Bye Bye Seretide. Hello Symbicort

I had another asthma clinic appointment last Wednesday so please forgive me for the late update.

I believe that the appointment went quite well since I have managed to switch from seretide to symbicort like I wanted to. At first my nurse really didnt want to switch me but after I had explained how I was waking up most nights and was still needing ventolin multiple times a day and the fact that I hadn’t got my peak flow past 70% for ages she agreed to switch me. Thing is because my peak flow has been so low for so long she has messed around with my action plan so now my best is only 400 instead of 450 which I’m really not too impressed at since I have been symptomatic when I was getting peak flows of 350 which according to this new play is about 87% but on my old plan was 77%. So I am quite annoyed at that.

I am hoping with this change to symbicort that my peak flow will be reaching 450 again and soon. My nurse was also worried because I am going skiing in two weeks (WOOP!) and she thinks because my asthma is still uncontrolled it will really flare so I’m going back on the 13th just before we go to get a little check up and she said she is probably going to prescribe some emergency pred, which I would be very grateful about!

Anyway back to symbicort. She switched me to the equivalent dosage I was on for seretide which is symbicort 100/6 2 puffs bd (twice a day) to start with then I am allowed to move up to three puffs twice a day if I feel I need to and then I’d be moving up to symbicort 200/6.

My initial impressions of symbicort are quite good, I’m having minimal if any wheezing after I take it and no chest tightness at all. But the one thing I am worried about is that the LABA is stopping working after about 8 or 9 hours, and then the coughing and wheezing starts. So I’m going to see if it is possible to take another puff at lunch to last me till the evening, but she might just suggest going straight up to 3 puffs twice daily, I have no idea really. One downside is that my hands are shaking like a leaf but I think that after my body gets used to this LABA it will sort it’s self out.

So I’ve taken a picture of my symbicort, I always like pictures in blogs and its one of the things I keep meaning to include more of so here it goes 🙂

image

And this is one showing the actual inhaler without the lid on:

image

While I was there my asthma nurse also gave me a turbohaler whistle which has absolutely fascinated me. It tells you if you have an inspiratory rate of 15l/min or more which is needed to take a turbohaler. So basically you use it exactly the same as a turbohaler and if it whistles when you inhaler it means you are good to go. Here’s a wee picture of it:

image

I’ll be posting a guest post soon by Nicole and her life with type 2 brittle asthma.

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13 thoughts on “Bye Bye Seretide. Hello Symbicort

  1. really think you should be on the 200/6 as a combination SMART thearpy then can take your 2 puffs morning and night and then use is another 8 times during the day. Its said that if need extra during the day is more beneficial to use this inhaler as a reviler as its likely need a small dose of the steroid to

    1. Hey nursekermit, I would love to go on the SMART regime but unfortunately I’m not allowed on the SMART regime till I’m 18, so another two years to wait. I’m in two minds whether to ask my asthma nurse if I could join a clinical trail about using the SMART regime in under 18’s if and when one comes out.

      1. I’ve been on the SMART regime since I was 15 and that’s 400/12, 3 puffs twice a day and as required so it is allowed! X

      2. Really! my asthma nurse was adamant that I couldnt go on the SMART regime. Do you see a consultant? Maybe they are the only ones who are willing to put patients on the SMART?

    1. Yeah I’m going back on the 13th and since I still dont feel well controlled I will see about moving up the number of puffs a day or moving to 200/6 instead. Thanks for your advice

  2. Symbicort is indicated for 12 and up – fixed or SMART
    400/12 is NOT for SMART and this dosing should be reviewed – fixed dose only in COPD and sever asthma 18+

    Symbicort rep – AstraZeneca Australia

    1. Thank you for the insight Bellnblack… Although I do know some people on 400/12 on the SMART regime, but they have brittle asthma and it has to be prescribed off licence.

  3. It’s interesting that you were given Seretide before Symbicort…my Asthma Nurse said that Symbicort is the first-choice combination inhaler for people who need them. The only reason I got Seretide was because I can’t take DPIs, and Seretide was the next most common one in MDI (puffer) form.

    Oddly enough, Flutiform is cheaper than both Seretide and Symbicort, and indeed Seretide is cheaper than Symbicort (based on equivalent doses and blah blah blah) so how is it that Symbicort is the inhaler of choice?

    1. My friend was told the same thing when she was first put on Symbicort… I presume I was put on Seretide because they had tried me on Serevent (Salmeterol, the LABA component of Serevent) rather than Oxis or Foradil as my first add-on therapy before we moved to combination inhalers (I still had a full Steroid inhaler which would have been a shame to bin).

      As for Symbicort being used as a first choice even though it’s more expensive, that could be because the LABA in Symbicort works a lot faster than the LABA in Seretide and can actually be used as a reliever (using the Symbicort SMART therapy). Also now there is an inhaler called DuoResp which is a generic of Symbicort and is available as a Spiromax… Although, off the top of my head, I think that it is still dry-powder.

      One of the doctors at my surgery thinks I might benefit more from Seretide so I presume they will want to try my on it, especially because it doesn’t look like I am going to stay on Singulair/Montelukast. Thing is, that the dosage of the steroid component is exactly the same but you don’t have as much flexibility in dosages so that would mean I would be under-dosed using the 125/25 or over-doses (in comparison to what I actually need) using the 250/25 (which is super expensive too).

  4. Hi there, I have been on Flixotide & Seretide since I was young for my asthma. I am 36yo now. I was getting bad pharyngitis/sore throat with the Seretide (even using the spacer). I am now on Flutiform & the sore throats have disappeared, but my asthma is not as well controlled. My peak flow has decreased from about 800 on the Seretide to 500 on Flutiform. Is Symbicort a similar ingredient to Seretide, because I really want to try it & hoping for no sore throat recurrence!

    1. Symbicort like Seretide contains a steroid component and a long acting bronchodilator…. Both flutiform and Seretide have the same steroid but different bronchodilators, whereas Symbicort and flutiform have the same bronchodilator but different steroid components. You can also use Symbicort as a reliever provided your GP is happy for you to use the Symbicort SMART scheme.

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