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confused about my inhalers now

gypsy49 profile image

Hi all

Really confused now i've been on both Fostair and Ventolin inhalers for years now seems to work for me always got told the Fostair was a preventer and the Ventolin was to use when i needed it hmm... got told today by the asthma nurse i shouldn't be on both as they're both the same thing . In me prescription i always got two Ventolin and One Fostair did wonder why i suddenly started only getting one Ventolin now been told my Ventolin will be stopped and to just use the Fostair plus tablets i have to take at night can't remember name M something she also wants me to go for a chest x-ray always had a cough since a child (im 57 now) nothings changed just the darn nurse , just wondering if she's right about my inhalers are they one of the same ? she's totally put me off track now and questioning everything and my old asthma nurse . Anyone know whats what cos i don't . Thank you for reading .

14 Replies

Hi, so the fostair has a faster acting reliver in it to open the airways and is meant to last longer then the ventolin along with steroid to treat the airways. The idea is to take your doses morning and evening regardless of symptoms then can take extra puffs as needed if symptomatic instead of ventolin. I get one ventolin a year now which I dont use now as the mart regime with fostair works really well for me, then montelukast at night helps with night time symptoms and allergies. Hope this helps or maybe someone will be along later to better explain it.

Sounds like they are trying to switch you to MART (Maintenance And Reliever Therapy) .... basically the fostair has a steroid and a longer acting reliever than ventolin (ventolin lasts 4 hours but the formoterol in fostair should last up to 12)

In MART you use the fostair as both preventer and reliever.... the benefit is every time you have a puff of fostair your also getting a shot of inhaled steroid to help with any inflammation that's causing the breathlessness

This works for most however they shouldn't be "taking ventolin off you" as you can only take a number of puffs of fostair (depending on the dosage it could be 8 or 4) so you should still have a ventolin for the just incase..... when I was on MART my GP insisted I also have a ventolin, so I left a boxed on in my glove box and carried around the preventer ..... just incase

Ventolin and Fostair are absolutely not "the same thing". It's not that simple so I hope the nurse didn't mean it quite in that way!

Ventolin is a short acting reliever, so it relieves symptoms but doesn't treat any underlying inflammation. Fostair contains 2 drugs - a steroid to treat underlying inflammation and a long-acting reliever. Most people take preventers such as Fostair twice a day, every day, and then ventolin as required, as you have been doing. Some people use the MART regimen (as Chip mentioned) where you still take Fostair regularly twice a day but then have a specific number of extra doses you can take if needed. However, if this is what they want you to do, this should be explicitly explained and a proper plan in place so you know exactly what you're doing with extra puffs and what to do if things worsen.

This explains about different inhalers:

healthunlocked.com/asthmauk...

I think you need to contact your nurse and ask if they want you to use the MART regimen and, if so, for a proper plan regarding that.

(Apologies to Andy/Chip for any overlap - it was easier to just write without working out who'd already said what!)

Casper132 profile image
Casper132 in reply to twinkly29

I have also been told the same thing but the nurse has changed my fostair to a 200/6 inhaler? When I tried to explain that I have been suffering with breathlessness for years even though I am on montelukast (which has improved my symptoms massively btw, no more asthma attacks thank god) the nurse started to get annoyed with me, still don't know why, she didn't tell me how many times I could take my new fostair inhaler but she did tell me to stop taking my serevent, when I asked what I should use instead she told me the fostair, My gps/nurses don't like it when you ask questions, my old asthma nurse encouraged me to do this so I could learn more about managing the condition, it would seem that they want you to do as your told and go running back to them with every little thing but yet you can't get an appointment and when you do they don't read your notes/know your history?

I am know worried about the affects of long term high doses of fostair after my opticians told me the strange problems with my eye sight could be linked to my inhalers and that was before the dosage was increased, if anyone can help I would appreciate it

twinkly29 profile image
twinkly29 in reply to Casper132

The serevent wouldn't be taken with the Fostair because they're both preventer inhalers. So stopping the serevent and switching to Fostair would be correct (new inhalers take about 8 weeks to kick in properly so there is usually a period where it's less settled until this point).

Inhaled steroids can affect the eyes but usually it's oral steroids that do that (prednisolone) when taken long term. Unfortunately inhaled steroids are needed for asthma so it's just an unfortunate side effect (I've been there and yes it's rubbish!)

Not all breathlessness is asthma related so it could be your asthma was controlled but the breathlessness was something else. But can I suggest you give the Asthma UK nurses a call to discuss everything? They are brilliant and your nurse/GP don't sound very helpful if they won't listen!

Casper132 profile image
Casper132 in reply to twinkly29

My apologies, I meant to say salamol was my reliever but thanks for the advice

twinkly29 profile image
twinkly29 in reply to Casper132

Oh I see - as opposed to serevent? Either way I'd phone asthma UK as at least they'll listen and answer queries as your nurse doesn't seem to want to which is not helpful!

Gggrrrr! I had a flat out argument with a consultant on this very subject. She relented in the end and I was "allowed" to keep my Ventolin as the emergency reliever in the event of an attack.

Twinkly is spot on and Fostair and Ventolin are different and definitely not the same. Ventolin acts more quickly but lasts up to 4 hours, whereas Fostair's bronchodilator is slower acting but lasts up to 12 hours. Personally, if I'm suddenly struggling for breath and I know things are taking a nose dive, I will take my Ventolin - up to 10 doses if necessary, in order to control an attack and prevent a 999 situation. Fostair just doesn't do that, in that you can't take 10 doses.

If you feel you still need to carry your Ventolin then talk to your asthma nurse again and discuss your asthma plan and emergency protocol.

Not every asthma patient responds well to steroids and/or long acting bronchodilators that are found in inhalers like Fostair. Careful assessment of the patient after each medication change is necessary in order to satisfy that the change has been a positive one for the patient. An attitude that "one size fits all" is depressing, given the advances in understanding that have been made in respect of asthma care.

Ventolin is not a bad medication and it's not forbidden. It serves as part of a wider package of treatment for many asthma patients.

Casper132 profile image
Casper132 in reply to Poobah

I have a few medical conditions and get the same treatment from my doctors/nurses, they treat me like its all in my head even though I have been diagnosed by specialists, last time I checked gp meant general practitioner meaning they know a bit of everything and are not specialists but what do I know, they contradict most of what the specialists have told me, unfortunately for everyone gp's are our first point of contact and decide whether to refer you to the specialists so there isn't a lot anyone can do, it's very frustrating

Poobah profile image
Poobah in reply to Casper132

I agree, it's very frustrating Casper. I find that my GP surgery hardly ever read the communications sent by consultants with regards my medical care and I have to follow up hospital appointments with a telephone call or a face to face appointment with the GP in order to obtain any recommended change to medications/treatments.

The daily max dose of Fostair 200/6 is four inhalations, though on the MART regime (no Ventolin) Fostair 100/6 can be used up to 8 inhalations a day.

As for your eyes, are you on any other inhalers apart from Fostair? And what did the optician say about your eye health? There are various eye problems that can arise from different medications so knowing what exactly the optician said is important. Ideally, the eye doctor talks with the asthma doctor whenever there's a need to reconsider how your health is treated.

Having said that, my eye consultant didn't liaise with my asthma consultant and I had to do my own research as to the possible cause of my eye problems. I believe I have that identified and addressed, but have to wait until next spring to get the tests again. Hopefully by then things will have improved or at the very least, not deteriorated.

No medication or surgery is without risk, but we have to be given enough information in order to make informed choices about our health and medical treatments. I always read the patient leaflets when I get a new medication, but I've still been caught out on occasion when unwanted side effects have not been expected.

As for ling term inhaled steroids - they're a double edged sword. Can't live without them, but the risk of other health problems can be minimised by a healthy lifestyle. It's a balancing act I'd rather not have to perform, but at least I have control over how & what I eat, my exercise, how much I sleep and necessary supplements. After all these asthma years I'm still learning.

Anniecath profile image
Anniecath in reply to Poobah

Hi everyone, this is so deperessing to read. I am 67 and have been asthmatic since a baby. For the last 30 years or so have been taking Serevent with Qvar and Montelucast tablets (which stopped me getting chest infections every year), which works MOST of the time. However I am allergic to all manner of things and it simply would not be possible to avoid all triggers, so I have Ventolin inhalers as rescue inhaler. I have been refused it because I have used it too often, because I havn't had a repeat for over a year or because the Qvar and serevent should be enough. I had horrible side effects with fostair and had to fight tooth and nail to go back on my old regime. The refusals via a receptionist no less. I am sick to death of this one sze fits all nonsense. A combination of algorythms and tick box mentality. How can we educate the people who are supposed to be looking after us ???

twinkly29 profile image
twinkly29 in reply to Anniecath

Usually ventolin "refusal" for not using very often just means it's dropped off your repeats but should be able to be re-added or at least prescribed as occasional use when required.

"Refusal" for 'using too much' is usually just that it means maintenance/preventer meds need reviewing because using 'too much' means asthma isn't as well controlled as it could or should be.

But if you're getting unhelpful comments from a receptionist, I would request a GP or asthma nurse call back to discuss it - then they can deal with it. It's not for the receptionist to decide how to deal with it.

Anniecath profile image
Anniecath in reply to twinkly29

Yes I am well aware of the points you have raised. What I was trying to get across was the refusal of so many medical people whether they are GPs, receptionists or asthma nurses to be aware that Ventolin is a useful tool in the treatment of asthma. For instance if I am now 67, how come I am still alive and kicking if it is such a dangerous drug ?

I sympathise with you as I'm sick of conflicting advice from GPS and asthma nurses down the years, makes you worry which of them aren't up to speed.A GP once said to me no-one should need a reliever and if they do their daily medication is inadequate. I'm on fostair but still have ventolin reliever just in case, although to be fair hardly ever need it.

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