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How often is it OK to take brown inhaler?

DaveT81 profile image

OK, so by that I'm obviously meaning Beclomethasone/Clenil Modulate.

I only ask as, when first prescribed it to see if I had asthma about 5 months back, I was told 2 puffs, twice a day.

My breathing issue has not abated, and another doctor I've seen reckons it's definitely asthma so he asked if I still had the inhaler and said to try 2 puffs, 4 times a day.

I was a little unsure, as all indications I can find say twice a day.

Is that the max?

12 Replies

You might need to change your brown inhaler because it's not suited to you. Ask the asthma nurse's on here they should be able to assist you

EmmaF91 profile image
EmmaF91Community Ambassador

It depends on the dose you’re on really. If you’re on a lower dose you can have more puffs than if you’re on the higher dose.

If you do feel like it isn’t really helping tho, it’s definitely worth asking about triallinga different inhaler - there are lots on the market and some may work better for you than others

Hope that helps x

When i was on the brown inhaler, i used to take 2 puffs in the AM and 2 in the PM but if i had a cold etc i would up the dosage to 4 puffs in the AM/PM for one week and if it still didnt improve, the DR would give me some steroids to take. Best off booking an appointment, you may need a different inhaler.

in reply to micajay89

Yes, this is exactly the same advice my asthma nurse gave me. Seems to work for me.

Have you had an asthma review with an asthma nurse? You should have done if you are so newly diagnosed. I’ve found they are more helpful and expert in asthma than the GP and a few of our GP’s phone her for advice if they are unsure of what the best course of action is. You should also have an action plan for when things worsen.

As far as increasing the dose, I’d be doubling the morn and eve, rather than doing it 4 times a day. I do think if you were expected to remain on that level then you need a different inhaler, possibly a different type altogether.

I hope things settle. Don’t be afraid to keep going back. Mine saw me ALOT when I was newly diagnosed 5 1/2 yrs ago. I was always down there for advice and needing my inhalers changed and things added on until things settled and I knew what I was doing. They really don’t mind keep seeing you. X

I was taking 6 in the morning and night at one stage that is when my nurse changed me and I have not looked back. I am stable and I am controlled. Try and speak to a nurse. I have nurses that is trained in this area and I find them useful.

Good luck

Have you had breathing problems for 5 months? or has it gone and comeback?

Have you been seen by a pulmonologist?

If you havent I would push to see a specialist and get a definitive diagnosis.

Taking Clenil should have given some improvement.

DaveT81 profile image
DaveT81 in reply to

No, had a breathing problem permanently since last July to be honest.

It started when I took up running again. About 3 weeks into running 3 times a week, I got a bit of a cold. The breathing problem started around then and got gradually worse. It kind of levelled off at the point it is now.

It's bad 24/7, gets worse on exertion and in evenings. I'm breathing hard doing simple things like showering, walking up a flight of stairs.

I wasn't officially diagnosed with asthma, but the nurses I saw at my local GPs trialled me on steroids, salbutamol and then clenil. I didn't notice a significant improvement, to be honest.

I later saw the actual GP. He quickly decided it was anxiety. So I've been reluctant to see him since, because he's pretty much made his mind up. He tried my on prozac but didn't really do anything for me. Just took the edge of my decreasing mood. A decreasing mood caused by my deteriorating breathing.

Had chest x-rays, spirometry, CT scan, heart echo, manometry, gastroscopy - all pretty much clear.

I'm also seeing a private doctor who is convinced I'm suffering with symptoms of various autoimmune disorders (I have other symptoms), but he can't explain my breathing either. He's the one who said it sounds like asthma and to try the clenil 2 puffs, 4 times a day.

I'm at a real dead end right now. So pretty keen to see a specialist of some description.

in reply to DaveT81

You are similar to me, I started experiencing shortness of breath (SoB) after a cold/bad hay fever in April and it has been continuous since then, I will have periods of feeling slightly better but it never goes away.

Mine gets worse on exercise but feels the same in the evenings.

Here is where it is interesting, I am asthmatic and have been my whole life but my asthma is totally controlled.

After several months of taking the max dose of Clenil and regularly using ventolin (trip to A&E and started Pred) and getting virtually no improvement my GP worked out it isnt asthma.

If you have had a spirometry and the inhalers dont help your SoB there is a reasonable chance you dont have asthma.

Anxiety is extremely unlikely to give you continuous SoB, plus exercise would not make SoB worse if it were anxiety driven.

I have 2 possible causes on my list.

Laryngopherangeal (LPR) Silent reflux

Some sort of vagas nerve damage, post viral vagal neuropathy

I think you private Dr might be right with a autoimmune disorder which might cause vagal neuropathy

I have some other symptoms that are LPR type symptoms.

DaveT81 profile image
DaveT81 in reply to

You're one of about 3 people that has mentioned vagal nerve damage to me! I have thought this myself from the beginning, as I also suffer with afib, which I believe is vagally triggered a lot too (lying down, moving too fast, head or neck tilted to specific angles), particularly at night. I've not had the guts to mention this to any Dr yet, but I may bring this up with my private Dr when I see him on the 18th Feb.

Also, it's interesting that you mention silent reflux as this was something that was looked at early on. I do have new-found stomach issues, which arose around 12 months ago. They gradually became worse to the point where I am no almost entirely gluten, dairy and wheat free. I was on Omeprazole for a few months but they gave me minimal relief. I have a LOT of bloating and wind these days, which I think contributes to my worsening breathing in the evenings but isn't the main cause.

in reply to DaveT81

I had the bloating, extreme bloating and gas, mine appears to be wheat sensitivity. With the bloating I would get palpitations and anxiety, lying down would trigger this, once I stopped wheat all of these symptoms stopped. I think I get some minor bloating from apples and a few fruits but not too sure I am thinking of trying the fodmap diet but I cant really afford to loose much weight.

I think I have stopped most of my LPR symptoms but still get a sore throat every morning, the lump feeling in the throat is going but I need to keep clearing my throat.

I saw a GI and have a hiatal hernia and am due to see a ENT its so difficult to get to the bottom of this, ultimately if it is vagal then there is no treatment as far as I know.

I get some relief from the SoB when I eat a reasonable size meal, sometimes lying down can help, do you notice when your breathing is better?

Good luck and if you get any answers and you remember please send me a message, Id be interested.

This seems a bit haphazard - a lot of people on this forum seem to get this treatment. Spirometry will tell you whether you have asthma, as you can undergo a reversibility test; you may need other tests to confirm or eliminate other causes of your breathing problems, but I wouldn't be fiddling about with inhaler doses in the absence of some definitive diagnosis. However, if you feel you need to increase the dose (rather than try a different inhaler - some work better for some people than others) then you can consult the BNF for typical and maximum doses:

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