Fostair chest pain: Hi there, 2 weeks... - Asthma UK communi...

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Fostair chest pain

None23 profile image

Hi there,

2 weeks ago I have been diagnosed with post covid asthma syndrome and been prescribed fostair. I have taken it for a week but had to stop because I was feeling chest ache/pain when when walking whilst on it, and sometimes shar pains.

I got scared and asked the doctor several times about it. At first he said continue, then, because I was scared he advised to stop taking it. I am seeing him again next week anyway.

Chest pain doesn't seem to be listed in the side effects patients leaflet information but was wondering if anyone else has experienced it with fostair?

Thank you

13 Replies

The chest pain could be post covid related rather than asthma related and it could also be anxiety related. So it might be worth asking the GP about those possibilities.

Side effects from new inhalers ususally disappear over a few weeks - and all preventer inhalers for asthma need to be tried for about 8 weeks for them to become fully effective (for future reference if another is suggested). Hopefully they've also ruled out breathing pattern disorder too as this is very very common after covid and breathing exercises fix it whereas asthma meds don't.

None23 profile image
None23 in reply to twinkly29

Thank you so much for your reply.I did lung functioning tests and they found my small airways are narrower than they should be and that is why I am not exchanging gas as well as I should.

Hence why they prescribed fostair. I do suffer from anxiety but was worried of having damaged my lungs perhaps if I am allergic to any of the ingredients and that would be why oli had the chest pains?

Thank you!

twinkly29 profile image
twinkly29 in reply to None23

Ah that makes sense with the Fostair as it's small particle.

It can often cause palpitations which maybe present as pain? It's the formoterol in it, the long-acting bronchodilator, that does that but that side really does disappear after a few weeks in most cases and is "a feeling". In case that helps you reason it out?!

I don't think damaged lungs and allergy are linked though and if you were allergic to something I would have thought you'd have allergy symptoms.

I also had quite a lot of chest pain after covid and it was certainly worse when we finally got on top of my asthma and I could breathe deeply again. Mostly my pain was across my sternum and lower ribs. But there was a raw feeling when I took ventolin too.

You should ask your GP to do an ECG to check your heart is ok (as a precaution, it's probably fine). There's a lot of people who also get post covid heartburn/silent relux so it might be worth asking your GP about that too as it's easy to rule out with a medication trial. Unfortunately it could well be that it's just a combination of your lungs/ribcage/sternum being able to move more as the fostair starts to do its job and you can breathe more deeply which causes discomfort.

I hope you start to feel better soon, post covid is horrible.

twinkly29 profile image
twinkly29 in reply to Glty

Does physio help that? Genuine pondering as much as anything as resp physio to teach people to breathe properly (ie not shallow breathing) in a not-covid sense would presumably do similar in learning to fill and empty lungs.....so just wondered if such exercises would make the pain more normal in a post covid situation?

Glty profile image
Glty in reply to twinkly29

I don't know, I couldn't access physio as my respiratory and cardiology referrals took so long and no one would take me until cardiology had cleared it as safe 🤦🏼‍♀️.

However, time helped, and so did reclined exercise to remobilise my torso. I didn't have the muscle strength to do anything whilst standing or sitting. Suzy Bolt's YouTube channel has some wonderful, gentle post covid rehab classes - no cardio at all, just relaxation and strengthening. I did try the free stasis breathing course from Mount Sinai which helped, but for me, I think Suzy's classes helped more. I found that I'd lost the ability to sit upright and maintain posture, which was preventing me from breathing right.

twinkly29 profile image
twinkly29 in reply to Glty

Glad you found a way through bit but it's so frustrating that you had to do it yourself. I know it's resources but I think everyone who has any breathing issues after covid should have respiratory physio.

Also glad cardiology cleared you too!

Glty profile image
Glty in reply to twinkly29

Oh they've not cleared me yet 🙈 but I'm 19 months in and my heart symptoms are almost certainly POTS according to the long covid clinic. I'm doing ok with self management and reclined exercise. I've had an ECG and echo which were ok but my cardiologist doesn't believe in POTS so I'm at a bit of an impasse.

twinkly29 profile image
twinkly29 in reply to Glty

Ah well it's nice some consultants in other areas are also frustrating, not just in respiratory!! Totally unhelpful to you of course though

Thank you all. I am so worried because they only diagnosed me with this post covod asthma now and it has been 9 weeks simce I had covid and I have postal nasal drip too and I am worried I have damaged my lung because they didn't diagnose it sooner ☹️

twinkly29 profile image
twinkly29 in reply to None23

I'm sure that won't be the case. People can go years with coughing symptoms before asthma is diagnosed and it doesn't damage the lungs as such. Covid itself doesn't actually damage the lungs in most people either - most people just need to teach their bodies to breathe correctly but their lungs are actually fine. If someone does have asthma then airways can become narrowed but that's to do with inflammation not actually damaged lungs. The inflammation is then treated by the likes of Fostair - to reduce it and so stop the airways narrowing.

It's important they address the post nasal drip too though - not for a "damage" reason as it doesn't cause damage to the lungs either but it could be making your symptoms worse. Similarly anxiety will be causing asthma-like symptoms too - notably chest pain is a definite anxiety symptom.

Sorry to hear about your problems. Just to share that I occasionally get sore/aching lungs when I’m recovering from an asthma flare up. (Haven’t had Covid so can’t comment on that). It usually only lasts a few days but is a very strange feeling. I have decided that it’s a sign that the inflammation is getting better but isn’t completely cleared.

I am also on fostair and have small airways problems

It's a steep learning curve and knowing what is "normal" and what requires attention can be stressful. Pain around the chest area would be normal after a chest infection, let alone covid, but an ECG can rule out any heart irregularities (unlikely, but good practice to check out chest pain).

The muscles and connective tissues of the ribs can take a real battering during a chest infection and after a while will start to feel achey or painful, even tender to the touch. Regular painkillers can help. But breathing exercises are extremely helpful in aiding recovery. A referral to a respiratory physiotherapist may be part of the post covid clinic's services, but if it isn't I would ask for a referral. I cannot stress enough how good breathing techniques are key to respiratory health and recovery.

My go to breathing guy is Patrick McKeown, a Buteyko practitioner. The exercises on YouTube are great as they help me remember what my respiratory physiotherapist taught me (it's difficult to remember technique after just one appointment). Even when I'm well I practice my exercises most days as I have a tendency to default to mouth breathing which is hard on the lungs. Here is a link to Patrick's vid on post covid breathing exercises and what is good and bad practice. youtu.be/AiwrtgWQeDc

Fostair is a potent, small particle medication and full benefits won't be seen for at least 8 weeks. To get the full benefit, learning how to breath to maximise inhalation of the meds is important, followed by holding the breath and then a good breathing technique. While you're in covid recovery I would wait at least 20 minutes after taking your inhaler before doing anything. This would be a good time to do your breathing exercises.

Fostair is a powerful medication and so your body will need time to adjust. The good thing about an inhaler over tablets is that the medication is targeted to the lungs and this reduces any unwanted side effects that accompany steroid tablets, the alternative. It also means a lower dose of the medication is required; micrograms rather than milligrams.

I hope you start to feel better very soon. All the best.

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