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Can albuterol be used alone without a maintenance inhaler?
When first diagnosed with asthma I was prescribed an albuterol inhaler by my PCP, without talk about anything more needed. Then I saw a lung doctor who prescribed Symbicort twice daily, which I took for 10 months until I was told it was no longer available through my insurance. So I was put on 500 mg of Wixela instead, which I took once a day for 6 months when I discontinued on June 6 because of side effects. At that time my asthma was pretty much in control. At least I had lost the cough, even though I still had chest tightness.
Side effects included thinning of the skin. I would get red blotches on the extremities without bruising. At one time I had three blood spots on my ankle, causing it to be sore. The cataracts in my eyes have worsened, and I noticed some blurring, of deep concern because I only have central vision in one eye and have had surgery for glaucoma in the past. I was also having a problem with high BP.
I am 88 years of age. I read on a Mayo Clinic site that geriatric patients are more likely to develop high BP and osteoporosis from corticosteroids.
After discontinuing the Wixela I met with the lung doctor to see if I could use the albuterol if and when needed. She told me that if I used it without a maintenance inhaler it would be life threatening. She was unwilling to work around my side effects or prescribe anything different. And refused to treat me further. The problem is that no one in her UBMD Pulmonary division is able to take me on as a patient because of this. This is a group of University of Buffalo medical providers that works with the Jacobs School of Medicine here in Buffalo. And their lung practitioners, at least on paper, seem to be the most knowledgeable about lungs in Western New York. I unfortunately chose the wrong person to treat me and now I'm blackballed.
Before I started the Symbicort treatment I was diagnosed with "moderate persistent asthma." Then, 16 months later, after the corticosteroid treatment they are saying it's "mild, intermittent asthma."
But my central question is: Can someone explain why using an albuterol inhaler without Symbicort, Wixela, or other maintenance inhalers is dangerous? Albuterol is nonsteroidal, which I think is to be preferred over the long term with someone my age (at least that's what I've been reading). And why would a PCP prescribe albuterol alone?
I apologize for taking so much time trying to describe my problem. And I'm grateful for any help I can get in understanding this.
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@nancyra I forgot to mention, I have been allergy tested by an environmental medicine doctor who does specialize individual testing for each type of mold, pollen, etc, and they make a custom vial for you for allergy shots. I've been trained how to inject myself and I should be doing it. It really helps. If you have a bad dust allergy like I do, the hydrogen peroxide seems to work well, except that it eats leather, so don't spray leather furniture. There is now Pacagen spray (from Alpacas) being advertised for this and it is fairly expensive. I do have cats, and I'm allergic to them, and I use hydrogen peroxide for that, let it dry, and let the cats come back in the room. That works well. I also wipe them down with water on a damp rag. They get used to it. LOL
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1 ReactionThere are generic versions of corticosteroids like Arnuity (fluticasone furoate powder) - some with exactly the same ingredient, others with similar ones like budesonide and beclomethasone.
Recent research has shown that an inhaled corticosteroid, which lessens the inflammation that is part of asthma, is more effective in slowing the progression of the disease than a bronchodilator like albuterol used alone. And the steroid is more effective in calming the cough.
I agree that some research for an affordable solution is a good idea for you. Over the years I have switched from brand-name Symbicort (about $600/month, $145 with my insurance) to Breyna (about $300/month, $75 with my insurance) to generic (about $230, $5 with my insurance).
Finally, don't overlook the possibility of a program like GoodRx to help cut the cost of medication.
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2 ReactionsGot off of albuterol, no other breathing meds.
If not already doing so, try:
deep breathing exercises, fill your diaphragm first, then lungs
inhale aroma of thyme leaves several times a day, before attacks and after walks, etc.
drink 4-5 ounces of organic tart cherry juice at breakfast
Regards,
Sagan
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1 ReactionYou make a good point about working to slow the progression. That is what the pulmon said.
I did not know there were generic versions of arnuity out there!!! Will ask office to look into that option. Thank you so much.
I don’t have asthma . I am a stage 4 (they say) Emphysema patient . I have used the inhaler Trelegy for two years . I didn’t have any symptoms besides low air. So they put me on Trelegy. They asked me shortly after if it helps . I could not say . I felt no difference . I am on 24/7 4 ltr oxygen . I have been taking Guaifenesin and a prescription for acid reflux . I have good days more than bad . I have occasional chest/lung pain. I am not able to walk long distances or exercise. My oxygen gets down to 85 when I dress myself . Even with my air on . I still say that I do not know what Trelegy does for me . I have never been an advocate of medicines . Looking back I don’t think I should have started it . I sure would not start it again . I don’t think anyone should start an inhaler or drug if they are not sure they need it . That is my “4 Ltrs” on the subject. 🧐Blessed Be, Crystalena
Wow thank you for sharing your story. Seems you are alluding to the inhaler causing more problems for you. It’s so hard to know what is the right path to take. I’ve already been on a medication that gave me massive skin cancer so I am gun shy to say the least.
Thank you for sharing your opinion. All help in making decisions
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1 ReactionYes I would imagine deep breathing exercises on a regular basis would help with lung strength but no professional has suggested that route. Do you have experience with non medication treatment yourself?
Whenever any doc offer me a prescription, I immediately ask for the names of the drugs in it and if there is a generic equivalent. Sometimes, with combo drugs, I might have to take 2 pills or use 2 inhalers, but the inconvenience can be a small price to pay for saving a lot.
Generics do not always work for everyone - sometimes the filler or propellant may be different between the name brand and the generic, and cause issues for a few sensitive individuals. I have had that experience with 2-3 medications in my lifetime. But it is definitely worth a try.
Also, generics are not yet available for many new drugs - these are protected by patent for a number of years, to allow the developing company to recoup their enormous research and development, testing and marketing costs before they have competition. For example, most biologics are still under patent protection.
Here's a cautionary tale for you on why slowing progression is important! As the mother and aunt to at least a dozen asthmatic kids, and an allergy sufferer, I should have known better, but I "pretended" not to have asthma for years, refusing to use albuterol because it made my essential tremor worse.
Then I started to have regular exacerbations, with frequent bronchitis. I still resisted using a nebulizer and tried to rely on my Levalbuterol rescue inhaler. Over 30 years later, I became a walking case of repeated asthma attacks, bronchitis and pneumonia, being treated several times a year with oral steroids and antibiotics, "getting better" only to relapse in 6 weeks or 3 months.
Finally, I was diagnosed with Bronchiectasis and two lung infections. Now I have to be eternally vigilant to keep infections away and do daily airway clearance to remove the mucus my lungs can no longer expel on their own.
Please listen to your pulmonologist so you don't end up as an old lady with Bronchiectasis, COPD or another complication.
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1 ReactionI’m not a doctor but my understanding is that if you use emergency inhalers without long term bronchodilators, it will cause pulmonary remodeling and leave you in much worse shape permanently. I wish you good luck. It’s not fun and the pollution isn’t helping.
Yes….. Don’t use rescue inhalers without regular use of a maintenance inhaler, like Symbicort, e.g.
That has been established by the research.
On the other hand, it has been decided by the medical research that a maintenance inhaler like Symbicort can also be used for “rescue.”
Volunteer Mentor Sue has a link on one of her early posts that explains this in detail.
I’m the one who initially posed this question and am grateful to Sue for answering it.