Albuterol long term use

the difference between Anoro and Breo is that Anoro does not contain a steroid (fluticasone) like Breo does instead Anoro replaces the steroid with an anticholinergic called Umeclidinium (Breo does not have an anticholingeric). Both Anoro and Breo contain Vilanterol a long acting bronchodilator. I personally try to avoid anticholinergics because they are drying and I want my cough to remain productive. I have no clue whether this is medically necessary or I made it up! (An example of a common anticholinergic is Benadryl.)

Hi @ling,
I was diagnosed with COPD ( Emphysema) in 2009 and prescribed an
albuterol inhaler as needed. I used it before playing sports or aerobic exercise for more than 10 years with no side effects and in 2022, I was told to use it twice a day and then encouraged to nebulize albuterol 2 x per day and found it to be harsh on my throat but still think it has contributed to more productive coughing which has been hard to tolerate. Hope this helps in some small way.....Lately I'm inclined to only use the albuterol inhaler to open up the airways before nebulizing saline and I do the same before nebbing Arikayce a new med I just started today.
Flo@frankie160

Following my bronchoscopy on 7/6, my pulmonologist prescribed Ipratropium-Albuterol 0.5-3mg. It is to be nebulized which means I have to spend another 15 or so minutes doing that, followed by another 15-20 min with 7% saline and then 20 min with my vest. The idea of nebbing the saline while vesting is not appealing with all that shaking going on. So...I am wondering if there is an inhaler that would be just as effective instead adding addition treatment time with nebbing Ipratropium-Albuterol. There are only so many hours in the day! I wanted to pose this question here, first to get feedback. I will be going to a more experienced BE/MAC dr tomorrow and will inquire with him as well.

@liz440 Within the last month, I've started Spiriva, an anticholinergic, for asthma (it's also used for COPD in a higher dose). While it doesn't seem to interfere with clearance I have noticed less mucus. As explained to me by doctor, anticholinergics work by relaxing the smooth muscles in the airways, helping them to widen and improve airflow. Benadryl is an antihistamine and anticholinergic. Often a med trial can be helpful in figuring out if it's helpful or not.

Hi @frankie160,
Thank you so much for spending the time to explain your practice in using albuterol. It does give me comfort to use it twice daily before my fluttering. I think it helps to get mucus out. My lung function tests are normal with or without albuterol. My pulmonologist told me that it was not effective without using it to flutter. I feel he is right about it. So I decided to use it. Your experience and others who shared their experiences with me give me confidence in doing so.
Many thanks!
Ling

@equanimous It would be great to replace Ipratropium-Albuterol with an inhaler. Many say inhalers for albuterol as just as effective as nebbing albuterol. Another thought, replace nebulizer with something faster than your current one? Pari makes one that I've been eyeing but it's spendy. Apparently, it's very fast and reliable.
https://nebology.com/products/pari-erapid-nebulizer-system-with-eflow-technology

Hi Scoop,
Sounds like Spiriva is working for you instead of taking the steroid inhaler? Does the steroid inhaler have some effect of anti inflammation? Spiriva, the way you described doesn't do that, right?
I am glad to hear it is working for you.

Ling

Hi, Ling, Spiriva has allowed me to cut down on steroid inhaler but not eliminate it. How much is asthma vs bronchiectasis is the question, which is not so easy to answer without trying the medication. I'll keep you posted!

Thanks for your input, Scoop. I have a Pari Vios LC sprint nebulizer with the green compressor. It says on the site it is fast and that is why I bought it.... but I find it takes about 20 minutes for 4 ml saline. That rapid neb looks great but the price...wow!! I am looking forward to my appointment with Cedars Sinai provider whose CV indicates he is well-versed in BE and MAC.

Hi Sue,
Almost a year I have been using Albuterol twice daily before my fluttering, morning and evening. In your shared personal experience, you and your two daughters, do you use it the same way as I do? So far, two pulmonologists and an infectious disease doctor all agreed I continue the practice. While your experience gave me lots of comfort, I need to confirm, do you use Albuterol twice daily for all those years?
I will see my pulmonologist next month, I will discuss it with him again. But your experience means more to me.
I am so happy to have someone like you to turn to.
Many thanks and take care!
Ling