Does anyone nebulize Budesonide and Albuterol?

@pled Technically, it is OK to mix them - they are chemically compatible. One of my exacerbation meds is actually a mixture of albuterol and an inhaled corticosteroid.

However, the respiratory therapist told me it is more effective to nebulize the albuterol first to open airways, wait 5 minutes then do the budosenide. When using saline as well, my instructions are albuterol first, then saline, do airway clearance to get up mucus, then steroid last (so more stays in the lungs.) Fortunately, I only have to do that when I have an exacerbation.

My usual daily routine is: Symbicort inhaler, wait 5-10 minutes, 7% saline & airway clearance. After almost a year, I can confidently say this new regimen has kept me healthier than anything in the past 10 years.

According to my ID doc, the most important order is "however you can do it and still live your life." That is very important, because just like New Years' resolutions or diets, regimens that you cannot easily fit into your life are quickly abandoned.

Are you doing airway clearance? Using saline?
Sue

Thanks, Sue. You are always so helpful. I am one of those people who do not cough much of anything up. I have tried several times unsuccessfully to give a sputum sample. I also use an acapella after nebulizing, and a vibrating vest. Every now and then in the course of the day I may cough up a small chunk of mucous. I do not use saline.

I am also one who could not cough up enough for a sputum sample, until I started regular nebulizing with saline. I do 7% twice a day 10 minutes after albuterol inhaler. I've also switched from Acapella to Aerobika which I find more effective.
Anna

Thanks for your reply. There seem to be so many ways to skin this cat! I think I will talk to my pulmonologist about the saline on my next visit.

I think I need to re-check the way I'm nebulizing as I had understood from pulmonologist to use saline first -- then albuterol followed by Budesonide, Perforamist and Yupelri. It's not a program that seems to help but if I stopped, perhaps I would realize it did help some. Not having great luck with anything. Have been in Rochester Mayo's hospital a few months back -- came home with picc line and have done many infusions with different meds -- none of which worked. Sometimes it's quite depressing. I had breathing episodes with tobramycin and colistin and did 63 infusions of another one I can't even remember the name -- and that was not effective either. I have tons of green phlegm every day -- the coughing is continuous. Any ideas, anyone?????