LABA Question: As most of you know, a... - Asthma Community ...

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LABA Question

Matman profile image
3 Replies

As most of you know, a LABA (Long Acting Beta Agonist) is a drug you find in many Duel Inhalers which - just like Salbutamol (in a Blue 'Rescue' Inhaler) opens your airways, but, typically, keeps them open for 10 to 12 Hours, rather than the '4 to 6 Hours' relief you usually get from the more powerful Salbutamol.

I gather that - primarily due to some serious sounding safety issues concerning LABAs which surfaced a couple of years back (especially when used on their own without a Steroid Component in the same Device) - it became impossible to get a LABA Inhaler without that device being a Duel / Combo Inhaler, that also includes an Inhaled Steroid.

When I saw a Doc a short while ago, I said was interested in reducing the LABA in my Inhaler, but keeping the same level of Inhaled Steroid. The response was that - in my case - it might be more sensible to do the opposite (i.e. increase the LABA and reduce the Inhaled Steroid).

The Docs opinion was that - in my case - 'High Dose' Inhaled Steroids (I'm on the Max Allowed) represent a bigger risk than the LABA (Up to then, I had thought the opposite, i.e. that the LABA was the less desirable constituent).

While I seem very responsive to Oral Steroids (Pills), my response to Inhaled Steroids is somewhat debatable. Therefore, since the conversation mentioned above, I'm now wondering if the 'benefits' I'm getting from my Duel / Combo Inhaler (LABA + Inhaled Steroid) are mostly down to the LABA.

The session with the Doc ended without me having time to ask the following questions, so:

1. Does anyone know if things have since changed, and you can now get a LABA Inhaler 'without' an Inhaled Steroid constituent? AND

2. What's the minimum dose of 'Inhaled Steroid' you can get in 'any' Brand of Combo Inhaler that includes both a LABA and a Steroid

Thanks in advance for any response, and apologies if I omit to reply direct to a Comment left in reply to this Post.

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Matman
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3 Replies
risabel59 profile image
risabel59

Hi Matman,

I had my inhaled medications changed from a combination inhaler, Seretide 500, add on steroid inhaler, (ciclesonide 160) and a LAMA inhaler (Spiriva respimat). To Ciclesonide 160, variable puffs depending on peak flow, and a Combination LAMA/ LABA inhaler called Ultibro Breezehaler. ( the Ultibro is actually not yet licensed for asthma, ( in phase 111 trials). But my consultant thinks this gives more flexibility with the steroid component.

I was doubtful at the start of this massive change but I am now into 3 months of being fantastically well. Crossing fingers here. This is the best I've been for 2 years. So am happy.

I know there is a limit to the amount of LABA you can have. I have found the LAMA very helpful in combination. My consultant would not prescribe the Ultibro without the separate steroid inhaler.

There is a way you can check if the inhaled steroids are working for you, and that is with a FENO test. But the docs have to test several times, after a 24 hr break from meds, and then when using meds. The test is really simple and only takes a few minutes and measures inflammation.

Not sure any of this helpful, but maybe is another regime you can compare.

Best

R

Matman profile image
Matman in reply to risabel59

Most helpful and very interesting (have noted). Glad to know your new Meds are working well for you. Take Care. PS This (recently discovered) Asthma Article is quite illuminating. You may wish to check it out (time permitting): atsjournals.org/doi/full/10...

risabel59 profile image
risabel59 in reply to Matman

Thanks for this, always interested to keep up with the science.

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