Fostair nextHaler dry powder inhaler experiences

[Starry4321]

I am currently on the pink Fostair inhaler. My asthma nurse said she wants to move me to the dry powder inhaler. She said due to government cuts Fostair puffer regular inhaler won’t be available to me anymore and I would need to switch to a different one regardless.

My asthma has been pretty well controlled on the Fostair inhaler (apart from a flare a month ago due to what I think was Covid) so I am a bit nervous about trying the dry powder inhaler.

Does anyone have any experience of this one?

I was forced to move from fostair to luforbec. I was really unwell for about a month, but it has settled now. I have to take twice the dose I was on.

Oh no, it's all that's worked for me

I am on Fostair Nexthaler, is that the dry one? I have never had any issues, really easy you just open it and inhale (nothing to push). I also got moved to an Easyhaler for Salbutamol, which I think was an environmental/cost-saving measure, but it is so great. Much easier to use than a normal inhaler. That one, you push the inhaler in and then inhale in your own time, so you can't miss-time it. I don't know why they don't just say this to people instead of making us worry.

I've moved to a Fostair NEXThaler 100micrograms over the past year It's excellent (foe me anyway) The powder is a bit gritty and you need to make sure you inhale it properly but I've had very few breathless moments even through a couple of nasty colds, which usually have me wheezing

That’s interesting I’m sure she said that would be the one I would need to switch to if I didn’t like the dry powder one. Luforbec is cheaper than Fostair (£14 vs £30) but it’s the same active ingredients. God knows why it’s cheaper and it’s frustrating that they are making people switch for that reason.

When you say you were really ill what were your symptoms?

Yes the Fostair Nexthaler is the dry powder one. I’m currently on the Fostair traditional puffer one. That’s good you are getting on ok with it. Were you on the Fostair puffer style one previously at all? If so did you notice any differences with your asthma control on the Nexthaler? It’s totally different from what I’ve been doing for the last 2/3 years is I currently use a space device so just hoping it’s ok.

I thought it wasn't government cuts, it was about reducing the greenhouse gases by aerosol inhalers. The powder inhalers have a much smaller carbon footprint.

There has been a big push to get rid of aerosol inhalers for a few years, I have been wondering why I am still getting away with it with mine.

Were you on the Fostair puffer style one before you moved to the Nexthaler? Do you find the nexthaler is better? Trying to figure out if this might be better than the one I’m on or whether I need to prepare for a reduction in control.

Oh this is a worry. I currently have the normal fostair with a spacer and it works so well.

Exactly the same experience for me. The change was due to cost cutting but I've had to go on to a higher dose.

Same here. It's the same active ingredient but is made by a Pakistani pharmaceutical company and some much more cheaply.

So her moving me to the Nexthaler isn’t for government cuts. I asked her if I didn’t get on with the Nexthaler, could I go back to my traditional Fostair inhaler and she said it’s too expensive and I would need to switch to a cheaper version of Fostair. Yes, she mentioned greenhouse gases as the reason she wanted me on the dry inhaler. I get the environmental concern but when masses of people are spraying deodorant on the daily surely that’s contributing more than asthma patients.

Were you ill with the switch to Luforbec? What were your main symptoms if so?

New asthma sufferer here ( thanks COVID) and I tried the dry powder fostair nexthaler but couldn't tolerate the side effects. It controlled my symptoms really well but I suffered really badly with the shakes for up to 6 hrs afterwards. I've just started another dry powder combined inhaler last week called Relvar which seems to be working ok with only a mild case of the jitters for a short while after inhaling. The good thing about Relvar is that it's only taken once every 24hrs so you take it then forget about it.

Respiratory specialist nurse here so happy to answer any questions.

The main thing that all clinicians should aim for is for a patient to be well controlled. However...!

There is the green agenda plans within the NHS where they are trying to cut carbon emissions, and although it is a tiny weeny percent of where the NHS creates carbon emissions, it has become an area of target. So this is where some of the push for dry powder inhalers has come from. That, plus coupled with the fact that a lot of patients actually get a lot more of the drug to their lungs when using a dry powder inhaler (unless they use pump inhalers with a spacer).

Fostair pump inhaler and the Nexthaler have the same drugs in and are made by the same drug company. It's simply down to the different technique of taking it.

Fostair and Lufrobec also has exactly the same drugs in - Formoterol and Beclometasone. The reason there has been a big "switch" with these two is that Lufrobec is almost half the price of Fostair, so it's a big drive for the NHS. However, the drug company that make Lufrobec don't have a dry power equivalent, so where patients need a dry power then Fostair is normally chosen.

Rightbreathe is a great website for inhaler information / technique videos etc.

So frustrating as Fostair is so good

@Starry4321 it sounds like my situation is different to yours so I don't want to say 'don't worry' and it be meaningless to you. I think the best thing (which I always forget to do myself) is start doing your peak flow regularly now and keep it going when you change over, so you will be able to measure whether there is any change.

For me, both my inhaler changes were fine and I only noticed the change in the way I took it, not the effect it had. I don't use a spacer, so I don't know if that makes a difference as I don't think you could use a spacer with the Nexthaler. I can photograph it if it is helpful for you to see what it looks like?

I'm on the pink fostair puffer now, I got out onto it last year because A) I'd been pushed into a dry powder one ( forgot the name of it sorry) just before covid and really hated it but couldn't get a review until last year. B) they said the fostair was more environmentally friendly. I just had another review and she said it was ok for now if I was happy on it, but I've got to have another lung function test at the end of the month as although I think I'm managing my asthma well, apparently I'm not and she wants to rule out copd. I'm not going on another powder one, I struggled with the last one as I couldn't get the sharp breath in needed to inhale it properly.I think it was called relvar, yellow flip back top once a day, horrible thing

@Starry4321 100% BS that Fostair "won't be available to you" anymore. Yes the local guidelines that the practice follow may not suggest Fostair anymore, but it is an inhaler that is. Still licensed and prescribable in the UK.

So my advice to you is don't be scared to try the dry powder nexthaler, but make sure you are competent to use it. The asthma nurse should check your inhalation technique to make sure you have a good enough breath IN to draw the medication in. Watch the video and ask for an assessment.

Give it a go, remember oral care -
Rinse mouth - afterwards. Any inhaler with a steroid in can give you a sore throat, but powder inhalers slightly more.

However, if at any point your asthma deteriorates due to starting the inhaler, then my advice to you is that it is far more important to be on an inhaler that suits you and controls your asthma, so if that happens push back.

I have a LOT of patients on Fostair nexthaler, it is a great inhaler and a lot of people get on well with it.

But with asthma and inhalers it should never be one fits all. It should never be a generic switch. All patients should be assessed for suitability.

Thank you, this is very informative. Do you have any info on why the Luforbec is so much cheaper? Is it a poorer quality inhaler? When you are having to inhale a drug directly into your lungs every single day I feel it’s important to understand what I am actually taking in. And I feel frustrated if I am being fobbed off with an inferior inhalor (Lufoerbec) if I know the fostair works very well.

In terms of the Nexthaler it’s reassuring to know it might actually deliver more medication. I already use a spacer device with my existing fostair so I do think I’m taking that as prescribed.

@Starry4321 and you can't use a powder inhaler with a spacer so for you it may be the Lufrobec with a spacer is a better option for you.

I swapped from the fostair inhaler to the nexthaler nearly two years ago and I’d never go back. I find it much easier to use, no need for a spacer and my asthma has been so well controlled that I’ve not needed my ventolin at all. In fact I’ve just switched over to the Fostair Mart regime so only one item to worry about.

Give it a try.

@summerlovingvibes I've a question for you if you don't mind answering... Re: the fostair dry powder inhaler. I wonder how much of the powder is inhaled vs ending up in my mouth then rinsed out (my tongue feels gritty after inhaling). If you've any comments/tips etc I'd appreciate it, thanks.

@Starry4321 I was on aerosol inhalers before (clenil/ventolin) and only take half the dose now that I'm on the dry powder version.
(200mg beclometasone -- > 100mg, no need for ventolin now)

@Starry4321 Lufrobec is cheaper simply because the drug company making it saw the massive share of the market that fostsir currently holds and swooped in with a much cheaper price tag. They plan to take all the Fostair business and will make a lot of money.

It's not inferior with regards to the drug - that's exactly the same - but they do use a different propellant within the inhaler. So whilst Fostair has quite a strong propellant gas, Lufrobec has slightly less powerful. This is partly to appeal to the green agenda, and partly because of technique again.

Thank you. I’ll give the nexthaler a try. Asthma is so scary so it’s hard not to be anxious of making a change that could give you horrible symptoms when you are already happy on your existing medication ☹️ she basically said her hands were tied on it and it’s guidelines she has been given. So I wondered if I did really put my foot down and say I want the pink Fostair if they would just need to give me it.