Expert: Bailey - 12/13/2006

Question
Hi, I have been taking advair 500 for about 6 months now and for the first time in many years I am symptom free.  I do not use a rescue inhaler except for maybe once every two weeks and even then it is minor. My phsycial activity has increased and I've lost weight because my asthma is managed.
My question is, I don't want to be using too much advair because I don't know if it will have bad side effects in the future.  I am only using it twice a day as the instructions say.  I haven't tried 250 strength yet but I'm so happy to be asthma free that I don't want to cut down either.  Any advice?  I love it that my asthma is "gone" but don't know what price I'm paying for it. By the way it took about 2 months for my asthma symptoms to totally disappear with the advair 500.

Answer
Hi Betty,
 I am very happy to hear that your asthma is now under control! I know the feeling of being worried about losing that control with switching medicine as well, but I would recommend that this is something to discuss with your doctor. Any medication has the potential to produce side effects, especially with long term use. Inhaled steroids are generally safer then oral steroids but they do have some known long term side effects. They're not usually severe, but it's always a good idea to be on the lowest dose of medication that is safely possible. If advair 500 is working well then I would suggest that you switch to advair 250 and see how that goes. Since your asthma is already under control, the 250 may be perfectly capable of maintaining that level of control. Now, if your asthma was not under good control, then it may not be as effective at getting it back under control but since you are doing so much better, I would talk to your doctor about doing this. It may be a good idea to make sure you have a peak flow meter handy and monitor your progress. These devices can usually alert you to any potential problems before you even have symptoms. If your numbers begin to drop, or if you have any increase in symptoms then go back to the 500 and you should be able to gain control pretty quickly. I'm going to assume that it took 2 months the first time because your asthma was not well under control so if you needed to switch back, it should be easier and take less time to get the asthma good again. Exercising is also excellent. Keep it up! It actually helps many asthmatics improve their lung function which improves asthma. These are things you are going to have to discuss with your doctor to have a plan of action but I would suggest that you try switching, as long as you monitor your condition closely. Best wishes!
Bailey