few months my dose was increased from the 100/6 as well my improvement was quite fast... within a couple of days. I'm now on spiriva too which has helped, it's a really bad time of year with the rapeseed being in flower.

  • So I had a acute asthma attack last night. My first nasty one where you feel like your drowning on dry land, can't catch your breath and the dr on the phone says to your flatmate put down the phone and call 999.

    So I went hospital, chest X-ray came back clear, there is a higher amount of white blood cells so I have been given antibiotics for those, preds for 4 days and I have to an asthma review in a week when they have all had a chance to work. I was going to be admitted but my lungs rallied apparently which was good.

    I really don't want another attack like that any time soon if ever. It was so freaky. I always thought oh what makes an attack bad enough to call 999 so now I know. I feel like I have been hit with a stick and it hurts to breathe too deeply but I got away with it mostly unscathed.

  • Sorry to hear this but well done for doing the sensible thing and getting help! Yes it's horrible and scary when it happens and you just can't do anything πŸ˜•.

    I hope they get you sorted soon and that the pred gets you back to normal quickly. At your AN appt make sure you talk to her about everything that lead up to the attack as well as the months before when you hadn't been feeling great and ask if you're worried/unsure about anything!

    Feel better soon. Thinking of you x

  • Thank you :). I will I think I have narrowed it down. Cigarette smoke is definitely one, damp air and sort of humidity and air pollution. The UK air quality particularly in the south is terrible. You can check it on the governments websites. I will make today and insist the Drs at the hospital said a week.

    x

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