Inhaled Corticosteroid For Asthma

[Jingthing]

Anyone here on inhaled corticosteroid asthma therapy? These prevent attacks from ever happening in the first place and they really work.

I have been combining this with albuterol (Ventolin) inhaled bronchodilator for decades.

I used to be on Azmacort (triamincinolone acetonide) in the US but was never able to find that in Thailand. This I find weird considering in the US 53 million prescriptions have been written for this drug and clearly asthma is common in Thailand.

In Thailand, the only thing I have been able to find to replace Azamacort was Inflammide (budesonide) manufactured by Boehringer Ingelheim of Germany. Also an inhaled steroid used for long term therapy. Now a major Thai pharmacist tells me this med is longer being manufactured.

I don't have another alternative right now. If you are talking another kind of inhaled corticosteroid for asthma and have obtained it in Thailand, please say what the brand name is and where you got it either in Pattaya and Bangkok. Thanks ...

Edited February 8, 2007 by Jingthing

[bina]

pm sheryl she's a health worker she should know the brands available

[Phil Conners]

FWIW, my wife suffer from asthma as well and usually get by with Ventolin, but somethings up with the air these days and she had trouble breathing. She went to Memorial Hospital in Pattaya and got Sulbutamol 2mg 2 x 1 daily (seems basically Ventolin in a pill form) and Prednisolone 5mg, 2 x 2 daily. Of course they also had to throw in a bag of Paracetamol in the true Thai style

Judging from the Internet Prednisolone is some sort of anti inflammatory stuff, it had some negative side effects listed (swollen face, acne) so she tried going with the Sulbutamol alone first. It didn't help much, so eventually she took the Prednisolone and that has worked really well, and so far without any of the side effects.

Of course, usual disclaimer apply, i.e. check with your doctor...

Edited February 8, 2007 by Phil Conners

[Jingthing]

Thanks, Phil. Sounds like an oral steroid. Those have alot more potential bad side effects than inhaled steroids.

[Phil Conners]

That may be so, the bottom line for her is that she feels good now. She didn't before.

[chuchok]

FWIW, my wife suffer from asthma as well and usually get by with Ventolin, but somethings up with the air these days and she had trouble breathing. She went to Memorial Hospital in Pattaya and got Sulbutamol 2mg 2 x 1 daily (seems basically Ventolin in a pill form) and Prednisolone 5mg, 2 x 2 daily. Of course they also had to throw in a bag of Paracetamol in the true Thai style

Judging from the Internet Prednisolone is some sort of anti inflammatory stuff, it had some negative side effects listed (swollen face, acne) so she tried going with the Sulbutamol alone first. It didn't help much, so eventually she took the Prednisolone and that has worked really well, and so far without any of the side effects.

Of course, usual disclaimer apply, i.e. check with your doctor...

Yep, Sulbutamol is oral ventolin.Opens up the airways and speeds u up a bit.Prednisone is just a run of the mill steriod that helps breathing.best anti inflammatory on the market.

[Jingthing]

Yes, oral steroids are needed sometimes in a crisis, but can't be taken for life. Inhaled corticosteroids can and often prevent a new crisis. Now, if only I could find some in Thailand.

[jcgodber]

Asthma

Seretide Accuhaler

(Fluticasone Propionate 250mg )

This is what I use and it has allowed me to almost stop using albuteral.

It is available everywhere in Thailand an cost between 1000 B and 1300 baht

2 sprays a day one morning one evening,

I have been advised by my doctor to use this consistently not sporadically.

Jim

[Jingthing]

Asthma

Seretide Accuhaler

(Fluticasone Propionate 250mg )

This is what I use and it has allowed me to almost stop using albuteral.

It is available everywhere in Thailand an cost between 1000 B and 1300 baht

2 sprays a day one morning one evening,

I have been advised by my doctor to use this consistently not sporadically.

Jim

Thank you very much, Jim!

And the forum for being such a great resource for things like this.

That sounded like it would be exactly right. Fluticasone is indeed a corticosteroid.

However, it is not exactly what I need, darn:

This combination inhaler provides these two preventative medicines in one inhaler, so that preventing asthma is not made more complicated. It is used for asthma that is not sufficiently controlled by using just a regular steroid inhaler and a reliever inhaler (eg salbutamol).

http://www.netdoctor.co.uk/medicines/100002369.html

... because I am fine with a regular steroid inhaler and a reliever inhaler, so it would be medical overkill.

I also agree this class of meds are really fantastic. As long as you keep using them, they are as good as a cure for many.

I suppose its time to see a doctor or sniff around a hospital pharmacy. I have been to the obvious pharmacies in town and they couldn't help me.

Edited February 8, 2007 by Jingthing

[tangoll]

I have been prescribed the following by Bumrungrad Hospital respiratory doctor, and these meds are readily available in Bangkok:

1. Singulair tablets 10 mg (montelukast sodium) baht 1900 or so for 28 tablets

2. Seretide accuhaler 250/50 baht 900 from drugstore just off Sukhumvit soi 15, baht 1400 from Bumrungrad

3. Pulmicort turbuhaler 200 mg/dose budesonide, baht 700/100 doses at Bumrungrad

Prices of these meds are sometimes cheaper in Thailand than elsewhere (eg. seretide acc is almost baht 1900 per unit in Hong Kong) and sometimes more expensive (eg. Singulair is baht 1500 for 28 tablets in HK); so if you are able to get meds outside of Thailand, you should check and compare.

I also use clarityn tablets, which are baht 24 per piece in Bumrungrad, but baht 15 per pc in HK.

[Phil Conners]

If you haven't already, check with Fascino in Pattaya Nua - probably the best stocked and priced pharmacy in Pattaya...

[Ijustwannateach]

Last year I was prescribed that exact brand when I became very sick- I was at Bangkok Nursing Hospital. Not the cheapest place, though.

[Pink Mist]

FWIW, my wife suffer from asthma as well and usually get by with Ventolin, but somethings up with the air these days and she had trouble breathing. She went to Memorial Hospital in Pattaya and got Sulbutamol 2mg 2 x 1 daily (seems basically Ventolin in a pill form) and Prednisolone 5mg, 2 x 2 daily. Of course they also had to throw in a bag of Paracetamol in the true Thai style

Judging from the Internet Prednisolone is some sort of anti inflammatory stuff, it had some negative side effects listed (swollen face, acne) so she tried going with the Sulbutamol alone first. It didn't help much, so eventually she took the Prednisolone and that has worked really well, and so far without any of the side effects.

Of course, usual disclaimer apply, i.e. check with your doctor...

Yep, Sulbutamol is oral ventolin.Opens up the airways and speeds u up a bit.Prednisone is just a run of the mill steriod that helps breathing.best anti inflammatory on the market.

prednisalone is an anti-inflammatory drug, it's a steroid and from what I am led to believe is cortizone in a pill form.

It's good for athsma but also other uses, I have had it prescribed for gout.

It puts the weight on and should only be taken for short stints, 2 weeks tops, then give it a rest.

[Jingthing]

OK, in my case, the pulmicort turbuhaler is a very good match. I have never used a powder (as opposed to a spray) before but there doesn't appear to be any other one-active-ingredient inhaled corticosteroid available in Thailand. I think companies are also moving away from sprays to be green. Another case that shows you have to be flexible living here.

Edited February 9, 2007 by Jingthing

[julie_f]

I am also using Seretide. It comes in a number of doses, 100, 250 and I think there is a stronger one. I use Seretide 100 usually but here it wasn't avaliable, so used the 250 which has around double the amount of steriods. I just used it once a day instead of twice a day.

The pharmacy I went to had to order it in but they spoke very good english. Try a recommended pharmacy or a private hospital. It cost me around 1200 bht over a year ago.

My asthma is fairly well controlled with this medication and I rarely use Ventolin now.

[Sheryl]

Beclomethasone dipropionate is availablae here under several brand names, including Clenil and Becotide. the Clenil comes in several different formulations, one is a compound with something else but it also comes plain in 2 different strengths.

If you go to Bumrungrad, Samitivej or Bangkok Hosp they will probably have Azmacort imported but you'll have to see one of their specialists first and the drug will be quite expensive (as in, more than it costs in the US). I'd suggest you try the Clenil/Becotide first. Same mode of action and fairly inexpensive as made locally. it's been around for years and any large pharmacy should have it.

Other preparations you may find are:

Budecort (budesonide)

Pulmacort (" ")

As you have no doubt noticed, most pharmacy staff in Thailand aren't actual pharmacists and do not recognize what you need unless you ask for it by the local brand name.

There are real pharmacists around, just not in most "pharmacies" .

Take care

[cathyy]

As you have no doubt noticed, most pharmacy staff in Thailand aren't actual pharmacists and do not recognize what you need unless you ask for it by the local brand name.

There are real pharmacists around, just not in most "pharmacies" .

And don't forget to pronounce the generic name with a Thai accent. I usually end up just writing it down for them. I always ask for the generic name after asking for the US brand name, as there are many European brands sold here that I simply don't know. People from Europe should do the same because they probably don't know the US brands.

[kdf]

Asthma

Seretide Accuhaler

(Fluticasone Propionate 250mg )

This is what I use and it has allowed me to almost stop using albuteral.

It is available everywhere in Thailand an cost between 1000 B and 1300 baht

2 sprays a day one morning one evening,

I have been advised by my doctor to use this consistently not sporadically.

Jim

Thank you very much, Jim!

And the forum for being such a great resource for things like this.

That sounded like it would be exactly right. Fluticasone is indeed a corticosteroid.

However, it is not exactly what I need, darn:

This combination inhaler provides these two preventative medicines in one inhaler, so that preventing asthma is not made more complicated. It is used for asthma that is not sufficiently controlled by using just a regular steroid inhaler and a reliever inhaler (eg salbutamol).

http://www.netdoctor.co.uk/medicines/100002369.html

... because I am fine with a regular steroid inhaler and a reliever inhaler, so it would be medical overkill.

I also agree this class of meds are really fantastic. As long as you keep using them, they are as good as a cure for many.

I suppose its time to see a doctor or sniff around a hospital pharmacy. I have been to the obvious pharmacies in town and they couldn't help me.

Please note: Most informed (read the current peer reviewed journals) asthma docs recommend Advair or Seretide. Asthma has 2 causes, constriction and inflamation, Advair/Seretide is the only medication that covers both in one med. Most asthma sufferers can do without or cut way down on rescue meds (ventolin, combivent) with proper combination of inhaled cortisone and salmeterol (the long acting bronchodialator in Advair/Seretide). If your doctor is not treating you with Advair or seretide ask why. really

kdf

[cathyy]

Please note: Most informed (read the current peer reviewed journals) asthma docs recommend Advair or Seretide. Asthma has 2 causes, constriction and inflamation, Advair/Seretide is the only medication that covers both in one med. Most asthma sufferers can do without or cut way down on rescue meds (ventolin, combivent) with proper combination of inhaled cortisone and salmeterol (the long acting bronchodialator in Advair/Seretide). If your doctor is not treating you with Advair or seretide ask why. really

Um, because some of us don't need both on a regular basis? I take Singulair and use a Pulmicort inhaler. I have an albuterol inhaler for when I need it. I need it only when exposed to one of my triggers, like smoke or heavy perfume. That just doesn't happen on a daily basis. Mostly only when I go to BKK, in fact.

I seem to recall from a discussion in here previously that the US version of Advair contains salmeterol, but the Thai version does not, just the steroid. Or so a poster in here insisted. You might want to check the label to be sure what you are getting.

[JohnC]

I used to be prescribed Pulmiort & Oxis powder inhalers, my GP changed me to a combined one called symbicort which I get each month from Fascino on Pattaya Nua, it cost 1093baht but they gave me a member card the first time I went and I get a discount on all my purchases although I cant remember if ist 5% or 10%.

However that not withstanding I have found them to be the best pharmicist in Pattaya and get all my medication there every month (I am also diabetic)

What is Symbicort?

Symbicort® is a combination inhaler that contains two separate medications, a preventer and a controller/reliever in the same one inhaler.

The preventer medicine is an anti-inflammatory medicine called budesonide (Pulmicort). The anti-inflammatory effect of regular treatment with budesonide helps to prevent asthma symptoms. Formoterol (Oxis) is the controller medicine that relaxes and opens up the small airways, helping you to breathe more easily and avoid an attack. Formoterol not only works for a long period of time, but you will also feel the effect quickly – in fact as quickly as your usual (blue) reliever medication. Because of this speed, formoterol can act as both a controller and reliever.

When you use Symbicort, you can expect fast relief from asthma symptoms (within 1-3 minutes after inhaling the medicine) as well as long-lasting control. You should have fewer asthma symptoms during the day and at night, and be able to do more activities without getting breathless.

Also have a look at this website http://www.myasthmamedicine.com/

Hope it helps

JohnC

[bina]

as a mother to two asthmatic kids:

symbicort effective for one kid (chronic low grade asthma) symbicort just was easier for a teenager to stick with the program so to speak (sports freak), with ventolin before going for the 'goals'...

my daughter: briciline turbo and very rarely butecort for allergy season since she has mainly acute activity triggered asthma (she dances)

17 yrs of asthma meds and followups; peoples' airways change with age, medical problems, work, play, environment and willingness to use them(compliance), also coordination issues (turbo works for daughter who has coordination problems between inhaling and pressing the inhalor) ;

husband, thai , allergic asthmatic: ventolin we bought w/o prescription in thailand. typical thai usage of meds: never uses unless cant breathe at all and doesnt stick with any kind of med program.

what works for one doesnt always work for an other.

my mother is (ex) respiratory therapist from the states; she keeps us updated with the latest american meds but meds program should be that u dont need rescue meds for more than two/three days every few months (loosely speaking). if u keep reaching for the rescue, then be reevaluated or reinstructed in usage of current meds. could be improper usage. she says that a large majority of adults find it difficult to use inhalors properly and therefore many meds are used inaffectively. elderly adults also hae a more difficult time using inhalors due to finger stiffeness etc so other methods are needed.

[Phil Conners]

After completing the course of Prednisolone given by her doctor (and eventually getting quite bad acne from it) she went back for a control visit and was now prescribed THEOPHYLLINE, which according to many websites have very serious side effects.

She asked the doctor about SERETIDE and SYMBICORT and was told she could go and buy that herself if she liked, but that it was new drugs and, basically, "not invented here".

This was Memorial Hospital, Pattaya. A pity we had to find our own answers, but fortunately the Internet has some answers.

I found this UK NHS page comparing SERETIDE and SYMBICORT: http://www.nelh.nhs.uk/hth/seretide.asp

[bina]

theophylline was the drug of choice for many uncontrolled asthmatics or teenagers who refused to comply to other forms of medication. i had several students on theo when i was a house mother in the early 1990's.

if she was getting prednisone then she was in bad shape. dont know about respiroatory stuff in thailand but i would go to a pulmonary specialist in asthma, not to a regular general practioner.

symbicort in israel is also not in the natl medical insurance plan due to it being 'new' etc. we paid a fortune for my son's inhalor.

it also boils down to the age of the person and their activity and stuff. as i said earlier, different things owrk for different folks so what works for one person doesnt always work for an other as u can see by the ashtmatics in my family. we have various coloured inhalors laying around everywhere and in the car, and in my purse, and a portable inhalation machine still sitting in the salon by the tv for the youngest's recent flu induced asthma. my daughter gained a lot of weight from the predni.

[backflip]

"the US version of Advair contains salmeterol, but the Thai version does not, just the steroid."

Not true. Seretide is exactly the same as Advair. According to the Seretide package I have in my hand, "each inhalation contains:

SALMETROL (as xinafoate) - 50 mcg

FLUTICASONE PROPIONATE - 250 mcg"

The pharmacy I use charges me 880THB for each discus.

[Sheryl]

She asked the doctor about SERETIDE and SYMBICORT and was told she could go and buy that herself if she liked, but that it was new drugs and, basically, "not invented here".

NONE of the drugs in question were "invented here", not that where a drug was invented should have anything to do with it.

He may have meant that it was not available in that hospital; hospitals make a large profit on drugs and discourage physicians from prescribing anything they don't carry in stock.

Or it may have been that he just hadn't heard of theswe new drugs. The treatment that was given (prednisolone and then theophylline) is about 20 years behind the times. Sounds like a GP who hasn't kept up to date with advances in asthma management. Now, no-one can keep up to date in everything, but if he is not up to speed in an area he should refer to a specialist who is.

Change doctors.

[Sheryl]

OK now I have a question: doesd anyone know of a local source for nebulizers of the type that can be used on a small child or baby? My nephew's son has croup, which like asthma is treated with inhaled steroids, but he's only 18 months old and can't use an inhaler. I need to get a nebulizer with mask piece plus steroid in appropriate form to mix in a nebulizer. ..