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Is anyone else confused about all those inhalers?
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
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@alicebrew1 I used to use Trelegy and when I was at NJH for BE and MABC, the ID Dr and Pulm told me they would like to see me get off it since I got off them once before and due to inhaled corticoids inhibiting the lung immune system. With BE, there is a higher risk of NTM infections with inhaled steroid use. Years ago, I was diagnosed with reactive airway disease (at NJH) and later with asthma (by local Pulm)-which may or may not have been confused with BE. NJH recently retested me for asthma (NOx and methyl choline challenge) and results were negative for asthma. The Pulm there recommended Anoro. Unfortunately, my insurance doesn't cover Anoro, so my local Pulm put me on AirSupra which is short acting, about 4-6 hours. Though, I have now been able to reduce my use of the AirSupra, I would still like to eliminate inhaled steroids completely. My local Pulm has suggested I try Brinsupri to help with the inflammation-among other things, but I'm wondering if that too could reduce immunity in the lungs. I don't know, so interested if that topic has come up.
@alicebrew1 What specifically are you trying to figure out? Are you experiencing side effects? Do you feel it is not effective for you? Why was it prescribed? How long ago? Do you have other health conditions? Have you talked to the prescriber about your concerns?
@sueinmn I’m trying to research and figure this out . I stopped the trelogy for 10 days . Felt I had to take it . I just need the right protical
@sueinmn yes I was never given another inhaler just this major one . What do you take ?
@sueinmn yes I’m not sure why he started me on this inhaler . I have concerns about long term use too . That was allergist who prescribed this for asthma . Do I really have asthma or is it side effect of haemophilus and or brochectatis ? Unfortunately my allergist past away . I will be having a long talk with pulmonologist. To figure out right course of action
@alicebrew1 HI, I'm not sure what especially concerns you, and what condition you have that Trelegy is meant to treat.
Most combination inhalers are prescribed to people with progressive lung diseases like COPD, or chronic conditions like asthma that have not responded to more conservative measures. They are generally meant to be used long-term, and your doctor should consider possible interference with other medications and your other health conditions before prescribing it.
There is an increased risk of pneumonia (about 2-3%) for some people, but there is also a decreased risk of other exacerbations - so a balancing act.
People who have heart or kidney disease, osteoporosis, diabetes or hypertension or are on antibiotic therapy need to work with their doctor to determine if the benefit of better lung function outweighs the risks of long-term inhaled corticosteroids, and probably need extra monitoring. This will very from person to person.
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1 ReactionYes I’m very confused . I am on trelogy and I wonder about the long term effects .
@onana
Here is an article related to risk of infections as a result of using steroid inhalers.
https://pubmed.ncbi.nlm.nih.gov/41241409/
It is interesting that there is an increased risk of infection. However the absolute risk is also important to consider. Here is what the article states:
"The results of the NMA that explored differences by ICS type showed that beclomethasone and fluticasone increased pneumonia risk compared with control, with absolute risk increases of up to 2.3%. "
Hope this is helpful to you and others.
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3 ReactionsWixela is the generic for Advair and is supposed to work the same. All medications work better for some folks than others. If you don’t believe the treatment is working for you, try to journal your symptoms and report back to your provider so you can have a discussion with them about adjusting your treatment.
The COPD Foundation has a FREE COPD Pocket Guide app that is available on both android and iPhone that has a handy chart of all the medications by brand and also generic, for handy reference as well.
It also has videos on how to use your inhalers, nebulizer, spacer, and much more. Check it out!
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2 ReactionsThanks