Symbicort SMART

[Purplejane]

Hi I know we are not supposed to ask for medical advice on this forum but I would like some opinions.

I was started on SMART in September by a consultant at the hospital and by and large it has been ok. Previously, I was on Symbicort 400/12 which he considered too strong but was dealing with my symptoms. I now have a cold and would normally double my dose of preventer as a precaution but SMART doesn't work that way. I can take up to 12 puffs a day but would assume if I needed that much I should see a doc for rescue meds. It was never really explained to me how to deal with viral infections etc.

If anyone is on SMART what do they do in the event of a cold. Any advice gratefully recieved.

[Minushabens]

I think the best thing is to contact your surgery for guidance. I know what you mean about SMART - I used to have a regime of 'just double up' if I felt rough, but it seems more complicated these days!

Obviously, if you have Ventolin & feel short of breath, use that to keep your airways open until you can get some advice. They might want you to take a short course of steroids, but have the conversation with them & they can advise you according to their knowledge of your medical history.

Good luck & I hope you soon feel better.

[Wheezycat]

I am also on SMART and generally I feel it works well for me. It is not often I take more, mostly due to my not recongnising the need for it. However, with colds I do. I have just recovered from a cold, and my previous one was not long before that. I normally take two puffs twice daily, but with a cold I double that. I base that on the fact that the one and only time I spent time in hospital with an attack, I was told to do just that then, and my GP agreed. But I agree that there is lack of guidelines. With my last cold it did the trick and for once I did not end up with prednisolone and antibiotics. With the previous one I needed them in spite of my regime. I was recently given some guidelines (after two years) but it only seemed to cover slight variations, not colds and the like. One GP once told me over the phone when I was quite unwell that I was doing the wrong thing, should not increase the way I did. Can’t remember what he said I should have done instead. It undermined my confidence. Until I get clearer guidelines I am delighted I just last week managed to avoid oral steroids! Still, like you I do wish there was more clarity.

[Purplejane in reply to Wheezycat]

Thank you for your reply. Your experience sounds similar to mine. Last time I went to the asthna nurse at my GP's I asked for an action plan for SMART and she said she didn't really understand how it worked! Thats encouraging. I had a cold in August but was still on 400/12 then so doubled the dose and I too avoided steriods maybe just luck but I was very pleased.

I think I will use my own judgement and double the dose for now and hope I am doing the right thing. After all, the medics say they like us to take charge of our asthma so thats what I'll do.

Congrats on avoiding the dreaded antibiotics and steriods I don't know what you did (or didn't do) but ut worked.

[Wheezycat in reply to Purplejane]

Just doubled Symbicort (I am on 200/6), and then kept an eye on myself and my peakflow. If I had deteriorated further I would have sought help, no hesitation, but I am rubbish at recognising my own chest related symptoms. So the cold clearly wasn’t as as some. A couple of days ago went back on normal Symbicort levels, as my peakflow had returned to what I consider good enough, and this morning my pf is lower again, probably because I have reduced my inhaled steroids, so I am still keeping an eye, and may up Symbicort a little again.