British Lung Foundation

Inhaler advice asthma flare ups too often needing oral steroids

Hi all first time posting so thank you! Diagnosed with asthma in 2009 at age of 30. Contracted as result of viral infection or maybe swine flu. Was using symbicort once in morning and eve which worked quiet well for a while. Then getting flare ups though upping its use which required short doses of oral steroids 2-3 times a year. Have had 3 kids since and finished family, was thrilled with opportunity to review asthma plan. All my pfts etc are always perfect which is frustrating. So introduced singulair tablet initially which I feel didn’t do much, then got flare up in oct so put on new inhalers incruise 55 mcg and relvar 184 I think! Was thrilled to be trying something new but hated that these inhalers were big step up! Was so hopeful I would have new lease of life. I stopped singulair when starting these in oct. however had to take 3,2,1 steroids and antibiotics for cold in early dec, got break over Christmas but got another flare up requiring more oral steroids. I pick up any respiratory type infection very easily and really struggle with it mentally, it gets me down as I have three young kids. I teach full time but think for health reasons I might need to review this! Going back to consultant in end Jan. Anyone suggestions for other inhalers as I’m assuming the new 2 aren’t as effective as hoped. Really nervous of Aussie flu, have had jab. Consultant says one course of steroids a yr is ok but more than that not. Support or similar experience appreciated, feel very alone at times...feel like I’m crocked a lot though very good and active in sport etc when good🙈

4 Replies

Hi Timothy, and welcome. Hope we’ll be able to help you. My asthma largely linked to flu/viruses now that I’ve identified my other triggers and reduced problems with them to a minimum.....for me perfumes of any sort at all, smoke from open fires and salicylates in foods/toothpaste etc etc. I can’t givespecific advice on your meds as I don’t take those, except for singulaire, known to me as montekulast I find it very effective because it works well on my allergies, though took a while to kick in. It’s very very depressing being tied down to feeling awful with constant problems With the knock on effects of viruses in autumn and winter time. I know the feeling well! I’m surprised your consultant is alarmed by more than one course of steroids per year. I certainly have more. My doctor allows three courses per year on repeat prescriptions that I access myself, along with antibiotics, then I have to call in if I need more. It’s very wise to keep them to a minimum but not at the expense of causing damage to your lungs by fighting on without. Anyway, those are my thoughts. I do hope you don’t have to give up your teaching but I’m afraid teachers are prime targets for winter viruses! I used to teach myself but was fortunate that although my asthma started in my 30s it caused few problems until it built up later in my career. I think my regular stays in hotels when I began school inspections put me in the way of my triggers on a regular basis, and it took me and my dr some time to work out what they were. Constant irritation by what seemed to be increasing triggers sent my asthma well downhill, but much better controlled now. Good luck...hope things improve soon for you.


Hi Timothy

Yes when you have to use more oral steroids it is that your basic inhaler treatment is not doing the trick..

I am sure the Consultant will have a whole bag of NHS inhalers goodies to provide.

Just ask for some energetic treatment which prevents repeated flare-ups and and an action plan of what to do, which dosage to increase to etc when you do have a flare-up.

I have 4 inhalers, I can tell you which ones, but remember they are suited to me. I have severe asthma and LAM.

Am/pm Serevent and Alvesco 2 puffs of each.. then on demand Ventolin and Atrovent 2 puffs of each.

Regarding oral steroids the trend is beware..which is why your Consultant probably warned you because inhalers are already stronger than they use to be, the amount of steroids quickly becomes systemic..

In fact I was having oral steroids about 3 or 4 times a year with chest infections and I have been diagnosed with adrenal glands insufficiency as a result so I am on steroids for life now!

Since I finally have had my new 4 inhaler treatment in June I haven’t had any asthma flare-ups..which shows..

Good luck with your consultation.

Take care.


Hi Timothy, I think the other good people here know far more about the meds than I around this so would not offer my half baked ideas.

I care for my Mother with COPD so am not living with it myself however I was diagnosed with Hepatitis C about 21 years ago whilst I was the sole carer for my 2 under 10 year old children and thought ‘that’s my number up then, won’t see the kids grow up etc etc’ .

The actual truth was I did what I could to help myself etc., and took it a day at a time and tried not to look at the negatives that I have a natural talent at doing making me miss the good stuff in the here and now.

Hope that doesn’t sound patronising or anything, I guess what I am saying is take it a day at a time how you feel, if you can.

I have confused myself writing that. Hope that made sense!

Best wishes



Hi Timothy

Hello, thanks for posting this and to Breathezee Happylondon and Phil40 for replies. I learn so much from you all.

You're not crocked and keep at it! I believe you really are not alone, despite how it may feel at times. This forum shows this and armed with this, I'm reminded it is about getting accurate information and the more human side of being positive, and getting the right support. So I send you smiles. Being persistent when you have doubts about a course of treatment is a good thing, as is asking questions.

Perhaps I can risk saying why I find it so helpful and a relief to see you all helping each other with such wise input and kindness? It gives me confidence to try again.

I have just had a very odd GP home visit and reading your posts helps me to be more sanguine about it. I have a brain injury advisor that comes a few mornings a week and called my surgery requesting a home visit within minutes of her arrival today. I think I've just got an asthma exacerbation, but the pain and other symptoms for the past week or so now suggests my meds might need to be reassessed and I may need antibiotics or steroids. She had to be particularly firm in saying I needed a home visit as I can't walk well (mainly bedbound). I am long overdue any sort of review at this surgery. I had a call back and as I was struggling to talk the GP agreed to come round (less than a mile) a bit later.

We established that symptoms suggested antibiotics are needed and we went through which I can safely take. That was it. I don't need to be rushed in to hospital (as I have been many times). I was too tired other than to accept whatever was said, but I did ask if and when I could have my flu jab and review as requested for months. I was told I could get an asthma review 'but the government are telling them not to for two weeks'.

And other vague things.

Like many on here I have worked and had a full life. I had to verbally repeat details that are held centrally and easily accessible (click of a mouse simple). I did mention Aussie flu, and what did he think, or which media sources are reliable? I jokily referred to H5N1 and he looked blankly at me, not seeming to know that this is the 'bird one'. Like I am very stupid indeed.

This all makes my blood boil. I'm not good at anyone blaming 'the government' and asked how health intelligence is fed back to 'the government' and whether he meant the CCG, NHS England, or someone in the Department of Health? How do they do this? Email? Letter? Skype? When I am trying to engage with improving my own health, yet have to rely on services like this, I get very down. I have contacted the pharmacy to tried to get delivery of the antibiotics, and the surgery have not managed to go into the right screen to tick five boxes and get the prescription sent automatically. It was suggested I asked them to fax the request as none of them seem to know how the IT systems work. I will now have to wait until Monday to chase this again.

Sorry to rant. I hope you keep as positive as you can and gently question your Consultant and health professionals as to how things can be tweaked to improve things for you.

Hope your weekend is good.


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