Help me transition to a different INHALER

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Merry Widow

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Hi everyone, I'm very glad to have found this forum. I visited a few others but this one seems to have the most activity. :D Here is my situation:

I have mild asthma that isn't strong enough to warrant daily treatment. In short, I'm the perfect candidate for an inhaler, because I can use it only as needed.

Years ago when a pulmonary specialist here in the Bay Area first diagnosed my mild asthma (I didn't even know I had symptoms, came as a shock to me! lol) he prescribed two different inhalers. They were/are:
ALUPENT
AZMACORT

Over the years I had different doctors attempt to move me over to ALBUTEROL, but twice I tried their product and it didn't work for me. So I went back to the more expensive, brand-name one that worked best, ALUPENT.

The problem is that ALUPENT (manufactured by Boehringer) has been discontinued, and I do not want a cheap inhaler like ALBUTEROL, no matter how good anyone else says it is. For one thing, I can afford a better, more expensive inhaler -- I use it so infrequently that one inhaler typically lasts me up to 4 months.

I'm seeking brand-name/non-generic alternatives to ALBUTEROL and I simply don't know where to start!! My primary physician is happy to fill whatever I research . . . I just don't know which of the dozens of inhalers out there are the cheap ones, and which ones are the good ones. I don't want to have a $200 specialist office visit just to be educated on inhaler alternatives, so any advice here will be greatly appreciated. I don't have any allergies incidentally, and I'm a non-smoker. I suspect my mild asthma attacks are related to pollution but I can't prove that of course.

My second request has to do with brand longevity: What I mean by that is, I don't want to find myself with a product that has been around so long that I find myself, once again, faced with its discontinuation. :dizzy: I hope that makes sense! lol

Thank you for sharing any brand-name products you use and recommend. I've been meaning to get around to this since my ALUPENT has given up its last puff.

:wave:
Merry Widow
 
I'm not sure exactly what you are doing. You say you have asthma and dont' need daily meRAB but you are on Azmacort? Is that correct? And albuterol is a rescue med so if your asthma is so well controlled, you shuldn't need it at all...except maybe before cardio. And if you actually have asthma, then you need a daily med no matter what...even if it's just one puff per day. Mine is very mild and well controlled by one puff of Flovent per day.


So, basically, I'm very confused by what you say.
 
Well, I beg to differ with some of what you say. My doctor is of the opinion that all asthma patients should be on a daily med - even if it's just one puff per day, like I am. And Alupent is metaprovenol, not albuterol.
 
I said it was mild asthma, and that's what it is. Mild asthma. Not my diagnosis, my pulmonary specialist's.

I'm extremely impressed with SEREVENT
 
Thank you for your reply but I'm still confused (I tend to parse sentences so I sometimes don't get the overall meaning because I'm being too specfic). So;

1) are you on a daily med?

2) if not, why not?

3) Have you tried the latest version of albuterol with the HFA propellant or was it the old one with CFCs (many people maintain they can tell the difference though, outside of taste, I am experiencing no difference)

4) It appears the alupent is still available here in nebulizer form. It's possible it is available from some other country as an inhaler. Have you researched that?
 
Serevent is a long-acting bronchodilator, whereas Albuterol is a short-acting bronchodilator. Serevent is not a rescue inhaler, that's why you carry Albuterol! It should only be used along with an inhaled steroid. Long-acting bronchodilators are usually prescribed in the corabination inhalers Advair and Syrabicort...at least in the US. Those medications contain both an inhaled steroid and a long-acting bronchodilator.

Albuterol is generally the first-line rescue medication. I'm not sure why you say that Albuterol "doesn't work." Alupent is Albuterol and that's what you've been using. When was the last time you used Alupent? Was it before the change from CFC to HFA propellant? Albuterol also goes under the names: Provetil, Ventolin and ProAir.

Asmanex is an inhaled steroid, which should be taken daily. I use a corabination inhaler and I use it faithfully, twice daily, because if I don't it messes me up. If your doctor gave you Asmanex and you weren't using it everyday and it didn't mess you up, then you probably didn't need it. He may be "stepping down your treatment."

You should really be consulting your doctor about which rescue inhaler to use. Some bronchodilators aren't meant to be used as rescue inhalers in the event of an asthma attack. Your doctor's doing his job and giving you the best medication for the job. You need a medication to get you out of an asthma attack and Albuterol is really good at. Currently there are no generic equivalent Albuterol HFA inhalers. The ones I can think of right now of are Proventil HFA, Ventolin HFA and ProAir HFA. Xopenex is an alternative to Albuterol.

Titchou: There are people with asthma who do not require daily medication. People who have mild intermittent asthma are able to control their asthma using only a rescue inhaler when they experience symptoms or when exercising. Anyone who has persistent asthma, be it mild, moderate or severe, neeRAB to take some level of controller medication...inhaled steroiRAB and maybe a long-acting bronchodilator...depending on their situation.

I hope this helps. Good Luck!
 
I'm sorry about the misinformation about Alupent. You're right, it's not Albuterol. It's generic equivalent is metaproterenol sulfate. I actually looked it up on the Internet because I had never heard of it before. I'm not sure where I got the idea that it was Albuterol. Thank you for noticing my mistake.

According to the EPR-3, the mild intermittent asthma can be controlled sympomatically, without the use of inhaled steroiRAB. A link to a summary of the document is: http://www.nhlbi.nih.gov/guidelines/asthma/asthsumm.htm. Each doctor has his or her opinion, which may differ from the EPR-3 guidelines. I won't argue with your doctor's opinion because I don't know enough about asthma to make a reasonable counter-argument.
 
You are advised to use SERETIDE EVOHALER 25/250 mcg two puRAB twice daily regularly even if you are asymptomatic.
 
I beg to differ on what has been said about the fact that all asthmatics, even ones with mild asthma, should take daily medication. My allergy/asthma specialist actually told me he would rather that I NOT take a daily medication unless my asthma is out of control, i.e. having to use a rescue inhaler more than twice a week. I have gotten my asthma under control without the help of daily medication unless it is a bad time (high pollen content, or like now with the cold dry air) and then I take Singulair, (advair made my symptoms worse every time I have taken it). I have mild to severe asthma, depending on the season, my activity level, and other factors, and I do not take a daily medication more than a few weeks at a time. Some people need it daily, but some don't. The cases differ with each individual.

As far as the inhaler that you're looking for, I can't really help you there. I've always been on an albuterol inhaler. The one I used to use worked wonders, but then they went and changed to ones without CFCs and the one they gave me to replace it Xopenex HFA did not work well for me. The side effects were more prominent and I was still short of breath after two puRAB the majority of the time. I'm on ProAir HFA now, and it works a lot better than the Xopenex for me. Not all albuterol inhalers work the same, so if all else fails you might want to try a different kind?

However, what works for one person won't work for everyone. You might just have to look into the inhalers you've found and try one out. It might work for you, it might not. Have you thought about asking the local pharmacies?

Good luck in your search!
 
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