change in asthma medication

[starburst1979]

A few weeks ago we were notified that my ds prescription for seritide 250 would be changed to flutiform 250. It was explained they were very similar and there should be no ill effects. The new inhaler turned up in Friday and since then his asthma has kicked off. On the advice of the walk in he is back talking his seritide, however the gp doesn't think it was be because of the inhaler but more a case of unfortunate timing.

Has anyone else been switched over and feeling any Ill effects?? Does anyone worth its worth keeping on with the flutiform?

[TheAussieProject]

I would ask if the decision was cost-based. A medication which has proven to work well shouldn't be changed in my opinion. Ask for some justifications. Flutiform is cheaper, but still quite new and many things aren't clear yet about his effects and safety. A trial done on 5-12y children was done by the pharmaceutical company. Trial is completed but not published clinicaltrials.gov/ct2/show/NCT01511367

My son is on seretide 50/25 used with a spacer and I look closely to the research because of the proven effect on growth reduction in children. (All steroids have sadly this consequence).

[starburst1979]

Thanks for your response aussie. It is a cost based decision.

I asked to speak to the practice manager but she is in holiday until next week, the GPS are not allowed to prescribe seritide any longer. I'm furious.
He has about 2 weeks worth of seritide on a spare inhaler left so I have two weeks to sort this out.

I'll drag them kicking and screaming to the papers if I have to!

[MigGril]

I've found this you mite found useful
www.prescqipp.info/finish/215-flutiform/556-bulletin-23-flutiform

I don't understand the switch they have made that document shows the drug is different. My DS is on the seretide 50 also do glad I've seen this but think he's to young for them to change his at the moment.

[starburst1979]

That all says over 12, he's 11. Maybe I need another conversation!

[Sirzy]

They are the same drug so shouldn't make a difference, although other non active ingredients can make a difference I believe.

That document is just one trusts guidance it seems so wouldn't be an argument against, my son is 6 and on a dose of seretide not licensed in under 16s so ages tend to be more of a guide and they can prescribe out of the licensed range if they think there is a need.

I would make an appointment to discuss your concerns with the GP

[MigGril]

Sirzy intersting as you must be looking at a different document to me. Reading the link TheAssuie added they do not contain the same long acting drug, the steroid is the same.

That may only be the guild line for one trust but they are usually written based on Nice guidelines so should be similar. You maybe able to find the Nice guild lines of you search there website. That's what a quik Google came up with.

[Sidge]

Well they're the "same" in that they both contain an inhaled corticosteroid and a long acting beta agonist. The steroid is the same (fluticasone) but the long acting is different - formoterol in Flutiform and salmeterol in Seretide. Formoterol is considered quicker acting.

However 250 is a stonking dose, and isn't even licensed for under 18s. Was it prescribed by a respiratory consultant?

[SmallGreenBouncyBall]

almost all studies and clinical trials are sponsored by pharmaceutical companies. they have to or they wouldn't get a license. it's all heavily regulated.

[MigGril]

It's perfectly possible that different people will have different reactions to the two different drugs in the inhalers though. Until they trial them you won't know if they will be effective treatment for them.

I immigianie it will have been a consultant prescription. My son was started on seretide below the recommend age for it, he was only 3, when he first had it. I also know someone who has to take both seretide and a separate steroid Inhaler, apparently that's quit rare.

[Sirzy]

My son has been on 250 since he was 5, but he is a complex case and it was agreed by both his respiratory consultants it was the only option.

[Sidge]

Absolutely Sirzy, I remember you said on a thread before your son has very complex asthma and is under the respiratory team. Sometimes you have to prescribe huge doses to achieve good control, along with all the monitoring that goes along with that!

Starburst have his symptoms settled again since going back to the Seretide? If so carry on with that, then arrange a review with the asthma nurse/GP/respiratory team as soon as you are able. It may be that the local CCG prescribing authority have stopped Seretide prescribing routinely on a cost basis, but patients can revert back to original medications under an exception report where assessed and it has been agreed by a GP or specialist that the original is necessary.

[starburst1979]

Visited the gp again and he's back on seritide ☺
His peak flow had dropped from 240 to 180 and his chest is full. We had been asked to try the new inhaler over the weekend and this was the result. GP for the practice manager into the room and showed her the decline and she authorised it straight away

I just wish people didn't have to dick around with people's lives to make financial decisions.

So angry!!!

[TheAussieProject]

Well done!