Is Symbicort safe?

Your Question:  I'm an asthmatic and have been taking Symbicort for three days, one puff twice a day.  Should I keep using it or stop?  From what I've read, I am afraid about side its side effects and that it may cause asthma-related death. 

My answer:  Your physicians prescribed this medicine because he believes the benefits outweigh the risks. It is a very good medicine for controlling and preventing asthma, and  is a top line asthma medicine. 

and, so long as it is used as prescribed, is considered safe. I wrote an article about just this topic a few years ago, and I will link to it here for you to review. If you have further questions please feel free to ask.

Do most asthmatics avoid Advair like the plague

Perhaps one of my fellow asthmatics can help me out with this one. I recently saw a new asthma doctor, and, when I asked to have my prescriptions refilled he said, "You like Advair?"

"Yes! I love it!" I said.

"Wow! You're one of the few asthmatics who can stand it!"

"What!"

"Yeah. Most of my other patients hate that medicine." I will assume that he is also referring to any medicine like Advair too, such as symbicort.

"What do they take for their asthma then."

He smirked and said, "Well, nothing. They come in every 6 months complaining of asthma problems."

"Interesting," I said. The conversation moved on from there, although the idea that Advair was as unpopular as he was saying is still wobbling around in my mind, hence this post. I guess the naive person inside my head "assumed" if there's a medicine that works as well as Advair and Symbicort do to control asthma, that most asthmatics would at least try to like it.

Although, according to doctor Axel, that's not the case. Yet I think one of the reasons this threw me off guard is because my old doctor, Dr. Best, told me the opposite: "Most of my patients love Advair."

It's interesting the different perspective a doctor can have on a medicine. Yet this latest discussion about Advair has me wondering: do most asthmatics remain ignorant and continue to have

I wonder, though, if most asthmatics hate Advair if it has to do with the long-acting beta adrenergic medicine (Serevent) in it. I wrote here how it actually took me 10 years to get used to Serevent, and that I actually had to wean myself onto Advair.

Yet I don't think most doctors think about weaning onto a medicine, and when a patient says they can't take it, that's the end of the discussion. Yet I will contend, if you have uncontrolled asthma, Advair may just be the key and you should wean yourself onto it. You should try gallantly to get your body used to the stuff.

So, facts confirm Advair works wonders for asthma. Yet, is it a fact that most asthmatics continue to avoid Advair (and Symbicort) like the plague? If you have any greater wisdom on this cue your wisdom into the comments below or email me.

Advair/Symbicort: Is overuse really dangerous???

Warning: The following post is meant to make you think, and perhaps give you something to discuss with your doctor. Please do not change your asthma regime without first consulting your physician.

There has been much hype the past several years regarding the safety of long acting bronchodilators such as serevent (which is also a component in Advair) and formoterol (which is also a component in Symbicort). In fact, there was once a threat that the FDA would take this medicine off the market.

Some reports say these medicines are linked to worsening asthma and even death, such as this warning about Advair from MyAsthmaCentral.com:

"University of Iowa researchers have added their voices to growing warnings about Advair, saying that drugs that use salmeterol in combination with an inhaled corticosteroid can make asthma more severe or even fatal."

Or this warning regarding Symbicort:

"Rarely, serious (sometimes fatal) asthma-related breathing problems may occur in people with asthma who are treated with drugs similar to the formoterol in this product (long-acting inhaled beta agonists). "

Studies have been conducted to determine if it is the medicine itself that is causing asthmatics who use it to die? Or is it the fact that these patients are overusing it?

I think these folks are all wrong. I think they are so pent on looking in one direction that they fail to see the big picture. I say this because I do not believe overuse of Serevent is what causes most people to die

I believe what causes most people to die of asthma when they are on Serevent (or a similar such drug) is the fact that instead of seeking help they clutch to the inhaler seeking relief. Instead of controlling their asthma, instead of talking to their doctor or calling an ambulance, they stay home thinking they are going to get "relief" from the inhaler in their hand.

What they lack, really, is proper education.

I can say this because I have had COPD and asthma patients who have overused their Advair or symbicort inhalers. I have accidentally taken extra puffs of mine too, and even while I was a bit nervous about it for a while due to the "scare," nothing happened. My heart never stopped.

I think long-acting bronchodilators do not kill. I think overuse of long-acting bronchodilators does not kill. I think what kills is poor asthma control. What kills is the false belief you are going to get relief from your inhaler when what you should be doing is getting your butt to the ER.

This does not just go for long-acting bronchodilators either. I've seen reports of Ventolin getting a bad rap because some asthmatic dies with the inhaler in his grasp. The report notes: "Asthmatic dies from Ventolin overdose?" Really? You think so?

Back in the 1980s Alupent was deemed such a safe medicine by the FDA that it was made to be legal to sell over the counter. I remember my mom going to get me an inhaler and just grabbing one off the shelf. But shortly after this ruling seven asthmatics died of asthma while clutching their Alupent inhalers. So did poor asthma management get the blame? No! What got the blame was the Alupent. The patient abused the inhaler because it was so easy to get, and soon thereafter Alupent was taken off the shelves.

I'm not proposing that all asthmatics go out and start using their Advair or Symbicort more than they currently do. What I am proposing is that instead of blaming the medicine used to treat asthma, that doctors and scientists and scaremongers spend more time educating asthmatics instead. Let's stop scaring people away from the asthma medicines that work the best, and start educating them how they can manage their asthma and prevent themselves from getting so bad that they'd clutch an inhaler to their deaths in the first place.

For most asthmatics, one puff twice a day of Advair or a similar regime of Symbicort works just fine. For most asthmatics, if you need to use your Ventolin or Xopenex more often than three times in a week your asthma is not controlled, and you need to work with your asthma doctor to get your asthma controlled. You can do it.

Yet there are some asthmatics whose asthma is more severe and who need to use their rescue medicine more frequently. And it's for patients like this who may find a scientifically proven benefit from using medicines like Serevent and Formeterol more frequently. Which is why further open minded studies are relevent.

Yet due to the fear of death and lawsuits American companies fear advancing this research, and the FDA continues to send out warnings that serevent and formoterol are linked to fatal asthma. However, to give the FDA credit, it likes to wait until a medicine beyond a reasonable doubt is safe for patient use.

That said, I have learned that in Britain and Canada Symbicort has been approved to be used not only as a preventative medicine, but as a rescue inhaler. It's called the SMART program. Stay tuned, because next Tuesday I will discuss the SMART program, and discuss whether this, or a similar program, would be good for American asthmatics.

Random asthma questions

Every day at MyAsthmaCentral.com we get lots of asthma related questions. Below are some questions I thought my readers at the RT Cave would enjoy.

Question: can the Breathalyzer show a positive/negative due to my asthma or medications? I had one test show a positive of 0.12 and 20 minutes later show 0.00. how is that possible if the machine was calibrated correctly? HOW IS IT POSSIBLE PERIOD?

My humble answer: It's funny you ask this question, as I've heard it from other asthmatics as well. However, I have never heard any credible evidence that any asthma medicine would cause a false breathalyzer reading.

What asthma medicines are you taking? If what you are saying is true, it would be interesting to pin down which asthma medicine is accused of altering Breathalyzer results.

Honestly, I do not know the answer to your question, yet I remain curious

(Update 8/11/10: Check out this link)

Question: My mother (95 years old) was just diagnosed with asthma. Is this unusual?

My humble answer: Ironically, I was just reading something the other day about how more and more elderly people are being diagnosed with asthma, so I don't think it's completely unusual. When I come across this again I'll be sure to keep you in mind and send you a link.

Question: A nurse prescribed spiriva for my asthma. I thought spiriva was for COPD not asthma. Is it safe for me to use spiriva or is it the incorrect medication?

My humble answer: Spiriva is a safe medicine for both asthma and COPD patients. It is an anticholinergic medicine like Atrovent that acts as a bronchodilator, only it's taken once daily and works for up to 24 hours. There have been studies that showing Spiriva actually improved lung function and decreased exacerbation's in COPD patients. While Atrovent used to be used as a controller medicine for asthma, Anticholinergics are no longer recommended as a top line medicine for asthma as there are other bronchodilators that work better, such as Albuterol and Serevent and Formeterol.

Usually Spiriva is not the first medicine prescribed to control asthma. However, without knowing the rest of your medical history, and what other medicines you are on or have tried, it's tough for me to form an opinion on your NP (nurse practitioner) ordering Spiriva for your asthma.

As is noted in this post, finding what medicine(s) works best to control your asthma can often be a game of trial and error. Likewise, if you want to find out what your NPs plan of action is for you, ideally you should ask your NP.

Question: Which is better, singulair or pulmicort. Advair is to expensive but is a great product. Is there a generic for it?

My humble answer: At this point there is not generic for Advair. I have heard rumors that say Advair wil be available in generic form soon, but I have heard no verification of this.

Singulair and Pulmicort are two different kinds of medicines, and you can read about them in the links I provided. Which one "is better" basically depends on you and your doctor. Sometimes the best way to determine which one works best is by trial and error. Some asthmatics find Singulair alone works great to control their asthma, and some find that Pulmicort alone works fine. For some asthmatics, other meds or combination of them works best.

For a great article on which asthma medicine works best for you, click here.

Question: I have heard that there will soon be a generic version of Advair. How soon?I credit Advair with controlling my asthma enough that I seldom ever need my rescue inhaler. I am on Medicare and Advair is very expensive. Because I must take other non generic medications for other problems, I reach the "gap" of Medicare very quickly, so a generic version of Advair would be would be most helpful.

My humble Answer: I have heard similar rumors, but I have also not heard any credible evidence that the rumors are true. However, at the present time there is no Generic Advair available. As soon as one is available I'm sure we will report this news here on this site. In the meantime, there was a similar question asked here if you care to read more.

If you have a question you would like to ask you may inquire at freadom1776@yahoo.com

Flutiform to compete with Advair & Symbicort?

In my perusal of the health news world today I found this article about a New asthma drug that is probably going to hit the market soon. It's a medicine that will compete with Advair and Symbicort. This is good news, I think, for chronic lungers.

This new medicine is called Futiform. Like Advair and Symbicort, it's a combination dry powder inhaler with both a long acting bronchodilator and a corticosteroid. It seems to be a copy cat medicine with the intent on profiting on the latest craze in asthma medicines that aim to treat both the major components of asthma: bronchospasm and chronic inflammation.

I should mention here that the FDA recommends that if a long-acting bronchodilator is prescribed for asthma an inhaled corticosteroid should also be prescribed to treat the underlying chronic inflammation of the air passages in the lungs.

In this sense, combination inhalers such as Advair and Symbicort are a recommended and common treatment for asthma. And, perhaps soon, we can even add Futiform to this list.

The interesting thing here is that while Futiform is a new medicine per se, neither of the medicines it is composed of are new. The corticosteroid in Futiform is Flovent, the same corticosteroid that is in Advair. The long-acting bronchodilator is Formoterol, the same that is in Symbicort.

In my lifelong experimentation with corticosteroids, I have found that none works better than Flovent. My pharmacist insists it's not any better than the other such steroids on the market, but I beg to differ. I have many asthmatic friends who feel the same way.

Serevent, the long acting bronchodilator in Advair, is a medicine I have often wondered about. While I've been using my Advair compliantly for over 2 years, I still have to use my rescue inhaler a few times a day. Of course that's not bad, but it could be better.

Serevent does not provide quick relief for asthmatics, however I have learned that formoterol does. Therefore, and I'm just speculating here, I'm wondering if perhaps formoterol is a better medicine than Serevent.

Thus, I'm wondering if this new medicine combines the best corticosteroid (Flovent) with the best long-acting bronchodilator (formoterol). If that's the case, this product should do pretty well in the world market at least until a better medicine is invented.

Of course, like you, my job as a gallant asthmatic is to always be thinking along these positive lines. We are constantly on the look out for that new asthma medicine that might help us get that much better control of our asthma. If nothing else, this "probable" new medicine may provide another option for us chronic lungers to try.

On a side note here, I don't like to be a Guinea pig for new medicines, but both Flovent and Formoterol have been on the market long enough to know they are safe if they are used only as prescribed.

Oh, and one more thing, the article referred to above mentioned something about generic forms of Advair and Symbicort perhaps hitting the market soon. It'll be interesting to see how this option benefits us asthmatics.

Whether or not the generic forms will be as efficatious as the original may always be up to debate, but a lesser expensive Advair and Symbicort might be the best thing to happen to us asthmatics during an economic downturn.

Well, we'll see.

Primitine mist not a good option for asthma

I promised some of my readers a while ago I would discuss Primitine Mist and why it should never be used to treat asthma. I believe the following Question from the Q&A section of MyAsthmaCentral.com followed by my humble answer should put this topic to rest.

My boyfriend has asthma and resists using the Advair as much as possible because he's concerned about long-term steroid use and because it's so expensive. Instead he regularly uses Primatine mist - I've heard this is even worse. Any feedback on this? He is almost 58 and his asthma is moderate. He is 5'9 and around 165-170 lbs. - very active (cyclist and skier).

I will provide you with some info you can share with your boyfriend:
1. Primitine Mist has a medicine called epinepherine in it, which is basically adrenaline. Adrenaline is a natural chemical in your body that increases when you are under a highly stressful situation or exercising. It dilates your lung passages to make it easier to breath, and constricts your vasculature to increases your blood pressure, elevates your heart rate, and force oxygen to vital organs. It can also make you extremely jittery or hyperactive.

When you use Primitine mist to treat asthma, you are actually adding more adrenaline to your system. If your adrenaline is already high from stress or anxiety of the attack, or you are abusing the primitine mist, this can lead to cardiac arrhythmias that can lead to death.

2. Primatine mist is not a medicine that is recommended by physicians, yet was grandfathered in as an over the counter medicine and is still available. However, as you can read here, the medicine may be phased out by 2010. So he'll have no choice but to find another option. It's already not on the shelves where I live.

3. By using primitine mist your boyfriend is only treating the acute asthma symptoms. Advair treats the underlying chronic inflammation that can actually prevent asthma from ever happening, and may even eliminate the need for a med like P. mist. I wrote about the importance of using Advair as prescribed in this post.

4. Unlike systemic corticosteroids like Prednisone, the corticosteroid in Advair is inhaled directly into the lungs and, therefore, systemic side effects are minimized (click here for list of possible side effects of Advair). Most asthma experts now believe that the advantages of Advair for most asthmatics far outweigh the mild side effects.

5. It is true Advair is expensive. He may chose to discuss this with his doctor because there are other less expensive options available. Or, if you are really strapped for money, you can call the pharmaceutical company for financial assistance (click here for more information).

6. Of course if you are on Advair you will still need something to use as a rescue inhaler for those acute asthma symptoms that may occur from time to time. The medicine doctors recommend most is Albuterol. This is the same type of medicine as Adrenaline in that it dilates the air passages in the lungs, yet it is fine tuned so systemic side effects are minimized. Therefore, Albuterol has very minimal side effects.

7. Actually, most doctors agree that you cannot overdose on Albuterol. However, if you are to the point you are using it more often than recommended by your physician your asthma is probably not controlled and you should either call your doctor or come to visit an doctor in an emergency room.

8. Albuterol comes at a reasonable cost even if you are without insurance. If you remain strapped for cash most pharmaceutical companies offer assistance programs so you don't have to go without the medicines you need.

On a side note here, I never bought a Primitine Mist inhaler for my asthma, as I've always been fortunate enough to have access to good health care. Yet I had a freind purchase one once for himself and he never used it, so he gave it to me.

This was back when I was a hardluck asthmatic bronchodilatoraholic, and I used that sucker up in a few days. Yeah I walked around like a lit up lightbulb for a few days, but it didn't really do much for my asthma. To me, it seemed Albuterol is twice as strong as Primitine Mist anyway.

So, not only is Albuterol 110% safeer than Primitine Mist, it is much more effective in my humble opinion. Yet, ironically, Primitine Mist is available over the counter and Albuterol is not. Someday soon, however, Primitine Mist will be a distant memory.

There, I think that should pretty much answer all your questions about Primitine Mist.

Q&A about Advair and Symbicort

What follows are some of the most common questions asked in the Q&A section of MyAsthmaCentral.com and my humble answers.

Keep in mind that both Advair and Symbicort are generally the same type of medicine, both having a long acting bronchodilator to prevent bronchospasm, and a corticosteroid to treat the underlying inflammation prevalent in most asthma patients. They are also used for other respiratory illnesses, like COPD.

1. Can Advair cause you to bruise easily?: Even though bruising is not listed as a side effect of Advair, I know a lot of people who use Advair who complain of bruising. Yet, if this is an actual side effect, I also wonder if it could be eliminated with proper technique, i.e. rinsing after using it. I suspect this might be true, but I don't know for certain.

It is true that inhaling Advair directly into the lungs is supposed to eliminate systemic side effects, like bruising. At the same time, not rinsing your mouth out after using it can cause your body to absorb a small amount of the medicine, thus causing some minor systemic effects.

I'm interested in reading what other experts might have to say about this.

2. How long should anyone use anAdvair Diskus and can I use it every now and then? Advair is a medicine that is intended to treat chronic inflammation associated with asthma and prevent bronchospasm. It usually takes 2-3 weeks of continued use to fully get into your system. Therefore, it is an asthma controller medicine that must be used all the time, whether you are feeling good or not.

The corticosteroid component of this medicine (Flovent) strengthens you lungs, reduces inflammation, and creates more receptor sites for your rescue medicine to sit on, and thus makes your Ventolin work better. The long-acting bronchodilator component (Sevevent), works to prevent bronchospasm.

In this way, if you have Adviar in your system at all times, when you are exposed to your asthma triggers your lungs will be better able to prevent them from causing acute asthma symptoms, or make asthma symptoms less severe. And, in this way, the Advair may be working and you not even realize it.

So if you quit taking it on a daily basis you take away all the benefits of Advair, and risk even worse asthma symptoms when you are exposed to your triggers -- and no asthmatic wants that.
So, to answer your question, this is the type of medicine you may need to take forever to control your asthma. Do not change your asthma medicine regimen or dose without first talking to your physician.

For more information, check out this link.

3. I am using Symbicort twice daily can I use anything else to back it up for occasional relief

When I started taking Advair, which is a similar medicine to Symbicort, I had the same question.
The answer to your question is YES! Even though you are taking Symbicort twice a day you may still feel short-of-breath on occasion, and on these occasions it is safe to use your rescue medicine (Albuterol, Xopenex, Pirbuterol) as needed or as directed by your physician.

4. What is an alternative to advair and symbicort with less of an oral thrush side effect? There really is no alternative to Advair and symbicort, as they are the only meds that have both the long acting bronchodilator and the corticosteroid combination to prevent bronchospasm and combat chronic inflammation.

However, it's such a great medicine for asthma I'd hate to see you quit using it due to thrush. Thankful, there is a way to prevent and treat thrush. Check out this link here for some solutions.
5. could long time use of advair cause sore, white spotted tongue and red roof of mouth: The answer is YES.

The steroids that settle in your mouth may wipe our the normal bacteria that live in your mouth that prevent the buildup of yeast or candidiasis in your mouth. Absent this bacteria, yeast may build up and cause white patchy spots in your mouth called thrush.

After using inhaled corticosteroids for over 25 years I I had thrush only once and my doctor prescribed Diflucan. It is a pill I took for only five days, and it worked great. Nystatin is a rinse that works fine too.

Here is a good tip: The best way to prevent thrush is to rinse and spit after every use of Advair or any other inhaled corticosteroid.

6. Can inhaled steroids like Advair cause cavities?: I did read recently that inhaled corticosteroid use has been linked to cavities too, and it is a good idea to brush your teeth after using an inhaled corticosteroid along with rinsing.

If you have any further questions about asthma you can set up an account at MyAsthmaCentral.com. Or you can email me any question at freadom1776@yahoo.com

Thoughts about Advair and alternatives

As I blogged about yesterday, many people have been asking about alternatives to Advair and Symbicort due to the high cost of these meds. I have listed some options here on this blog as they've come to me.

Today I have another option that has popped into my always thinking head. I'm a very curious person, and therefore sometimes I find myself thinking of things other people may never have considered. I'm not saying they'll work, I'm just thinking here.

It's something that's far out there, but actually it isn't. Since Advair** is an expensive mixure of a corticosteroid (Flovent) and long acting bronchodilator (Serevent) meant to treat both the chronic inflammation and prevent acute bronchospasm, why can't a mixture of less expensive meds be used as a replacement for Advair.

Of course Advair is the asthma wonder drug of choice not just because of what it prevents, but because it's easy to carry around, easy to use, and only needs to be taken twice a day. It's highly convenient, and makes asthmatics much more compliant than in years past. If cost were no obstacle, Advair is the medicine of choice.

The only problem with Advair (aside for some minor side effects), is that it costs an arm and a leg. And, since it costs so much, people who do not work, are poor, or have no health insurance have no way of gaining access to it. And it's these people we see in hospital emergency rooms.

So, as a replacement for an Advair discuss that costs $120 a month, why can't Asthmatics (and COPDers too), take Vanceril at $38 a month and Ventolin, which costs $42. That's still a chunk, but it's $40 less than Advair.
I can see a doctor switching a patient from Advair to Vanceril or some other generic corticosteroid (like Azmacort, Beclovent, Aerobid, etc). But instructing every asthmatic to take Ventolin every four hours is frowned upon. Why?

The asthma guidelines themselves say that any asthmatic who needs Ventolin more than 2-3 times in a two week period does not have control of his asthma. If that is true, then why are people who need Serevent in their systems all the time considered under control? Aren't they the same type of medicine, except one lasts for 12 hours and the other 4-6?

And yet, while the asthma guidelines recommends Advair and frown upon overuse of Ventolin (overuse would consist of using it more than the asthma guidelines recommend), it seems every single patient admitted to the hospital with Asthma or COPD is given Ventolin*** every 4-6 hours regardless of whether their disease is exacerbated. Ventolin lasts in the system about that long.

So a wise man asks: Why is it okay to order Ventolin every four hours as a preventative medicine in the hospital, but not okay to order it the same way for outpatient therapy?

A doctor recently gave me an answer when I questioned why she keeps ordering Ventolin Q4 on all her patients. She said, "Because they need it in their system to prevent shortness of breath."

Okay? So, if a patient needs it in his system while in the hospital to PREVENT shortness of breath, then why does this philosophy not apply outside the hospital? Either Ventolin is a preventative medicine or it is not?

It would seem to me if a patient does not respond well to Serevent, then Ventolin is a viable option. Of course you must consider what works for one patient does not work for all.

Personally, I don't think Ventolin prevents anything for most patients. The pre-use of Ventolin has never prevented me from having a bronchospasm. However, the pre-use of a corticosteroid has. However, I'm not saying Ventolin won't prevent for some patients.

I know Ventolin doesn't prevent for me because I had a pre and post PFT done to prove this. But doctors rarely order PFTs to determine if the Ventolin they are ordering on all their patients is working.

That would make too much sense. Better sense would be to use common sense and not order ventolin at all unless it is needed, or at least proven to be effected, which could be a subjective or objective measure.

But actually assessing to determine effectiveness would mean an actual assessment, which would be way to much work for some doctors to bother with. So they just order what feels right, not what is right (Kind of like Washington Politics, hey!).

I suppose you can create a third angle with this argument. If Ventolin should never be used unless a patient is having an exacerbation, then Serevent should never be used period. If the corticosteroid is doing its job, the patient should never get short of breath in the first place.

Yet that may not be a reasonable claim for many patients. Still, Serevent and Ventolin are the same medicine. And, while a patient is taking Serevent on a daily basis, it is still considered safe to use Ventolin with Serevent ( but never safe to use Serevent more than twice a days).

So, if you still need to use Ventolin every day regardless of being on Serevent, is the Serevent even doing it's job? Is it really preventing bronchospasm?

Or, is the reason Advair improves the lives of asthmatics so much more do do with the fact it's easy to use, convenient to carry around, and only needs to be taken twice a day, and not because it has both a corticosteroid and long acting bronchodilator. In other words, would a discus of Flovent alone work as well as Advair?

If the answer is yes, then any patient on Advair that costs $120 could easily be switched to a medicine like Vanceril which costs $38, and not lose any of the benefits. However, there would be one big if here: the patient would have to be as compliant with the Vanceril inhaler as he is with the Flovent discus.

Vanceril may be needed 4 times a day instead of the convenient two. Plus those patients who are now taking Vanceril will also have to lug around a bulky spacer. Obviously we're supposed to carry one around with our Ventolin too, but you and I both know most asthmatics (especially guys) don't carry spacers with them.

Ideally, Advair is better all the way around, except for cost. But, if you are strapped for money, perhaps an alternative generic corticosteroid may work just as well as the Advair, if proper technique is used. That means you have to use a spacer.

And perhaps, if you or your doctor thinks Serevent works so well for you, then why not take Ventolin every 4-6 hours round the clock too, regardless of what the guidelines say.

If I haven't lost you with my rambling here, tell me where you think I'm wrong (or right).

* costs listed are estimates.
**Advair and Symbicort are basically the same med, so when I refer to one, I'm also referring to the other.
***Xopenex may be ordered as well, and if it is the frequency is usually every 4-8 hours because that's how long the medicine lasts.

Can't afford Advair? Here's another option for you

With the economy the way it is, and so many people without jobs and/ or without insurance (and even people with insurance), we have been getting lots of questions such as the following:

"I have COPD and will be getting laid off at the end of this month, and without insurance, the pharmacy said advair discus will be about $150.00 per month. But I do not think there is a generic. Is there?"

I think this is a very important topic, because asthmatics who take their meds exactly as instructed by a doctor can really lead a normal life, and can do things that any other person can do, like run a marathon.

On the other hand, not taking your controller meds is a "contributing factor in asthma deaths," according to the authors of Fatal Asthma. And those most likely to be non-compliant with their asthma meds are those who of the low income variety. A tough economy can make many of us poor.

And, with poverty, comes the unfortunate outcome of having to make cuts in the budget. And, unfortunately, when those among us lose our insurance, and the cost of Advair shoots up from $10 a month to $150.00, this becomes an easy place to make the cut.

That's understandable. But don't use this as an excuse to stop taking your asthma meds. If you simply cannot afford Advair (or Symbicort), there are options for you.

A few months ago I addressed this topic here at the RT Cave with this post "8 ideas for those who can't afford Advair." This post was a list not just of ideas I came up with on my own, but ideas many of my readers

The best option on my list is the one that allows you to continue taking Advair at a cost that is affordable to you. This option involves calling the pharmaceutical company to see if they have a program available to help you afford Advair.

Joy Buchanan, producer at MyAsthmaCentral.com, offered the following advice for the above question.

"Our expert, Dr. James Thompson, has written a post about saving money on managing your condition here. Also, you should contact Advair's manufacture, GlaxoSmithKline at 1-866-518-4357. Companies have programs to provide their brand name drugs to patients for cheap (or, sometimes, free) if they meet the income qualifications. GlaxoSmithKline's program for Advair is called GSKAccess. Also, try these organizations for help with your prescriptions:* Partnership for Prescription Assistance* RxAssist.org* RxHope.com* TogetherRx

There are a lot of COPD and Asthma patients who have benefited a great deal from Advair. If your wallet is a little thin, at least this gives you another option to try to keep that Advair in your system.

UPDADE:  CHECK OUT MY NEW POST: HOW TO GET HELP PAYING FOR ASTHMA MEDS AND PHYSICIANS

Pharmaceutical companies need to make money

I have written the past 2 days about the high cost of Advair and what an asthmatic might do instead of choosing to not take this medicine at all. One of the ideas that was sent to me was this:
We could make it so pharmaceutical companies no longer make so much money at the expense of people who are sick. It's ridiculous that they make so much money anyway.

Another common question is this:

Why doesn't Obama put a cap on how much prescriptions can cost?

I had a reader email me the following, and I think it will make a fine answer to the above questions:

It is the capitalistic system that developed Advair--and other useful drugs. The drug companies have huge development costs, and huge costs getting through the FDA, and if the drug company can't recoup its expenses, and make a profit for its shareholders, there is no point in the company's ever developing a new drug. We won't ever get any new ones. You don't work for free; me neither. Neither do the shareholders, or the employees, of the companies that develop new drugs.

I agree with this answer completely. What makes America such a great country, and why our economy is the best in the world (despite the recession), is because of capitalism. And the key to making capitalism work is the risk/reward factor.

In the case of Advair, a pharmaceutical company sacrificed millions of dollars and many years of research developing a medicine that they had no idea of whether it would even be approved by the FDA for use.

If it were not for the reward factor (making a profit), there would be less risk taking. And, if there is less risk taking by pharmaceutical companies, that would be fewer new asthma meds, and less hope for even better meds for the future.

8 ideas for those who can't afford Advair

Yesterday I wrote about some ideas I had to help people cope with the high cost of Advair. This may perhaps be the greatest medicine ever invented for asthma patients, and yet it costs so darn much. Those with no health insurance may have to choose between Advair and nothing at all.

But that's not necessarily true. There are options. Here are some of the ideas people have emialed to me.

1. Talk to your doctor about free samples
2. Advair comes in two strengths--for example, if the doctor prescribes the 250, to be used twice a day, and the patient needs only the smaller 100, and uses the 250 once a day, maybe that is better than not using it at all.
3. Perhaps the doctor could prescribe one puff once a day to make the discuss last 2 months instead of one.
4. Talk to your doctor about taking alternative Corticosteroids, like Beclavent, Azmacort, Advair, Vanceril.
5. For those who need the added corticosteroid, they could take Advair in the morning and a substitute corticosteroid in the evening.
6. You could do a combination of the above to make the med last longer
7. Check this website out to find the cheapest asthma meds: http://www.needymeds.org/.
8. Pharmaceutical companies have programs for folks who can't afford drugs- call them!

These are just some ideas from me and some of my readers to help those of you who cannot afford these meds. You can discuss these with your doctor and see if they might work for you. You may have to experiment a little, and get creative.

But, please don't stop taking you preventative asthma meds just because you can't afford them. And please don't stop taking them just because you feel good after not taking them for a week. Asthma can pretend to not be there at times and then can show its ugly head on a dime.

Advair may be too expensive for many asthmatics

Being that we are in a recession and many of us are scrapping for money, some Gallant Asthmatics are finding it quite hard to afford their asthma medicines. This is especially true of Advair, which costs about $120 without health insurance.

Personally, even with health insurance I pay $80 a month for my asthma medicines. Thankfully I have a good job, and (fingers crossed) a recession proof job too. But others aren't as fortunate as me.

That in mind, in this edition of My Answer to Your Rt Queries I tackle the following tough question that was asked over at MyAsthmaCentral.com:

QUESTION:

I can no longer afford Advair. Are there different (and cheaper) meds to take?

ANSWER:

Advair is a medicine that has benefited many asthmatics, unfortunately it is a very expensive medicine. The cost of a medicine usually does not decrease in value until the patent runs out and generic meds are produced. A patent usually lasts about about 25 years.

This is something you should definitely talk to your doctor about, because while Advair may be the best medicine for you because it contains both Flovent and Serevent and is relatively easy to use, there are alternative corticosteroids on the market that are less expensive, such as Vanceril, Beclovent, Azmacort, Aerobid (although Aerobid tastes nasty, like rotten mints), etc.

Even though these may or may not be ideal for you, I think your doctor would rather have you on a med you can afford than to take nothing at all.

As for the Serevent component of Advair, I do not believe there are alternatives to this on the market right now.

I bet another alternative would be to talk to your doctor about getting free samples, but because one discus lasts only a month, this would only be a temporary solution.

I think it is unfortunate that the worlds greatest asthma medicine (in my opinion and my doctors) has to cost so much. But that's the way it is in a capitalistic system.