[Idiopathic PN]

Hi. Has anyone taking Advair or Symbicort worsen their PN or react with Gabapentin?

I used to have an asthma years ago but I have not had any attack recently. I have been experiencing shortness of breath for 2 years now. I did not associate it with asthma because I thought it was a different shortness of breath. This afternoon, the shortness was worse than on most days, so I tried the Symbicort (I always have a stand by). I normally used Advair but Symbicort was the only available at home.

Before I continue using either Advair or Symbircort, I want to know if anyone using either one of them and has any problems with their PN or Gabapentin?

Will appreciate your inputs.
Thank you.

[zygopetalum]

See my thread 'Gabapentin' in the medication section, Flovent is the steroid in Advair.

Frankly I'm so confused right now I'm not sure what is going on but I can tell you that for the past year I've seen over and over that a higher dose of Flovent causes more burning and pain. I've also stopped it a couple of times and felt it travel down the nerve and cause a burst of pain when I restarted it. I recently had shingles and it did the same thing when the infection was acute, after I took my dose I could feel it move down the nerve and burn.

That said, I may have something going on with my other med that is involved and I've had some immune issues that may be a factor as well, I really don't know. Things seem to resolve when I stop it so you could just try Advair and dc it if it bothers you.

judi

[Idiopathic PN]

You mentioned about Xopenex in one of your posts, is this better than Advair? Does it has contraindication with Gabapentin?

I hope we all feel better. Sometimes it sucks

Originally Posted by zygopetalum

See my thread 'Gabapentin' in the medication section, Flovent is the steroid in Advair.

Frankly I'm so confused right now I'm not sure what is going on but I can tell you that for the past year I've seen over and over that a higher dose of Flovent causes more burning and pain. I've also stopped it a couple of times and felt it travel down the nerve and cause a burst of pain when I restarted it. I recently had shingles and it did the same thing when the infection was acute, after I took my dose I could feel it move down the nerve and burn.

That said, I may have something going on with my other med that is involved and I've had some immune issues that may be a factor as well, I really don't know. Things seem to resolve when I stop it so you could just try Advair and dc it if it bothers you.

judi

[echoes long ago]

xoponex can be used in inhaler form or through a nebulizer. it is a rescue type medication that opens up the airways during asthma flairups or attacks.
advair or symbicort is a medication you take everyday to control your asthma long term. it is not effective for immediate relief of an asthma attack.

it sounds to me like you need a rescue type inhaler for when you are constricted.

the advair is meant to be taken everyday regardless of wether you feel good or not that day.

[Idiopathic PN]

Originally Posted by echoes long ago

xoponex can be used in inhaler form or through a nebulizer. it is a rescue type medication that opens up the airways during asthma flairups or attacks.
advair or symbicort is a medication you take everyday to control your asthma long term. it is not effective for immediate relief of an asthma attack.

it sounds to me like you need a rescue type inhaler for when you are constricted.

the advair is meant to be taken everyday regardless of wether you feel good or not that day.

Thank you for the information.

When Zygopetalum wrote that Flovent triggers the PN, I am now so scared to take anything that will worsen the PN. I need to relieve my breathing. So, its likes a choice between the "devil and the deep blue sea" My main concerrn is which is the lesser "evil"?

The doctors would always downplay the side effects of their prescribed medicines. I remember when a couple of pulmonologist told me that the asthma puff/inhalers are safe because its localized. When you are younger and has only singular health issue, you will accept this statement at face value. But, as you grow older and developing other health conditions, you become more vigilant about the interactions among medicines, more especially when you are in pain.

[echoes long ago]

i really cant tell you from personal experience. my asthma and PN developed at the same time from the same toxic exposures. i have no idea if my use of advair or albuterol or xoponex or duoneb led to further damage to my nerves or not. there is no way for me to tell. i really have no choice about the asthma meds.

Have you tried steaming up the bathroom when you are feeling tight or conversely stickng your head in the freezer of the refrigerator and breathing deeply for a short while? these help me .

[mrsD]

As Echos states, you should use only a rescue inhaler for a short time and see if you get results from it alone.
Xopenex or albuterol.

Both Advair and Symbicort have long acting versions of the
non steroidal part (called beta agonist)... and those over time can cause irritation of the airway, leading to more constriction.
This is a recent warning on combo products:
http://www.msnbc.msn.com/id/35463947.../#.T6A0xVLPzPM

Symbicort has formoterol in it and if used more than recommended can cause serious things to happen, including
rebound constriction.

Advair has salmeterol in it which has caused serious rebound events for years, some resulting in death.

Both products are for LONG term control and not for rescue or immediate effects.

Xopenex or albuterol used carefully may work for you, without the steroid. But they too if used improperly (like 4 puffs at a time or often) can do the same thing as the two long acting ones above. Abuse of rescue inhalers can also cause death if overused, and that was the theory behind making Advair and Symbicort. (those long acting beta agonists are now showing problems of their own)

Another option is Singulair...which is oral and works on inflammation another way. But very long term use of this is implicated in depression. But it works well, in most people and children. This is a B4 leukotriene inhibitor which blocks a specific inflammatory cytokine from constricting the bronchi.

[echoes long ago]

i was on singulaire for years and it worked pretty well. my pulmonary doctor took me off of it about 4 years ago, he said he was reading reports of singulaire exacerbating peripheral neuropathy and causing nerve damage including numbness, tingling, twitches etc in very low numbers but with my backround he thought it was best to switch..

[mrsD]

That is interesting. I never saw anything in papers on that, Echoes.

Here are the FDA Drug reports:
http://www.drugcite.com/?q=singulair

Only .37% had paresthesia on this drug. That is not much. You can expand the categories by clicking on them, but the address does not change so I cannot link to that.

The most remarkable problem is depression (with suicidal ideation), and increased risk of pulmonary infection. This is because B4 leukotrienes are a signal for invasion/infection and people on high dose Singulair did have an increase in pulmonary infections, although not great.

I still think it is an option for Idiopathic PN... but it is between her and her doctor to decide.

I took this drug for several years, and stopped it when my asthma seemed to go into remission.

Certain drugs like beta blockers can make asthma worse, so my doctor took me off the Tenormin I was on for over a decade.

[zygopetalum]

I'm sorry I made you paranoid IPN, I don't want to discourage anyone from taking meds they need but at the same time there are issues and it makes me mad when they seem to be ignored or dismissed as coincidence.

If you look on Drugcite and click on 'neurological' for Advair, etc. you will see that parathesia, hypoesthesia, and burning also have been reported at less than 1%. I suspect that there has been a little more but its still not common.

Are you a male or a female? In trolling the sites I have never seen PN accompany the meds in a male, women metabolize medication differently and may be more suceptible. Some people are just more senstivie to drugs as well. Before I had surgery the anesthesiologist asked if I avoided OTC cold medicines because they made me feel weird and increased my heart rate to an uncomfortable level, and if I had ever noticed I only needed 1 aspirin or tylenol for the same pain that other people took 3. I was a yes to both and I think its a way to assess your sensitivity to some degree (he didn't kill me during surgery, must have worked..!). I couldn't tolerate Advair either, my face and airways swelled, I hurt everywhere, and my bp and heart rate increased too much. They tried me on salmeterol without 'clearing' the Advair and I had a seizure. I don't remember what dose they gave me on either.

I think some of it may have to do with dose as well, I was on 440mcg Flovent a day for a couple of years and I think it was too much, I dropped myself to 330 mcg for about 4 more, I think that was too much too but I didn't know any better and my pulmo wouldn't do anything. Now I'm on 88mcg and I can get by with 44mcg.

Everything Mrs D said about the heart issues and rebound constriction is true but also as Echos said you have to do what you need to to breathe too. If you tolerated Advair before you might try it and watch for symptoms or Xopenex is also an option if thats all you need and your insurance will pay for it. You can damage you lungs from untreated asthma.

Now I'm paranoid because I know I've been using too much Albuterol...
I'd like to hear how you come out.

judi