Impact of reducing Relvar dose

[LizPat30]

Dear fellow asthma buddies I wonder if I could ask your opinion. With the introduction of Montelukast, I was already taking high dose Relvar and Incruse, my asthma has been wonderfully stable. I have taken my reliever inhaler once a week before my dance class only. I've been walking and dancing without any real asthma symptoms. So following my consultant's advice and discussion with my asthma nurse I'm trying to move from high dose Relvar to lower. First week alternate days this week two days low dose one day high. But disappointingly after exercise I'm suffering with tight chest and instead of using the reliever one day a week as preventative I've had to use it every day. Do you think this is a coincidence, is it my lungs just getting used to a change or do I need to stay with the high dose. I'd be interested to know your thoughts before I go back to the asthma nurse. Thank you everyone. Jo

[twinkly29]

It could just be adjustment - but it's difficult to say. When you feel tight chested after exercise, it might be worth trying some breathing exercises first, in case it's your body getting used having less steroid/bronchodilator on board and coping with that on exertion, rather than actually an asthma issue at that time. If it is just retraining breathing patterns, then exercises, such as the breathing rectangle in the link below, done for a couple of minutes should relieve the tightness.

blf.org.uk/support-for-you/...

It might of course be the reduction but given it's being done gradually, it's hard to say - I don't know how quickly one would feel the difference.

[LizPat30 in reply to twinkly29]

Thank you I'm going to try, I'm just so disappointed. I want to reduce the amount of inhaled steroids but was enjoying being able to do so much exercise without problems xxxx

[twinkly29 in reply to LizPat30]

Poobah's suggestion below is good - especially making sure something is ok before you reduce again. Also making sure you have time to recover (inside maybe takes longer than it feels on the outside?) after exercise. So maybe reducing how much you're doing if/when you need to but with the longer term aim of getting there gradually.

[Poobah]

It's not uncommon to reduce medication after a sustained period of controlled asthma, in order to establish if it can be tweaked downwards, gradually and with follow up.

I would say though that dropping a couple of doses a week at first just to see how that goes would be prudent. But only drop another one or two doses a week once you know that you've tolerated the first decrease over time - a week on week reduction is just too fast. That's just me, proceed with caution and as slowly as possible, monitoring your reliever inhaler use as you go. You have to let your body get used to each small reduction before proceeding with the next reduction.

Going too fast can lead to a flare up and more meds in order to get things back under control. It can also dent your confidence in the process.

[LizPat30 in reply to Poobah]

Thank you I obviously needed more guidance about this, I'll increase the high dose again and monitor and not reduce until I can manage the change.

[LizPat30 in reply to Poobah]

Poobah as you and Twinkly were so kind to help me I wanted you to know after a week of reverting to two days high dose and then one day low I have been able to exercise no probs, asthma stabilised again. I'll take the next step slowly thank you so much once again. Jo xx

[twinkly29 in reply to LizPat30]

Ah that's great! Glad to here you're getting somewhere 😃

[Poobah in reply to LizPat30]

That's great news Jo! Good luck with your new plan. P xx