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Dulera/chest pain/acid indigestion-anyone else?
pljohns posted:
I have severe uncontolled asthma with numerous med. allergies. I've been allergy tested and everything came back neg. I have non-allergic astham. I have been on a neb of Brovana twice a day+ QVAR for over a year with no problems and have done quite well on them.

I changed to Dulera last Thurs to try and get some freedom from the neb+separate steroid, and since then have had acid reflux(which I already take meds for) that got worse every night. The chest pain was almost unbarable. Last night I was up 2+ hrs with both. I know it's not cardiac because I have no other symptoms and I can feel the acid burn and the acid taste. I checked the side effects of Dulera and sure enough, both are listed as possible side effect. Needless to say, I went back to my neb and inhaled steroids this morning and am feeling MUCH better.

I am unable to take ANY other combo med-severe reactions to both Advair and Symbacort. I guess it's something about the combo's that my body just doesn't like. I was so enjoying not have to use a neb twice a day. The neb has been the only thing I can tolerate. Has anyone else had any of these side effects with Dulera?
Mathchickie responded:
It's the LABA part, the long-acting beta agonist.
I haven't tried Dulera, but I've taken Symbicort and Foradil, which contain fomoterol, just like Dulera. Both of those, plus Advair, severely worsened my reflux. Advair has salmeterol. Both salmeterol and fomoterol have a tendency to cause or worsen acid reflux. Apparently the same drug that relaxes the smooth muscles in your lungs also relaxes some of the smooth muscles in the digestive system!

I often have reflux after eating, but on the combination meds, I was going around 24 hours a day tasting acid in my mouth, whether I'd eaten anything or not! It's a problem, because I can't seem to get good asthma control using the plain steroids alone, but the constant reflux is worse, and will trigger the asthma to worsen anyway.

But you say you CAN tolerate Brovana, which is also a LABA. That's interesting.

I guess you have to go back the the nebs. It's a nuisance, but less of a nuisance than spending hours with heartburn too severe to sleep.
pljohns replied to Mathchickie's response:
I talked with my doc yesterday and yep-sure enough-the Dulera could be the cause of the problems. She told me to stop immediately, double my GERD meds until the reflux settles back down and if I still have chest pain/acid reflux to go the ER over the weekend. I started back on my neb Fri am and have had no further chest pain or reflux problems. That's strike 3 for me with the combo meds. It's not the LABA that gives me problems, it something in the combo process that they use. I've had major problems with all of them. I guess I"m back to the neb twice a day.
Mathchickie replied to pljohns's response:
That's strange. Have you ever tried Foradil? It's fomoterol by itself, in a dry-powder form. Same ingredient as Dulera or Symbicort, but NOT in a combo.

I couldn't tolerate it, but maybe you can.

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