Prednisolone for asthma - anyone had it?

[VagueButlmportant]

I've had a nasty virus which has made my asthma flare up. I've been really breathless although not had any wheeze.

The Dr prescribed a 5 day course of prednisolone on Wednesday. It's improved my breathing but it's still quite bad - walking upstairs or lifting heavy objects makes me breathless, sets off my cough and is occasionally making me sick.

My worry is that I am due to fly out on holiday on Tuesday. I take my last dose of the steroids on Sunday. Is it likely I'll get worse again when I stop taking them? I was really struggling to control my breathing even with massive use of blue inhaler before I started on the tablets. If I go back to being that bad I'd be really concerned about being abroad.

Just after experiences - how long do the effects last, and do you normally have a bit of a "relapse" when you finish taking them?

The symptoms from the virus should be subsiding so I would expect a relapse. Do you use a brown inhaler as well as the blue?

Thanks Flanders (great name btw!)

Yes I use a brown inhaler morning and night. I've been taking a higher dose for the last couple of weeks.

I think I'll try to get back to the dr on Monday to ask for some more steroids to take with me.

I really don't want to cancel the holiday because it will let a lot of people down, but I'll see how it goes.

Prednisolone is great for my daughter when she has an asthma flare up. I would see if you can get some to take on holiday with you, as a precaution. When DD had an asthma flare up in France she was prescribed Prednisolone, and there you just buy a full packet of the stuff, rather and getting a few pills. It was great to have an emergency reserve for years to take on holiday with us, as it does work quickly & effectively to prevent the tubes shutting down..

Not trying to scare you OP but I just landed myself in Resus, HDU and a Resp ward for a week with a virus that turned into a really bad chest infection and set my Asthma off.

Prednisolene is pretty instant (happy memories of my DD bouncing off the walls at 2am on the ward after emergency admissions a few years ago!) so if you're not improving after a 5day course you need reviewing again by an Asthma Nurse preferably. So yes do get back in on Monday.

Tip. If the brown inhaler is the Clenil one, the first thing the Hospital Dr did was change it to symbicort, Clenil is apparently one of the most basic inhalers and isn't widely advised apparently we need something stronger.

Hope you're feeling better soon.

Thanks all! Yes I've been bouncing off the walls at 2 am, but sadly still quite breathless while I'm doing it. It's France I'm going to, so good to hear it's easy to get there.

Not helped by the fact that yesterday I took the 8 pill dose, then immediately threw up. Practise Nurse said she couldn't advise me to take 16 pills in one day so I effectively missed a dose. I was definitely worse last night (despite being able to sleep much earlier) so that's what's made me worry about a relapse on Monday / Tuesday.

Yes an emergency appointment Monday morning is needed I think. I won't go on holiday if I don't think it's safe.

Sorry to hear you were so poorly snowgirl . This is my first real experience of very poorly controlled asthma. I was only dx about 3 years ago, and it's really only affected me when I've been running in cold weather or had a bug. This is the first time I've felt very vulnerable.

I'll ask for an alternative inhaler too. It is the Clenil one I have.

I have taken it and been fine with it. I am sure that my Mum took it very long term, my horse also has it when her asthma flares up not helpful.

I was prescribed fostair recently instead of clenil. It has to be refrigerated.

Do you use a spacer? At my recent asthma check up the nurse gave me a spacer, apparently with spacer use you get roughly 50% of the dose in the right place, this can reduce to 15% without, even for people with good technique.

I haven't had one before, thought they were just for children!

It sounds like you may need some antibiotics to help shift it if it has settled on your chest Vague. Or another course of steroids. I sympathise with the throwing up thing. They gave me about 20pills only a slight exaggeration on my last admission and my body promptly rejected most of them.

I was diagnosed last year and I am usually fine, in the sense, feel bit breathless take my ventolin and I'm fine. But I've had two hospital admissions since April. I got a nice telling off by the Practice Nurse about seeking help earlier but I quite literally just had a head cold for a few days before hand and just sleepy. I'd never in a million years get a GP appointment for a head cold! Laid down one night and couldn't breathe. Rang my Aunty who heard me wheezing down the phone and rang 999 for me and it all went to pot from there! Not meaning to sound patronising at all but just telling you to point out how quickly your body can change and asthma attacks can happen. I felt fine prior to this apart from the head cold which I was taking cold & flu tabs for, just remember walking home from the park with the DCs wondering why I felt so dogtired.

The Clenil one always used to make me cough half a lung up when I took it too!

France sounds lovely I hope you have a wonderful time

Thanks!

Yes I use a spacer. I am hopeless without it. I just spray it on my tongue!

I know how scary it can be to go downhill quickly. DD has had asthma since she was a toddler and we've had a couple of frightening episodes.

You can ask to have an emergency pack of telegenic steroids my out of hours gp advised to always have a couple of days worth incase of colds and viruses that end up making my breathing bad. Maybe even just phone your gp and ask for a prescription.

I have prednisolone from time to time for asthma flare up. I had a 5 day course a few weeks ago for the same reason as you, OP. It took about 4 days to start to have any noticeable effect. I've also been having 200mcg beclametasone twice a day. It's a lot better now, but it's taken a while to calm it down; the virus that was doing the rounds a couple of months ago seems to have been a real problem for some asthmatics.

my last flare up took 17 days of steroids to ease it- 5 days - 5 days -7 days.
now i have a rescue pack on me at all times.
clenil and ventolin didn't touch me so now im on fostair 4x a day and have not needed any ventolin or oral steroids.(touch wood)

Wow wfrances that sounds scary.

The Prednisolone isn't really doing the trick I don't think. I'm certainly better with it, but not by much.

Do you know what your peak flow was? I'm not really sure what mine should be and what is considered low.

I have googled and found a graph that says it should be 440 (I'm 42 and 5'5) but when I last did it at the Dr when I was well, it was nearer 500 (I'm a flute player and fell runner, and it's normally higher than average)

I didn't take a reading when I was really poorly on Wednesday. This morning it was 220, and I could tell my breathing wasn't great (although better than Wednesday) then after some blue and the oral steroids it is now up to 280. I feel OK now as long as I don't move anywhere too fast, but I would have thought the steroids would have brought it up more than that?

This is the first time I've had an episode like this so I'm not sure when to worry / what to expect.

Definitely go to the GP, it sounds as though you may have an infection as well. I have had asthma all my life and several courses of predniscilerone, I think you should be feeling better by now so you should have a review and probably another course.

As an aside, I struggled for years with different preventers until I was prescribed Seretide diskhaler, the delivery method really suits me and gets the medication to my lungs rather than mouth. I think it's expensive so they tend to try a lot of others before - I have never been so well.

I hope you are feeling much better very soon and can enjoy your holiday, let us know what the dr says tomorrow, take care.

I've been prescribed prednisolone a couple of times in situations similar to what you describe, and I've felt an improvement within 24-48 hours. Definetly worth a visit to your GP on Monday!

do you have a personal asthma plan?
mine was worked out by the consultant
my best peakflow is 500 , if i drop to 350 i have to up my fostair to 8 x a day
if no better im to start my rescue oral steroids and see a gp within 24 hrs.
if it drops to 250 , or i find it difficult to walk or talk ,or if im struggling to breathe see or speak to someone straight away as this is classed as an emergency. so id have to speak/see someone straight away with a 220 reading.
do you know your oxygen levels ? heart? resp rate?

No I don't have an asthma plan. I've only really been diagnosed for around 3 years, and this is the first time it's really caused a problem.

My heart rate seems normal when I'm sat still but goes up massively if I try to do anything. My heart rate is usually quite low (around 50-55) so I have a bit of room to go when it goes up!

I don't know my oxygen levels. When I was at the dr around 2 weeks ago, they were 98 but that was before my breathing went so bad. I don't feel like they are low, because as long as I sit still I am breathing normally. Not sure what to look out for?

I don't think I need any emergency treatment while my peak flow is at nearly 300. The problem is I've finished the steroids now so I will need to be seen tomorrow because I feel that it's going to drop again.

I will also ask for a proper review and get a plan in place. I don't want to go through this again.

that how i ended up having to have 3 courses ,id finish 1 course then 24/48hrs later the wheeze came back /oxygen levels dropped , chest gets tighter ect..
you can breathe into a machine which tells you how much inflammation you have in your airways , i had to do this after the last lot of steroids to see if it had settled.
yes get a plan ,hope your well enough to go on holiday.

Go back to your docs. Prednisolone should be doing a better job by now if there's nothing else there.

I had an infection, after a virus, a couple of years ago that brought my asthma back up for the first time in many years. Took two weeks of pred and antibiotics,along with my inhalers (with spacer!) in the end. I left it a while before going to the docs,stupidly, but spent a couple of weeks with a peak flow between 200-230 and had a very scary moment or two!

Get to your doc asap, especially seeing as you are recently diagnosed so don't have much experience with it

You have my full sympathy, I've just had a horrible 3 weeks that started as a nasty chest infection (I only had my previous chest infection six weeks previously!), caused a big asthma flare up and ended up with an A&E visit, nebuliser, the full works in spite of already being on antibiotics and Prednisolone. It's taken ages to get me properly back on my feet. My steroid inhaler is generally very good though - I take Seretide (purple) instead of the brown one and it usually works well for me.

Do definitely get an emergency appointment tomorrow and I hope you can get it sorted and have a good holiday.

My asthma flared when I was pregnant and didn't really improve for ages, so at my next review the nurse switched me to the Symbicort and it is the best thing I've ever done. It is so effective that I mostly only need one puff of it a day.
I used to end up on Prednisilone a lot as a kid, very effective stuff, but if you've got a virus that could take a while to shift comletely, so you'll be vulenerable until it's gone altogether.

You've had a tough time blackbird, hope you're on the mend now. I have seretide purple & think I'm on the maximum dose but it is working - do you have the diskhaler?

Thanks Emptynest. I'm much better thanks but still have less energy than usual. No, I have the evohaler, does the diskhaler do a better job or is it just higher dosage? Have my review with the asthma nurse in a couple of weeks so I'll be begging her for some sort of treatment plan that tackles all the chest infections!

Hi blackbird, I think the dosage is the same it's just a powder delivery and it doesn't make me cough - you could ask for a trial, I really like it and have been mostly well since I've had it. Not sure what they can do to sto the infections, have you had the anti pneumococcal vaccine? I had it after getting pleurisy when pregnant (20 years ago!) and not had anything nasty since then. Let me know what they say at your review. I used to always have an emergency pack of steroids and antibiotics for holidays but they don't like to give out antibiotic prescriptions any more. Glad you're on the mend, the attacks are exhausting.

Thanks for such great advice Emptynest - yes I'll let you know.

Thanks all. Sorry to hear I'm not the only one. Yes an emergency appointment tomorrow or OOH if I can't get one.

I'm not going on holiday unless I can get some more prednisolone to take with me. I don't think it would be safe. I'll take the dr's advice if she thinks it's not safe to go even with it.

I'll have some very upset teenagers to contend with if we have to cancel but it'll have to be done.

I'm trying to pack at the moment and it keeps setting me off.