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Asthma/Symbicort

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Question
My husband, who is 64 years old, has asthma and also what has been diagnosed as non allergic rhinitis. He takes Claritin, Azelastine and Symbicort. For the last month he has been experiencing hoarseness. Could this be a side effect of the Symbicort? He has a chronic sinus drip that I believe contributes to his rhinitis. He receives his medical care from the Veterans Administration and is planning to ask for an ENT consult at his next visit, which is in 3 weeks. The consult itself might take another month or so to get at the VA.
We live in southwestern Colorado, have no pets and he is retired.
The hoarseness concerns me and I am ready to make an appointment with a private physician (ENT) rather than wait another 6 weeks or for a VA appointment.
So, do you think it might be the Symbicort? (He has been on it for a year.) And do you have any other suggestions?
Thank you very much. Your services are very much appreciated!

Answer
Hi Christina!
   Yes, it is possible that the Symbicort may be causing this issue. Whenever a steroid inhaler or steroid combo and alar is used, the person should always swish and spit following each treatment. This reduces the likelihood of getting a thrush infection in the mouth and throat. In the early stages of thrush, which is a fungal infection, you can solely have the discomfort. After a bit more time, you would start seeing white spots on the tongue inside of the mouth. This is something I suggest you look at it this point in time. If this is the case, yes, certainly contact your physician. This is not difficult to treat at all. It will resolve quickly with appropriate therapy, which is not very expensive either.
   Let me know what you find once you investigate this further looking into his mouth and throat. Regardless of this outcome, it's very important that after each treatment he takes a glass of water, swishes it around his mouth, and spits it out.
   Sincerely,
       Marc

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Marc Rubin, RPh Asthma Educator

Expertise

I have worked directly with patients as well as caregivers for over 30 years. Have made presentations throughout Illinois educating school nurses as well as the teaching and coaching staff of public schools about asthma, and how they should respond to these students needs. Presented a public education program on asthma through the US Department of Public Health. Specialize in helping guide asthmatic patients to take control of their disease in order to live a near-normal, fully active life.

Experience

Practicing pharmacist for 40 years, specializing in asthma and COPD for 12 years. Developed nationwide education to nurses, teachers and athletic coaches regarding asthma and exercise induced bronchospasm. In addition, and closer to home. my daughter has asthma, and my son has exercise induced bronchospasm. In addition, I serve on the boards and committees of a number of asthma organizations: Sports, Exercise and Fitness Committee of AAAAI, Population Health Committee and Sports Medicine Committee of ACAAI, Sports Medicine Committee of the World Allergy Association. Board of Directors of the Chicago Asthma Consortium, Board of Directors of the Christopher D. Redding Youth Asthma Foundation, as well as the advisory board of a medical education company, Emmi Solutions. Directly involved in the creation of public education programs for asthma, COPD and diabetes.

Organizations
American Academy of Allergy, Asthma and Immunology / Sports Medicine Committee, American College of Allergy, Asthma and Immunology / Population Health Committee and Sports Medicine, American College of Chest Physicians, American Thoracic Society. World Allergy Association, Chicago Asthma Consortium / Professional Development Committee, Christopher D. Redding Youth Asthma Foundation, and Respiratory Health Association of Metropolitan Chicago: Development Committee for AE-C prep class, and presenter.

Publications
AAAAI PowerPoint on the new guidelines for EIB (Exercise Induced Bronchospasm), AAAAI Powerpoint on Asthma in School Setting for Teachers and Coaches, Annals of Allergy, Asthma and Immunology: Transition guide for teens with food allergies or asthma going out of the home to live independantly.

Education/Credentials
BScPharm, RPh, (NAECB Certified asthma educator in 2002), NIPCO Certified Respiratory Care Pharmacist

Past/Present Clients
Emmi Solutions, Chicago Next Level Health, Chicago

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