Salbutomol inhaler repeat prescription disallowed

Hi, I have been diagnosed with COPD for 4 months now, been hospitalised once and had another day in for a flare up. I have been on Salbutomol (to use when required) and Vilanterol (once a day), my doctor has now put on my notes that I must not be prescribed any more Salbutomol until mid December. I admit I have been hitting the salbutomol hard, and even used friends when desperate. Is their any medical reason known for why he should have taken this decision? Thanks in advance.

49 Replies

No idea chango but can you ring your doctor or Pharmacy and ask them maybe. Hope you are keeping as well as you can. Xxxx

Going in to Docs on Thursday, hope for an explanation then.

It might be worth speaking to the hospital Dr who treated you

Can't think of any reason apart if your inhalers are not working properly ask to be refered to a consultant at the hospital to be put on the right inhalers because if you are having to use your salbutamol inhaler more . You are not on the right preventor inhaler

Will find out on Thursday, if their are any problems with over use of salbutomol inhalers i'll post here.

I think that is ridiculous that he has stopped a very effective drug that dose not do anyharm if taken to much , i would go back and ask why he has done this , if the doctor thinks you are using to much then surely he should be asking you why and finding out more , do you use it through a spacer ; my mum has copd , i have asthma so some of our medication is the same but my mum cant take her salbutomal inhaler without the spacer as she just cant get used to the breathing in as she sprays the inhaler she would be as well staying it in to the air for all the good it dose her but with the spacer it helps and she uses less inhalers so maybe your doctor should speek to you first and find out why you are using so much , I have inhalers every where in jackets bags and all over the house my gp hss never refused or questioned the amount i use .

Hi Lorraine, I have been limited to how much I use.

Sometimes using too much can make you shake a bit , did the doctor say why they are limiting the anount that you use , normally you would use as required. you know how you feel and if you feel breathless then normally you would use your inhaler. Is always my inhaler at hand if not in my hand .

I have been having one per month on repeat. After a consultation with an ill tempered doctor who told me to stop using steroids as I don't need them, and pulled his face after a respiratory nurse asked if I could have an extra one every other month in a letter sent to the practice. I ordered steroids and abs 4 weeks later and noticed that abs had been removed from list of acute medicines. After chasing for the prescription I was told it had been declined so I changed doctor the same day. First thing I was told by receptionist was to keep emergency meds at home. Got them now but not needed them yet.

Im lucky i have a good gp, and he gives me a rescue pack of seteriods and antibiotics i call it my emergency pack , i do have to contact my gp when I start using it , its mainly for when the surgery is closed, but I have done this for years . it helps having a good gp who you can trust , but always remember to re stock your emergency pack .

Glad you have a good GP the one I saw knew nothing about me and only recently joined the surgery. Hope you are keeping well.

Thank you Joyce im doing okay on oxygen permanently now just getting used to it , only recently been given it at home after several hospital admissions this year , twice i went into type 2 respiratory failure so not had a year , roll on next year lol , i hope you are keeping well .

I am ok at the moment. I too am on the oxygen after stay in hospital in May. See it as an extra medicine. Am impressed how perfect strangers offer to help when they see you with it on. Just off to bed, goodnight.

Thank you

Taking too much Salbutamol can be harmful. My husband used to have very bad asthma when he worked in a tyre factory He would wAke up from a night shift after continually taking his inhaler and be so breathless and grey he thought he was dying You can overuse this inhaler. Or so your doc should be giving you something in addition to. Control your asthma or copd


It is possible to overdose with salbutamol.

On a recent respitory nurse appointment I was told to use Ventolin (salbutamol ) four times a day, morning, noon, teatime, bedtime, and any time in between. She even rang the surgery to up my script from one to two per month.

In the end I use it two or three times with spacer, and changed order back to one.

If you felt the need to use so much, then clearly you have not got your condition under control. Have you access to a respitory nurse you can be referred to, they have more time and a better understanding of the condition and effects.

Maybe the preventive inhalers are not working as well as they should, again the respitory team can take you through the various options.

Speak to your GP as to why the refusal and ask for a referral to the respitory team at local hospital, they do give you more time.

I presume you are a non smoker.

Thanks stone for that link.....a good reminder.

I very rarely use mine now, but I always carry it with me.

Prevention better than cure as they say.....I learnt the hard way.

Thats really good advise, my breathing problems are not under control alot of the time thats why I do use my inhalers a lot but i do see my consultant or gp regular they are really good and just now its trial and error . lol

If are using your Ventolin too much it will make your long acting inhaler less affective. If the receptors in your lung are full or partly full of Ventolin, then when you take your long acting Vilanterol there is less space left in the receptors for it to latch onto - so then it's effect is weakened and the time it is meant to be active for is shortened. This is why patients should never use Ventolin within an hour or two before/after a longer acting inhaler such as Vilanterol or Symbicort. Also high doses of Ventolin over a the long term can give rise to tremors of the hands that can be irreversible, as well as increased heart rate. My own Ventolin lasts me more than a year.

Thanks, I now understand, I was hitting it 5-10 times a day!!! Maybe the doctor was right. Will find out Thursday, it's just a bugger not being able to breath properly and not taking salbutomol.

I was advised at pulmonary rehab that Salbutamol can be used up to 8 times a day if needed.

This will be the reason why it has been removed. So that you have to ring or visit to get a replacement and the doc can monitor just how much you are using.



I've always been told to use the reliever about 15 mins before the long acting inhaler to open up the airways and make it more effective.


Sue x

I've been advised the same

Hi Watford girl....if it works for you that's's just that we are all genetically different ...what suits one person may not suit another.

I just can't cope with too much Ventolin now.

I was told the same thing

Hi - It would depend on what your other inhaler/s you are on. If you are just on the reliever (proper term 'Short Acting Beta Agonist' or 'SABA') and then an inhaler that is a different type of medication - eg. Spiriva, Seebri Breezhaler (these are not Beta Agonists) - then it's OK to take the reliever. But if - as many of us are - you have something like Symbicort or Vilanterol that contains stronger, longer acting versions of Beta Agonist medication then you should not take the weaker, shorter acting 'rescue' inhaler first. Properly trained Specialist Respiratory Nurses should know this - but many 'ordinary' GP nurses don't. It's not the end of the world if you take it before a long acting Beta Agonist - it just means you won't get the full benefit of the stronger/longer medication.

At PR we were told to take the ventolin first thing, but the consultant said to try and manage without taking it until later in the day as often the breathing settles down after the long term inhaler is taken.

It gets a bit confusing with all the different advice, doesn't it?

Have just come back from appt with consultant and asked him about this.He grinned and said "take them when you want to" - meaning, I think in relation to each other. So now I'm reassured and totally confused!!

Information overload, I'm afraid! I don't think there's a definitive answer to any of it as we are all so different. Still, you got an answer of sorts and are reassured. I'm inclined to stick with what the consultant says - unless, of course, I disagree with him! Haha!

Another problem many aren't aware of with Ventolin, is that if after shaking it you take say two sprays of it, without shaking again in between your 1st & 2nd spray, then your second spray delivers no medication - just the 'carrier' chemicals. So always, always shake between each and every inhalation.

I can relate in a way, I too used a lot to start with until I had cleared out all the gunk from my lungs that was causing "plugging", a solitary cough would make me really short of breath. I hardly use Ventolin now.

Years ago my middle daughter was told that she was overusing Ventolin.....she needed a review of her preventer.

I have been too reliant on it in the past .....and it ended up not working at all....I collapsed and had to be carried into A and E by my neighbour ...who has never let me forget it.

I know now, if I am needing to use Ventolin more that it's time to up my steroids or get help.

I hope your visit to your GP goes well.....explain to him why you need to use it so often....then ask him why he has limited its use, hopefully he will find a preventer that helps you.

Meanwhile if you find you are getting increasingly breathless before Thursday....ring your surgery or 111 out of hours for help.

Thanks all! My unauthorised inhaler (from a friend who no longer uses it) has now been confined to the medicine chest, guess I was getting too dependant on it, but the sheer hell of a COPD flare up - with full on panic attack is something never forgotten (I crawled to my phone to call 999 and then collapsed by my front door - luckily unlocked, and had to be stretchered to an ambulance purple and wheezing. Thank God for the NHS and amazing ambulance staff).

Hi changohank.......please keep your Ventolin near you until you see your GP....your body has got used to it for now and you may need it still.

You haven't got another inhaler in place yet keep it handy and take it with you to the GP.

I know what it is like to have a full blown attack....sheer's said to be like breathing through a straw, but it was much worse than that...virtually impossible to breathe even with multiple puffs of Ventolin. If it wasn't for my neighbour I don't think I would be here now....he always says it's a good thing I am skinny as he couldn't have carried me .

Keep your inhaler to hand.....and have you tried the pursed lip breathing technique as that can help with breathlessness.....breathe in gently through you nose......belly breathing with relaxed shoulders .....then gently out through your mouth with pursed lips for a longer time.....repeat a few times.

If you feel worse before Thursday remember to ask for more emergencies .

Have you tried contacting the BLF helpline....they are open during office hours.

I've been taught "mindful breathing" by a friend, breath through pursed lips almost permanently. The inhalor is just in a drawer, not in my pocket. If I do go out it will come with me, I think I just overused it as I was so terrified of another flare up! If it gets worse i'll dial 111 for advice ir ask for a home visit from me doctor. Will keep you all posted on progress. Hopefully I can get put back on a short course of Prednisolone again, it's been 6 weeks since the last one.

Hi changohank will be sick of me......but are you breathing in through your nose not your mouth.....nose breathing is best as it warms and filters the air and helps prevent hyperventilation. Someone did a good link the other day ....but I have forgotten who it was.....about good breathing .

Right I am going now and leave you in peace....have you made a note of what to ask your doctor , I always forget what I was going to say .

Good luck....and I hope you get sorted .....have Pulmonary Rehab classes been mentioned to you. ...another good idea.

Cheers for that, "mindful bteathing" in through the nose for a count of 5, out through the mouth for a count of 10 (if you can make it to 10. :-)

I seem to use plenty in the colds season... and not a lot in the summer. I carry on ordering it so I have a stock - I prefer to manage 'as required' by my judgement.

They'll probably let you get on with it when they have some confidence you aren't going to cause yourself a problem.

There does appear to divided professional opinion about which to use first if taking both LABDs & relievers vs Salbutamol.. our respiratory nurse is of the binding to receptors and partially blocking relievers & long acting bronchodilators camp - so she recommends you take the long acting stuff first and give it half an hour before the Ventolin... IF you can wait that long.

Hi the thinking on the salbutomel reliever has changed in the past year or so. What they are saying now is that it shouldn't need to be used more than 3/4 times a week. I was told if I need to use mine more than that to up my dose of symbicort instead as this has a reliever element in it as well. I must admit I do use my ventolin around 2/3 times a day and get a new one every month. x

Never thought I'd say thanks to a Man U fan (I'm Leeds), but thanks a lot. :-)

Ha ha. When I first started going to Old Trafford back in the 60's Leeds were a good team and well up in the old division one. It's always a shame to see such a big team decline over the years. x

We"ll be back (maybe not in my lifetime - I'm nowt if not realistic)


Hope so. :) x

I always think ,,,if my body gets toooooo used to the salbutamol entering my lungs by nebuliser strength ,, then what do I do from there when that no longer gives me relief,,,? ,, always use your inhaler and last resort the nebuliser ,and maybe your GP is thinking your not using your inhaler enough or properly ,hence he's holding back on the prescription ,I have on many occasion had 4/5 puffs at a time on my inhaler ,best wishes ,

I over used salbutamol and had serious twitching and very fast heart rate and as someone that has tachycardia not a good thing. However I rarely use it now as I have learnt to control breathing a lot better and the panic breathing has been controlled better. I am surprised that you have not been given something else though?

Bugger (sorry, hope that is allowed) think I've strained a muscle in my chest now due to all the coughing. Just send me to the knackers yard. :-)

This morning I put in a repeat request,online, and Salbutimol has been declined. My original prescription was listed as Salbutimol x2, but now the long acting inhalers have started to do there job I don't need 2 so I only ordered and received 1 only but they say it was 2. So if they don't sort it out then I will have to give up working, which also means closing down my workshop and putting 2 others out of work too. Business is so tight that all 3 of us have to be producing to be able to keep it going. It also raises the possibility that I could end up back at the hospital. How much is all that going to end up costing the country all through inefficiency. Not my fault because I only asked for 1 out of the 2 on the repeat form surely.

Hi regarding over use of the inhaler I found out the hard way about 3 weeks ago I went into hospital to have a pacemaker fitted because of my breathing problems and my heat was out of sync the opp meant that you had to lay flat for 2 plus hours and being fearfully of getting mucus forming I used my neb in the morning then I used my inhaler many many time's before the opp which was a distressing 4 and half hours as it went wrong now after it was all over my obbs were taken and they found my heat beat was 135 so they had to keep me in over night to try and lower it so over use of the inhaler can double your heart beat it took about 3 days to get it to settle down to something around normal when at rest sorry for the long explanation but that's how I found out I would have thought people who are using inhalers should be told about over use

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