Using Fostair 100/6 & Ventolin Advice

[BerthaEdwina]

I’ve recently been diagnosed as having adult asthma.

I’ve had various symptoms over the years including chest infections, acute rhinitis, etc. but not diagnosed as didn’t know it was an issue.

I was initially prescribed Ventolin but was moved over to Fostair a month or so later as the Ventolin wasn’t working.

My asthma has been getting worse again over the last few weeks so I had review with the asthma nurse who has now prescribed montelukast as well doubling up on the Fostair inhaler.

Over the last few days, I have had to have more than 7/8 puffs of Fostair a day sometimes and it’s still not enough. I’m also coughing and wheezing much more recently to the point of being physically sick quite a few times a day.

I read that I can use the Ventolin inhaler as needed which I did one last night but I’m worried about overusing the 2 different inhalers.

Has anyone else had this problem?

Would appreciate any advice.

Thanks

[Troilus]

Hi BerthaEdwina. When you say your Fostair was doubled up, do you mean you were put on the Fostair 200/6?

There is a limit on how much Fostair you can take per day. The standard high dose is 2 puffs twice a day, although there is an “off licence “ dose which I am on under the care of my consultant. My max is 6 doses a day.

If you are still using the Fostair 100/6 then the max dose is 8 - 2 in the morning and 2 in the evening, leaving a further 4 doses to use as necessary. If you need relief when you have used your allowance of Fostair then you use your blue inhaler.

For relief you can take your blue inhaler as often as needed, and you do not need to limit that to one or two puffs at a time. When I was first diagnosed I sometimes took 4 in order to get relief. In the event of an attack you can take 10.

High use of the blue inhaler indicates your asthma is not well controlled, which I assume you realise as you are in close contact with your asthma nurse. It may well be that the higher dose Fostair needs time to kick in.

You could try added an antihistamine into your daily routine. The pollen count must be high at the moment - for the first time in my life I saw yellow pollen dust on my car yesterday. If you are not already taking one, a steroid nasal spray may help with your rhinitis.

Do keep in touch with your asthma nurse. It may be that you need a dose of prednisone to settle things down and give you control of your asthma. Your asthma nurse or GP will be able to advise you on this.

[BerthaEdwina in reply to Troilus]

Thank you for the advice.

I meant to say the asthma nurse said to take 2 puffs of Fostair in the morning and then another 2 at night as prevention and then use it again as needed. At the moment, I’m taking about 8 puffs of Fostair and then topping up with the blue inhaler which is the only thing that seems to be helping.

I’m already on a steroid nasal spray and had a dose of prednisone earlier on in the year to help with a chest infection.

I’ll go back to the asthma nurse again as never sure what to do as quite new to this whole thing.

[Troilus in reply to BerthaEdwina]

It all takes a bit of getting used to BerthaEdwina, but you will get there.

[peege in reply to BerthaEdwina]

You're on the MART regime so safe to use as & when you need it - read the leaflet, it should explain the MART regime and maximum daily puffs. I too take it, occasionally during exacerbation I'll also use ventolin. I always use a spacer ensuring you get a maximum benefit & wait 30 seconds between inhalations as instructed. In the past my asthma took a downturn & I was exceedingly embarrassed to discover I hadn't been inhaling correctly 🙃.

There are usually youtube videos of using tge different inhaler brands, quite useful to double check. P

[kidas in reply to Troilus]

what is the difference in fostair 100/6 and 200/6 I was also changed from Ventolin to salamol and am unsure about it. I have been using more and was didn't really feel the benefit as quickly as as the Ventolin although it is the same product couldn't find any information on propellant used. I thought I was being triggered more because of the rewilding everywhere local council had let grass and weeds grow up to about 3ft I wondered if this was attributing to triggering me.

[Homely2 Administrator]

I am generally much happier on fostair 100 mart, like you are. However when my asthma is out of control I sometimes am switched back to fostair 200, and put temporarily on 6 doses a day.

I would start to work on what is triggering your asthma, which they can partly tell you with blood tests. I am per blood tests allergic to dust mites and tree pollen, I also hate cold and wet conditions.

Try keeping a diary of attacks and possible causes then look for the links, once you have this, you can then start to reduce the triggers.

So for me an air purifier helps, wearing a muffler over my mouth in bad weather, eating smaller portions of food to avoid Gerd, all help a lot.

Get your medication settled, minimise your triggers and then your asthma will settle down

[Patk1]

Ventolin/ salbutamol is yr main reliever inhaler

[Lysistrata Administrator Community Ambassador in reply to Patk1]

Not necessarily the main one if someone is on the maintenance and reliever (MART) regime, which it sounds like BerthaEdwina is currently. On MART you are meant to use Fostair or Symbicort first as a reliever to top up the preventer doses, up to a set number in total per day. Then use Ventolin on top if needed.

BerthaEdwina - it does sound like you're really struggling currently! When did you see the nurse and get the montelukast? You do need to give medications time to work, but on the other hand, don't hesitate to go back if you're really struggling, especially if you feel reliever isn't helping at all - get help as soon as possible in that case. Here's a reminder of what to do in an attack and how to spot one, in case you're not sure: asthmaandlung.org.uk/condit...

You may find it helpful to chat to the asthma nurses here: 0300 2225800 or WhatsApp [phone] Monday-Friday 0915-5pm

[Dizzart]

you need 180mg Fexofenadine, as you don’t need to live near fields to get really bad hay fever or allergies.Two asthmatic neighbours are also suffering.

Good luck 😉

[Lysistrata Administrator Community Ambassador in reply to Dizzart]

That may help and be worth asking about, but may not be the main thing to help - BerthaEdwina doesn't mention if her asthma is allergic or not. I'm also on a steroid nasal spray and fexofenadine 180mg. It's worth me taking and helps my hayfever, but doesn't have much impact on my asthma.

Worth addressing allergies of course if they are there, as they can contribute to asthma.

[Hikingfan]

From what I've been discovering and seen over the years, I would suggest you get some advice from a consultant as well. It can take some time for the medication to settle in and also to be optimised. Once you get into a routine you should get everything under control and be much better. It is a tricky time at the moment with so many bugs around and pollen kicking in.

[Callaghancam]

Hi, sorry to hear of your problems. I've been taking Fostair 200/6 and montelukast tablets a few years now. Along with the Fostair I have a Speriva Respimat inhaler which is an additional preventative and those together with the Montlukast work to stop me needing much of the blue salbutamol. I have Fexafanadine for my hey fever/rhinitis. The montelukast works for this aswell. I agree with Troilus's comments, and I would add you may need to see a Dr or your chest specialist to get advise if you are still needing your reliever this much. I was referred by my consultant to a Severe Asthma Clinic and I haven't looked back!Good luck

[SuziElley]

I take two puffs of Fostair morning and evening, then I’m allowed up to four extra puffs throughout the day. Only one puff at a time for the extras. After those four extra puffs I can then use Ventolin. I’m also on Montelukast and a Spiriva inhaler two puffs every morning. After having badly controlled asthma for some time, I’m at last feeling almost huma again. You need to talk to your asthma nurse again. Get it sorted with her.

[Chip_y2kuk]

Don't worry about using the two together they are different medications for different purposes.... the fostair has beclomethasone and formoterol (the beclomethasone is the steroid to reduce inflammation, and the formoterol helps to open up the airways for up to 12 hours). The ventolin just helps to open up the airways but for a short period of time (a few hours) ... the Americans call ventolin/salbutamol... "a rescue inhaler" which I think is quite fitting

Is it possible you need a short sharp blast of prednisolone?