Asthma, etc., inhalers

[661-Pete]

Anyone had trouble with the switch-over to inhalers with CFC-free propellant?

I'm talking about the 'preventer' type inhaler (beclometasone or similar: brown inhaler): I've just switched to a new one, CFC-free. The taste is very unpleasant compared with the previous one, has a surgical-spirit sort of kick to it and makes me cough violently each time I use it: I don't know whether I'm getting the right dose.

I took it back to the pharmacist today but he said, nothing doing, these sort are mandatory now: I'll just have to 'get used to it'. That's going to be hard!

My next recourse is to go back to my GP and seek alternatives, but I don't hold out much hope.

I was told, the same change is true of the blue 'reliever' inhalers (salbutamol etc.) but I've not come across that because I need to use the reliever only very occasionally, and I still have an old one with CFC propellant.

Why oh why do the eco-freaks (I used to count myself amongst their numbers, but not after today !) insist on imposing this unpleasant change on something which is a medical necessity for some? The amount of CFC contributed to the environment by medical inhalers must surely be minuscule, compared to the environmental damage caused by CO2.

I'd welcome advice on this because I'm in a bit of a panic...

 

[WimbledonCyclist]

Many moons ago, when I still lived in Holland, I used to have "diskhalers" for both salbutamol and beclomethasone. A quick internet search brought up this picture: http://www.asthma.ca/adults/treatment/diskhaler.php

If these are still in production and available in the UK, they may be worth a try.

Diskhalers come with their own pros and cons.
- Inhaling from them takes a bit more care (you need to hold them upright to make sure the powder doesn't fall out once you've punctured the blister, while in theory you can use your nebuliser while doing cartwheels)
- the diskhaler is a bit bulkier, and the blister packs/disks take up space too.
- on the upside: you can count exactly how many disks / puffs you've got left with a diskhaler, while that's not possible with the nebulisers.

I'm not a doctor and don't know whether switching to powder-based beclomethasone has any impact on effectiveness. But if at least you can hold your breath for a while without coughing, there must be some benefit in trying over sticking with nebulisers that don't agree with you and cause you to cough out the medicine immediatly upon inhalation - when that happens, there's no time for the drugs to be absorbed where they're needed.

Mind you, I must have switched over to nebulisers more than a decade ago. I have no idea whether diskhalers are still available in this country.

 

[Armegatron]

On a similar note to the above, I use the "turbo-haler" variety. Cant be nice having to switch over to a new type, I know I struggled when moving from a spacer to disc to turbo inhalers.

Good luck with getting this sorted.

 

[Chris James]

661-Pete, have no worries, thjere are plenty of options.

I seem to be allergic to the carrier in beclomethasone, resulting in a full body rash!

So I have been on flixotide, which comes in a powder (no taste either!). You can have that as either a diskhaler or accuhaler (my preference, less faff than fiddling with discs). I dare say there are plenty of other medicines, just talk it through with your doc.

 

[Crackle]

Agree with Chris & Wimbledon, there are lots of options, including powder inhalers, book in to your asthma clinic or see your GP, though the asthma nurse may be more up to date.

 

[Will1985]

I took it back to the pharmacist today but he said, nothing doing, these sort are mandatory now: I'll just have to 'get used to it'.

Not mandatory...your pharmacist will make more money out of giving you one of those compared to using one that's been on the "market" for a while.
You could ask your GP to change the prescription specifically to a powder version....even then, the pharmacist might say that CFC-free types are the nearest alternative to something they don't stock.

 

[661-Pete]

Thanks for the tips. I'll book into the asthma clinic; by the time I get the appointment I'll know whether I can tolerate the new inhaler or not. Another possibility is to get a 'spacer' - OK for mornings and evenings but not something I'd want to carry around...

Lots of interesting debate on the web, try googling "asthma" and "CFC-free". I am familiar with the powder-type preventer, though never used it myself: my wife (who's had asthma longer than I have) used to use one of those, but switched to beclamatasone some years ago. She doesn't appear to have the same problem as I do.

 

[661-Pete]

Update: just took my evening 'dose' (supposed to take two puffs morning and night) and it was a tad easier to inhale - managed to hold it in about ten seconds before coughing up. Perhaps that's it: you have to get used to it - like coffee - or booze.

But I'll still book into that asthma clinic all the same. They may have a better idea.

 

[style over speed]

I found the blue CFC free ventolins gum up and stop working... not much use when you need them infrequently and then it doesn't work when you do need it.

 

[Dilbert]

I use Turbohalers as well normally. I have found it depends which pharmacy I get them from as to what I get and my Asthma nurse said something similar to Will1985 about some pharmacists stocking cheaper ones than others. It might be worth asking what type they have before you get your next prescription and trying a different pharmacist if thats practical.

 

[AWM6]

I had exactly the same experience. My view is that Pharmacies try to give out generic brands rather than Ventolin as it is less expensive and they make better margins.

However, like you, I don't get on with the CFC free generic inhaler at all to the point that it is useless. Note: Ventolin is also CFC free....

As such, everytime i get a repeat prescription, I always insist on Ventolin and if they cannot provide it, I go to a different pharmacy.

Hope this helps... you are not alone.

 

[ELL]

I take Seretide (purple) which is a sort of mixture of Flixotide (orange) and Serevent (green). I have the Evohaler and have no problem with it what so ever but used to have the Accuhaler and if you are finding the Evohaler isn't working for you this may be your best bet. All you need to do is go to the doctors and tell them how you feel and they will be able to sort you out.

On a similar note I only like the Allen & Hanburys Evohalers as they are what I am used to and can tell how much I have left in the and when I need a new one. Its all a case of what you get used to and with Asthma its important you know where you are with your medication.

 

[Bandini]

I used to have the generic, Salbutamol, inhalers for a few years. I moved and now I get Ventolin. Much better. The others don't seem to 'puff' properly.

 

[661-Pete]

Update: the asthma nurse suggested that, as a first option, I try using a spacer with the preventer (brown) inhaler, so I've started on that with the Clenil (replacement for Beclazone which is now obsolete). At least that gives me the option to inhale the dose in several breaths, which makes it a bit easier on the throat! If I have rare occasion to use the reliever (blue), I can still take that one without the spacer, so I don't need to carry it around!

If the Clenil still proves troublesome I'm to go back to the nurse, I might then be put on Qvar which is a different formulation.