Can I Double My Intake of Flovent During the Cold and Flu Season?
- Sunday, October 4, 2009, 23:01
- Asthma
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- Kathy: I take Flovent and Serevent daily for asthma. I have a problem with all the viruses – cold and flu – come fall and winter, and I would like to get through this year without a flare-up. It has been suggested not to increase the Flovent unless there is a drop in peak flow. Since the drop is hard to stop after it starts dropping, why not double Flovent when I am exposed to those with colds? I understand the need to use the least amount of Flovent as possible, and thus the suggestion to increase the dose only with a corresponding drop in peak flow. But last winter, each drop needed to be jump started with prednisone. In that case, wouldn’t it be better to prevent or minimize the drop in the first place with more Flovent? I use 100 mcg (dry) Flovent, morning and night and I also get flu shots.
- Dr. Kraemer: You ask a very good question. How do you prevent worse asthma during the toughest times of the year? You have also described that, without changing anything, you are still going on prednisone with each cold or flu illness. The answer to this question would vary from doctor to doctor. My answer is to give patients a “Plan A” for the daily maintenance medications – in your instance, Flovent and Serevent – and a “Plan B,” which are the medications to use in the event of an exacerbation. It sounds like you have no additional medicines. “Plan B” medications can be inhaled albuterol, nebulizer albuterol, and even possibly a short course of an oral antileukotriene, such as Singulair or Accolate.
When that is not helpful, you will need to use a short course of prednisone. If you still find yourself constantly reaching the prednisone with every URI, then ask your doctor if they feel it would be better to upgrade your “Plan A” medications. Going to a slightly higher dose of Flovent, or even adding the anti-leukotrienes as a daily therapy may be all that is needed.
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