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cwille posted:
hi everybody, hope everyone is doing fine, I haven't been on lately, just real busy, but i do have a question, my doctor wants to take me off my asmanex and try qvar, i was wondering if anybody out there has tried that med. before. I am still on prednisone unfortunatly, it is getting very tiresome, I have been on it since nov. of last year. How long is to long to be on it. my doctor tried to take me off of it (ween me off of course) but then i got sick and put back in the hospital again. I just get worried about the side effects, i already gained 20 lbs. Oh well, hope everybody has a wonderful easter.

god bless
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Amelia_WebMD_Staff responded:
Welcome back!

I hope that you have been "good" busy, rather than "stressful/sick" busy!

I am actually on QVAR80 at the moment and have yet to find any side effects. Of course, I'm sure that I cannot speak for every patient on this medication, since we are all so different with our health and drug reactions. My asthma has never really been "out of hand" (KNOCK ON WOOD!!!!), so hopefully it will work well for you! Thanks so much for the Easter wishes! I hope that you have a wonderful weekend, too!!!
- Asthma doesn't seem to bother me anymore, unless I'm around cigars or dogs. The thing that would bother me most would be a dog smoking a cigar. - Steve Allen
 
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DUKE MEDICINE
Michael H Land, MD responded:
Dear cwille,

I have a number of patients who have persistent asthma symptoms and need to be on a daily inhaled steroid medication to get things under control. There are many different corticosteroid inhalers out there and if you ask 10 asthmatics, you probably would get 10 different answers on what they take every day. Mometasone, Beclometasone, Fluticasone, Budesonide--why is it so complicated? Well, there are different reasons that doctors may want to change your therapy. One may be that the delivery device has a better chance of getting you the medication--sometimes people prefer dry powder inhalers, and some prefer a metered-dose inhaler (a pump). Some metered dose inhalers have counters to keep track of dosing, and some don't. Some dry powder inhalers have counters as well. There are different dose strengths to the inhalers that may allow for flexibility in weaning the dose (if the doctor wants to start you at a higher dose and then wean down). Sometimes the doctor wants to do you a favor and give you a medication that works just as well as another, but costs less for you (maybe they're trying to save you some money).

To answer your question, I think there's probably a good reason your doctor wanted to change your asmanex to QVAR. Perhaps it was because he/she felt that your asthma has not been under good enough control (since you are still needing Prednisone), and wants to try a different dosing device to try to change the drug delivery. Are you using a spacer device with your QVAR? I would encourage the use of a spacer if you are going to be using a metered dose inhaler. This will help you get all the medication. If it makes you feel better, I have patients on both Asmanex, QVAR, as well as many of the other brands of daily inhalers. I switch patient's medications for some of the reasons I mentioned above.

Are you seeing an asthma specialist? I would encourage you to bring up your concerns with your doctor regarding how to develop the best asthma management plan for you. You could discuss other therapies to consider including combination (inhaled steroid/LABA), theophylline, Omalizumab (Xolair), immunotherapy (allergy shots), or leukotriene antagonists as possible ways to spare you from too many systemic steroids. I hope you can get off the prednisone with better asthma control!

Best of luck!


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