Asthma medication denied by surgery

I am new to this site and recently had an experience with my GP practice and pharmacy that upset me considerably. Recently I went to my pharmacy to pick up repeat prescriptions of inhalers etc. Amongst these was a request for ventolin inhaler. As I was going away and running low I wanted to be on the safe side. The pharmacist informed me that the request for ventolin had been refused, there was a block on my notes. Reason being I was now on Qvar and Serevent inhalers and didn't need the ventolin inhaler anymore. And as I hadn't requested a repeat prescription for the Ventolin for over a year they assumed I didn't need it any more. I have been using these 3 inhalers + Montelucast tablets for quite a while now and it suits me. I pointed out that Qvar and Serevent were preventive and Ventolin a rescue inhaler. The pharmacist said I would have to sort it with the surgery. I traipsed to the surgery. The receptionist said there was nothing on my notes which prevented the repeat prescription being given. She would request an urgent repeat prescription for me in time for my trip away. I went back to the pharmacy a couple of days later and picked up the repeat prescription without a problem. How has this happened ? I'm still non the wiser and deeply sceptical of what happened.

I am 63 years old and have had asthma since I was a baby. I spent much of my childhood fighting for breath and this continued up until my early twenties when the medication became much more effective. For about 30 years I lived in Lancaster where I had the good fortune to have an extremely good GP and excellent fully qualified Asthma nurse who put me on the montelucast tablets. This improved my life quality enormously. Since moving to Cornwall I seem to have had nothing but problems regarding my medication. I am on my 3rd GP practice now. They all want to change my medication immediately, even though the regime I have means that I am well and happy and can mostly do what I want to and need to. There will always be times when I am wheezy ie doing shed clearing etc etc but mostly I live a normal life. What nobody seems to understand is that when asking someone to change medication, which works , is like asking to take away the safety net. I have yet to come across a fully qualified asthma nurse here, a general nurse with an interest in asthma is what seems to be the norm. There also seems to be little attention paid to the maxim of partnership between patient and surgery.

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  • Your Serevent (Salmeterol) replaces the Ventolin:-

    "Salmeterol is called a bronchodilator because it widens (dilates) your airways. It works by opening up the air passages in your lungs so that air can flow into your lungs more freely. This helps to ease symptoms such as coughing, wheezing and feeling breathless. It is prescribed to relieve airways-related problems in people who have asthma or chronic obstructive pulmonary disease (COPD). Salmeterol is called a long-acting bronchodilator. Its effects are usually felt within 20 minutes and last for around 12 hours.

    If you have asthma, as well as a salmeterol inhaler, you will also be prescribed a preventer inhaler containing a steroid medicine. Alternatively, there are several brands of salmeterol inhaler which already contain a steroid called fluticasone. You may be prescribed one of these combination brands to help reduce the number of inhalers you need to use each day."

    Because I am on the Symbicort SMART regime I also do not really need Ventolin, I have it because I use it when I am out and not easily able to rinse my mouth and throat after using Symbicort.

    I am 84 and have had Asthma since I was 2!

  • Pete, I'm confused by this, because my understanding is that salmeterol is not the same ventolin, and should never be considered as a replacement for it.

    Ventolin is a fast acting medication, intended to give quick relief. Serevent does not work that way. Use serevent to try and bring an acute attack under control and it will not do the the job.

  • I didn't know that Pete. I do wonder what will happen though in the event of a sudden asthma attack if the meds take up to 20 minutes to work? Doesn't ventolin start to work immediately? Isn't that why it is prescribed as a reliever? x

  • Ventolin is slightly quicker 5-15 mins. The best replacement for Ventolin is formoterol such as an Oxis inhaler which is 5 to 10mins BUT lasts for 12 hours.

    salmeterol is 5 to 20 mins and also lasts for 12 hours.

    I have tried them all!

  • Yes you know a lot about them. If ventolin is a bit quicker acting then shouldn't it be prescribed as well?

    In a bad attack the extra few minutes can be crucial after all. x

  • Yes definitely, but many GP's like to keep things to a minimum where inhalers are concerned.

    I insist on having Ventolin to hand all the time.

  • I've been on serevent in the past - and ended up on oral steroids as a result. I didn't know at the time that I could use ventolin as well so I didn't use it; I relied on the serevent as a reliever (along with flixotide 250 preventer inhaler). It didn't do the job!! My asthma spiralled out of controI (it didn't help that a viral infection was brewing at the time). I ended up, to quote my GP, very very unwell.

    I have had many, many infections as an adult, but only on two occasions has my asthma gone badly out of control as a result. On both occasions it could be put down to the fact that the medication I was using was not sufficient to keep it controlled.

    I would refuse point blank to have serevent if a doctor tried to prescribe it for me now.

    AnnieCath, you know your asthma; you know the regime that works for you. Asthma is a very variable condition. If what your are on does the job, fight to keep it.

    I also order my ventolin inhalers infrequently (usually when they reach their expiry date, so often two years since the previous request). I've yet to have a problem re-ordering them. Yes, I do mean them. I always request two: one stays at home and one goes with me whenever I go out. My GPs understand the logic in that and let me have them:-).

  • Hi MaggieHP yes it works for me. Trouble is it seems I have to fight every time to get a repeat prescription because a receptionist has decided I shouldn't have ventolin. I'm running out of patience and fight. I too ask for two at a time. They are after all life saving devices in my eyes !

  • Absolutely! Only thing I can suggest is to make an appointment with your GP and go through this with him/her. Get your arguments sorted in advance, point out the mortality rates for asthma (the GP should know them, but it won't hurt the GP to realise that you know how dangerous your condition can be too). You could also ring the asthma UK helpline and ask advice from one of the nurses there if things continue to be difficult.

  • Hi a receptionist wouldn't do this off her own bat. S/he must have had previous instructions or maybe misunderstood them. Only a medical person can decide which meds you should be given and how many.

    If for example s/he looks at your details and the doctor has said no more so and so until a certain date then this is what they will follow.

    A receptionist never decides what drugs you can have or when. x

  • Yes I understand all this. However in this case something went horribly wrong. When I went to the pharmacist to pick up they said the receptionist had said there was a block on my notes. I then went to the surgery where the receptionist looked at my notes,on the computer and there wasn't a block on the ventolin. So either someone is playing silly buggers or someone is lying or they made a mistake and are covering their tracks.

  • Maggie we crossed with the same thoughts. I would like to know the answer to this too. x

  • Is Ventolin only available by prescription in the UK?I live in Greece but visit UK often.Like many,I always have it close by.

  • Yes, you need a prescription for it.

  • I have symbicort but I'm still prescribed ventolin for emergency use.

  • In South Africa quick acting inhalers (ventolin, asthavent, venteze etc) and long acting bronchodilaters(serevent) ar all over the counter, sorry u had to fight to get what you need to stay sane

  • Same here in Greece.Fortunately!

  • Sounds like they're more enlightened in South Africa re the treatments for Asthma.

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