Is Anyone Else Confused About All Those Inhalers?

While I have not been diagnosed with glaucoma, I'm aware that this is one of the side effects of a steroid inhaler. My ophthalmologist said that people usually know very soon after starting the inhaler if they have a sensitivity as it starts to cause glaucoma, within a year or 2. That's the way I understood it. What does your ophthalmologist say?

From what I've read budesonide steroid in an inhaler is a bit safer than fluticasone. Less likely to cause pneumonia in a variety of studies.

Interesting question.
I have had (stable) glaucoma for over 10 years, pressure maintained at 14-15 with eyedrops. For several years while battling asthma & bronchitis I was on prednisone and/or budosenide frequently - it seemed to have no effect on my glaucoma.
Then I was diagnosed with MAC & bronchiectasis and took antibiotics for nearly 2 years.
Recently I have been using Symbicort (budosenide plus formoterol) for over 2 years with no changes.
Both my ophthalmologist and my pulmonologist are aware of all my diagnoses and medications. The pulmonologist was specific in using budosenide - perhaps due to the glaucoma? - she never said that directly. I have visual field and retina scans, pressure checks and physical eye exams every 6 months, all showing very little progression in the glaucoma.
So apparently, not every steroid poses the same risk.
Sue

@sueinmn This is on my list to do this week - sort through the types of inhalers to see if I can get some improvement in keeping my airways open longer. Saw a commercial on television for Airsupra that I am going to investigate. I'm sure Medicare won't want to pay for it, but worth a try if it appears that it would work better. Airsupra is a rescue inhaler that has albuterol and budesonide. Thanks, Sue! @lindam272

Or...if you have an albuterol or levalbuterol inhaler and a budosenide (Pulmicort is one brand) inhaler, you can make your own combination - simply use the albuterol, wait one minute, then use the budosenide. This is what my daughter did for several years before she was switched to Symbicort (for the long-acting beta-agonist fomoterol.)

By the way, my pulmonologist prefers Symbicort to the albuterol/budosenide combo - formoterol keeps the airways open longer. It used to only be used for COPD, but is now the second-step choice for difficult asthma or reactive airways. I had a little drama getting it with Medicare Part D but after intervention by my pulmonologist they approved it. I have never had airway control this good since I was in my 40's. No nebs except 2-3 times a week saline, no exacerbations requiring ER or antibiotics, no bronchitis (even with getting 2 colds).

Sue

When I was diagnosed a year ago with Bronchiectasis, I was prescribed a Trelegy inhaler to use until I could get an appointment with a pulmonologist. After 5 days, my voice had been diminished to a whisper, and I was taken off of it. ($550. inhaler not covered by Medicare or my supplemental policy now wasted.)
I am getting by OK with nebulizing both Duoneb and Acetylcysteine twice a day while using my Hill-Rom Compression vibrating Vest. My problem comes when I lie down at night. I am sleep deprived, because when the wheezing and whistling start, I can't sleep. My next appointment with my pulmonologist isn't until June. Do you have an opinion of whether an inhaler would help to stop this noise if used during the night? Sue's list of all the kinds of inhalers makes me understand that it may not be as simple as just asking for an inhaler. (Thank you for the list, Sue!!)

@janskallerud I hear you! Exactly my issue - nighttime airway noises, sometimes I sound like a squeaky door. If I hear those rattles after I lie down at night I know I am in for a restless sleep.

I wish an inhaler would replace the extra session but I have yet to find one that doesn't turn the phlegm into cement. The first night or two on a recommended inhaler always feels pretty good but the gunk dries and builds up.

After a lot of experimenting, the good news is that I found that an extra clearance session right before bed is helpful. The bad news is that it's an extra session and I can't use a bronchodilator before, so the clearance can be time consuming. Working to decrease the time! Postural drainage has been helpful. Your mileage may vary but I found mucinex (guaifenesin) and NAC made night-time rattling worse. You'll likely need to experiment to see what works for you.

So my (present) routine: levalbuterol and 7% saline morning upon waking.; levalbuterol and 7% saline prior to dinner; autogenic drainage and active cycle of breathing and postural drainage before bed. Very little gunk comes out but apparently enough to help keep me rattle/cough free. Movement exercise during the day I find makes clearance sessions easier.

Thank you for sharing your method of dealing with this night time problem. I will try adding your suggestions to my routine. I think you are right though.....we need to experiment and determine what works best for each one of us. Thanks again! Jan

I am having trouble finding an inhaler that I am not allergic to.
I have a prescription for Serevent. I am wondering if I can use it only once a day instead of twice a day in the beginning to see how I react to it.
Thank you

@hip123 How do you know you are allergic to your inhaler? What are the symptoms?

Thank you for this information!
I have been searching for a method to wean off QVAR 80 mg two puffs in am and pm .

I have mild asthma completely controlled by QVAR when first pulmonologist put me on QVAR 40 mg 2 puffs once per day. After a few weeks he told me I was “cured” and could stop the inhaler without weaning off. I stopped gradually anyway and the symptoms came back worse than before.. so he added Pm dose. Every time I tried to wean off it got worse. I am now with a different pulmonologist who controlled the wheezing with my current 80 mg two puffs twice per day now for several years. I have been unsuccessful in weaning off and she says not to worry— just take it , it’s helping. But I can’t help thinking that the only reason I have to take such an increased dose from the original is not knowing how to wean/taper the dose in a way that works for me. I believe the steroids are causing my skin to erupt in blood spots now and the skin on forearms is paper thin. Pulmonologist said this is a side effect. I am trying now to drop one pm puff of 2 to see if I can wean off while taking lung supportive homeopathic remedy, but I am worried that I may trigger an onset of symptoms that will require prednisone which just escalates this steroid dependency further.

Does anyone else have experiences of trying to wean off maintenance inhaler…or use of QVAR?

Thank you!