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Is Anyone Else Confused About All Those Inhalers?

Posted by Sue, Volunteer Mentor @sueinmn, Jul 18, 2022

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

Shared files

Inhalers (Inhalers.pdf)

Interested in more discussions like this? Go to the MAC & Bronchiectasis Support Group.

dmcara | @dmcara | Jun 1 8:14am
In reply to @dmcara "Thank you for this information! I have been searching for a method to wean off QVAR..." + (show)
@dmcara

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!

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Ps I am 66 years old

REPLY
hlp123 | @hlp123 | Jun 7 2:13am
In reply to @scoop "@hip123 How do you know you are allergic to your inhaler? What are the symptoms?" + (show)
@scoop

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

Jump to this post

I react with itching over a large portion of my body.
It is very frustrating because I am allergic to many medications and have allergies to dust, trees, grass etc.
I also have severe arthritis and osteoporosis. I took one year of prolia and then followed with one year of reclast and had many side effect from the prolia. I am still dealing with a skin condition that has been diagnosed as a fungus. Almost everyone of the medications that are suppose to be helpful for me have the side effect of making one more vulnerable to getting infections. Also I have been very careful to stay up to date with all of the vaccinations, but I really think that they also cause me to be more vulnerable to infections. I got Shingles two weeks after the last COVID vaccination. I have tried many inhaler medications and I start itching all over after the second or third dose. Good luck to all of you who have COPD and are looking for an inhaler. Listed in the side effects of all of them that I have tried is the increased vulnerability of infections. I find the whole situation overwhelming.

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1fancydancer | @1fancydancer | Jun 8 2:45pm

68 Years old, severe asthma since birth. The inhalers will save your life. Been on Flovent since it came out in 1994. I take the highest dose they manufacture 2x per day. If sick, take more. Been on allergy shots since 2 years old. Allergy shots work and make a normal life possible. I too have allergic reactions to many of the drugs that are available for breathing issues. Flovent has always worked for me up until they quit making it October 2023. Struggling to find another inhaler. The re-branded version does not seem to work. I have ordered from Canada but I think that my package has been lost in the mail. Ordered May 6, 2024 and still not here. I have 10 days of Flovent left. Any ideas from those of you that use to take Flovent. Have your tried other inhalers that work as well?

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1 reply
1fancydancer | @1fancydancer | Jun 8 2:47pm
In reply to @scoop "@hip123 How do you know you are allergic to your inhaler? What are the symptoms?" + (show)
@scoop

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

Jump to this post

Throat and mouth swelling, skin peeling off inside mouth.

REPLY
scoop | @scoop | Jun 8 10:55pm
In reply to @1fancydancer "68 Years old, severe asthma since birth. The inhalers will save your life. Been on Flovent..." + (show)
@1fancydancer

68 Years old, severe asthma since birth. The inhalers will save your life. Been on Flovent since it came out in 1994. I take the highest dose they manufacture 2x per day. If sick, take more. Been on allergy shots since 2 years old. Allergy shots work and make a normal life possible. I too have allergic reactions to many of the drugs that are available for breathing issues. Flovent has always worked for me up until they quit making it October 2023. Struggling to find another inhaler. The re-branded version does not seem to work. I have ordered from Canada but I think that my package has been lost in the mail. Ordered May 6, 2024 and still not here. I have 10 days of Flovent left. Any ideas from those of you that use to take Flovent. Have your tried other inhalers that work as well?

Jump to this post

I used to take Flovent (fluticasone), and now I take a symbicort (budesonide). There likely are other products combined inhaler medications that contain fluticasone if that works best for you. According to the literature Budesonide causes fewer infections and then fluticasone. Fluticasone worked really well for my asthma for a long time but I did not like the side effects.

REPLY
1 reply
reneemc | @reneemc | Jun 9 6:40pm
In reply to @scoop "I used to take Flovent (fluticasone), and now I take a symbicort (budesonide). There likely are..." + (show)
@scoop

I used to take Flovent (fluticasone), and now I take a symbicort (budesonide). There likely are other products combined inhaler medications that contain fluticasone if that works best for you. According to the literature Budesonide causes fewer infections and then fluticasone. Fluticasone worked really well for my asthma for a long time but I did not like the side effects.

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My ID Dr prescribed an Albuterol inhaler to use just prior to nebulizing Arikayce. My Pulmonologist prescribed Anoro to use instead. The Anoro has a drying effect so I am using the Albuterol

REPLY
lianamtee | @lianamtee | Aug 2 12:32pm
In reply to @nannette "@sueinmn Wow, Sue. Thanks for that! I've ALWAYS been confused by all the inhaler names and..." + (show)
@nannette

@sueinmn Wow, Sue. Thanks for that! I've ALWAYS been confused by all the inhaler names and what they do or don't do! I saved that list in my files for future reference! You rock! Nan

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Thank you! I've actually lined up all of my inhalers, pills, nebulizer solutions, etc - then defined each one. To top that, I spent 21 days in 2 different hospitals in less than 3 months, with different meds. What a mess.

Your chart has helped me so much. Now I have a few questions for my current pulmonologist (all good).

Thanks Again!

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1 reply
Mentor
Sue, Volunteer Mentor | @sueinmn | Aug 2 12:45pm
In reply to @lianamtee "Thank you! I've actually lined up all of my inhalers, pills, nebulizer solutions, etc - then..." + (show)
@lianamtee

Thank you! I've actually lined up all of my inhalers, pills, nebulizer solutions, etc - then defined each one. To top that, I spent 21 days in 2 different hospitals in less than 3 months, with different meds. What a mess.

Your chart has helped me so much. Now I have a few questions for my current pulmonologist (all good).

Thanks Again!

Jump to this post

We just had the discussion last week with friends and family about people being sent home with new meds and nobody doing a medication reconciliation after hospitalization.
Your pulmonologist is a good place to start. You might need to follow up with a full medication reconciliation by a pharmacist who specializes in doing that - either your clinic or insurance company can help you.

REPLY
km6 | @km6 | Aug 26 1:44pm
In reply to @sueinmn "You are correct about when yo use inhalers, and which ones. In my case, I have..." + (show)
@sueinmn

You are correct about when yo use inhalers, and which ones.
In my case, I have no "evident" infection at this time, but asthma & bronchiectasis coexist in my lungs. For months I have been struggling with shortness of breath, chest tightness and rising heart rate at the simplest exertion (like putting laundry in the washer.) Nebs help, but being tethered to the machine repeatedly was not working well...So we are trying a different type of inhaler, with more long-acting meds, to get me back to being myself. As of today (#7 with no neb) - I am feeling better on the new med, even after a 3 day camping trip with 7 adults, 5 kids, 1 dog and a whole bunch of drop in visitors. I can't wait to see how I'll feel after a shower and some rest.

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Interesting, I have been on trelegy for years and I use a rescue inhaler and nebs as needed. My original diagnosis was asthma, but I never wheeze. Then a few years ago I found out I had bronchiectasis. It makes me wonder if I really have asthma. I have periods of severe shortness of breath and a croupy kind of cough a few times a year. Every time that happens, I am put on prednisone, And it works, but I know what it's doing to my body. it gets so very confusing. Just recently I had a possible diagnosis of abscessus, but I am not symptomatic.
I rarely if ever can cough up any mucus. I am being fitted for Smart Vest next week. Some days I feel like damned if you do damned if you don't.

REPLY
1 reply
irene5 Irene Estes | @irene5 | Aug 27 7:23am
In reply to @km6 "Interesting, I have been on trelegy for years and I use a rescue inhaler and nebs..." + (show)
@km6

Interesting, I have been on trelegy for years and I use a rescue inhaler and nebs as needed. My original diagnosis was asthma, but I never wheeze. Then a few years ago I found out I had bronchiectasis. It makes me wonder if I really have asthma. I have periods of severe shortness of breath and a croupy kind of cough a few times a year. Every time that happens, I am put on prednisone, And it works, but I know what it's doing to my body. it gets so very confusing. Just recently I had a possible diagnosis of abscessus, but I am not symptomatic.
I rarely if ever can cough up any mucus. I am being fitted for Smart Vest next week. Some days I feel like damned if you do damned if you don't.

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That is interesting about your asthma diagnosis. You may be correct. My husband was treated for asthma for years and was then discovered to have sarcoidosis! ( biopsy at a Boston hospital). He also has bronchiectasis and takes azithromycin three times weekly as a preventative measure. Good luck. Irene5

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