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Airway clearance with inhalers & 7% saline.
Hi everyone, my morning & evening airway clearance routine is as follows: neb 1 vial Levalbuteral, wait 10 -15 mins, then neb 7% saline intermittently using Autogenic drainage & Areobika. All this takes around an hour. My Mayo Dr. & UVM Dr. have me then taking a LABA which is Bevespi. My question is how long after I do my a.c. should I wait to do the Bevespi? It’s supposed to last 12 hrs but it seems to last at best 6-7. Is anyone else taking 2 different inhalers, or doing airway clearance filled by a LABA? I’ve asked both doctors but again don’t seem to get a good answer. Thank you all.
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I too use an LABA (formoterol), and use it immediately on rising every day. Airway clearance is done 15 minutes to an hour later later. With the LABA on-board, I have no need for levalbuterol since both medications serve the same purpose. In fact, my pulmonologist actively discourages me from using levalbuterol. (Sometimes I do need it during a bad allergy season, or if I have a respiratory bug that causes my asthma to flare.) I too find my inhaler sometimes isn't "enough" used twice a day - I have permission to use two puffs up to 4 times a day, and my prescription is filled accordingly. I would say I use it 3 times a day about 2-3 times a week.
You might ask your pulmonologist two questions -
Is the levalbuterol necessary every day? Maybe they would be open to a trial of using the Bevespi, waiting 15 minutes, then nebbing saline & doing airway clearance.
Is it possible to use Bevespi 3 times a day if needed?
@sueinmn thank you Sue, very helpful & interesting advice. I do have my next Pulmonologist appointment in two days and will definitely inquire about different options of airway clearance medication and techniques. I know I am likely many of us, willing to do the work it takes, just so hard to find that right combination that’s best. Thank you all.
@spider109 Yes is is definitely "just so hard to find that right combination that’s best" - and it is different for each of us!
I am lucky to have a great pulmo team working together - we even have our appointments in a group! One specializes in Bronchiectasis and related infections, the other in Asthma and allergies. Under their care, my lungs have been so well cared for, and other issues like vocal chord dysfunction, sleep apnea, and choking have been addressed. I feel blessed.
It took 3 years to get me to the right inhaler and dosage, as well as the correct combo of allergy medications. That was not fun, but it did result in giving up (mostly) my levalbuterol nebs and inhaler, which is a blessing as they made my tremors much worse.
Good luck with your appointment this week.
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1 ReactionI nebulize albuterol, then 7% saline while doing vest therapy. That takes approx 1/2 hour. I then do Arformoterol and Budesonide that takes about 15 min. I also take one injection of Fasenra every 8 weeks. So far it seems to work. I also incorporate exercise as often as I can.
Can you tell me what respiratory diseases you have been diagnosed with? I don’t want to be nosy though. If you don’t want to I totally understand and respect that.
I was diagnosed in summer 2025 with bronchiectasis and tried Brinsupri twice at 10 mg per day. Blood pressure more than 180/118 each time and then took weeks to normalize when it was stopped. Then in October 2025 diagnosed with both Aspergillus and M. abscessus. Treated with Cresemba, Nuzyra, and Linezolid. At NJH in Feb. 2026 the decision was made to stop all but Cresemba but the biggest change was that I started the twice a day 20 minute routine with the vest and 7% saline with AerobiKa. I do have a culture pending at NJH BUT this morning my pretreatment oxygen saturation is 100 %!!