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Is Anyone Else Confused About All Those Inhalers?
Is Anyone Else Confused by all the inhalers prescribed for our lungs?
After a lengthy visit with my pulmonologist yesterday, I came away with a new set of medications and a whole lot of confusion!
This morning, I sat down and made list of all the drugs I use/have used, all the drugs we talked about yesterday, and several that have been suggested or mentioned here on Connect. Then I got busy and figured out what they are and why we use them.
Here is a summary…incomplete for sure, listing the classes of drugs with a short explanation of each class, and individual drug names (not the Brand Name or Combo name).
“Rescue” drugs – may be inhalers, or in some cases nebulizer solutions
Short Acting Beta Agonist (SABA) Opens airways quickly, relaxes airways, but doesn’t last long
• Albuterol (Common Brand Names: ProAir, Ventolin, Proventil)
• Levalbuterol (Xopenex)
• Salbutamol
Short Acting Muscarinic Agonist (SAMA) Like SABA, opens airways, or prevents bronchospasm. Less often used than SABA
• Irpatropium Bromide (Atrovent)
• Tiotropium Bromide (Spiriva)
Long Term or Daily Use Medications
Inhaled Steroids Direct dosage to lungs compared to oral steroids which are systemic. Reduces inflammation which helps keep airways open.
Inhaled Corticosteroid (ICS)
• Budosenide (Pulmicort, Entocort, Rhinocort)
• Mometasone (only in combinations)
Inhaled Glucosteroid (IGS)
• Fluticasone Propionate (Flovent, Allerflo)
Long Acting Beta Agonist (LABA) Acts to keep airways open – usually used in combination with an inhaled steroid
• Formoterol Fumarate (Foradil)
• Salmeterol Xinafoate (Serevent)
• Vilanterol (only in combinations)
Long Acting Muscarinic Agents (LAMA) Relaxes muscles around airways for 12-24 hours to reduce asthma attacks
• Tiotropium bromide (Spiriva)
• Umeclidinium bromide (Incruse)
Here is a summary of the most commonly prescribed Name Brand medications and what drugs are in each one.
Advair - Fluticasone propionate (IGS), Salmeterol (LABA)
AirDuo - Fluticasone propionate (IGS), Salmeterol (LABA)
Anoro- Umeclidineum (LAMA), Vilanterol (LABA)
Breo - Fluticasone Furoate(ICS), Vilanterol (LABA)
Combivent - Irpatropium Bromide (SAMA), Albuterol (SABA)
Dulera - Mometasone (ICS), Formoterol (LABA)
DuoNeb - Irpatropium Bromide (SAMA), Albuterol (SABA)
Nebulizer Solution
Symbicort - Budosenide (ICS), Formoterol (LABA)
Trelegy - Fluticasone (IGS), Umeclidinium (LAMA), Vilanterol
(LABA) Explanation
This is not a list of inhalers you should use, just a list of those that are often used for Asthma, Bronchiectasis & COPD - some of us have only one of these diseases, some of us have several.
I have attached a PDF file if you would like to print this list.
Sue
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I prefer nebulizing the albuterol also for the added "moisture". Maybe that's a psychological effect but if so, that's ok too. However, I never used it or needed it as a rescue inhaler sort of thing. I assume that is for someone that has asthma? And, if I understand it correctly, albuterol used for nebulizing is not a steroid right?
Albuterol alone is not a steroid.
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1 ReactionThanks. I didn't think so but it's always nice to have reassurance!
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8629914/
"Fluticasone propionate is associated with an increased risk of pneumonia compared to budesonide in patients with COPD. In addition, the risk of pneumonia increased at higher ICS doses. Therefore, the types of ICSs and ICS doses need to be carefully considered in the treatment of COPD with ICS."
Even though this is a COPD study, having bronchiectasis we share symptoms with COPD.
Essentially, if one has asthma better to be on a budesonide inhaler vs. a fluticasone inhaler. Important to work with doctor to find the minimum effective dose.
Thank you Sue!
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1 ReactionI started treatment with Ventolin. Had annoying very scratchy throat. Was switched to Albuterol. No side effects. Medicare does not want to pay for Albuterol. Any ideas?
I have been using Atrovent and Breyna. I have decided to drop the Breyna because it is a steroid med. Will see how it goes on Atrovent alone. I am 74 and have moderate BE. I also take Azi 3 days a week.
Albuterol in vials for a nebulizer is $27 for 120 vials w/goodrx. About the same price as my part d copay
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1 ReactionMedicare Part B will pay for albuterol or levalbuterol in vials for the nebulizer. I've never had an issue with their paying for them. On the other hand, I still have not learned how to get them to pay for the saline vials, but thankfully they're affordable with GoodRx. Donna
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3 ReactionsHas anyone had an issue with steroid induced glaucoma? Recently diagnosed with very early stages of glaucoma. One of the side effects of Breo Elliptor (have been using it for 8 years) is glaucoma, which I was unaware. Any feedback appreciated.