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 need advise w/spiriva and advair
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jarity
Member

USA
42 Posts

Posted - Jun 07 2008 :  12:20:11 AM  Show Profile  Reply with Quote
I was in hospital in nov 07 for 4 exacerbations within 4 weeks. Average stay was 4 days. They never gave me a pft test but had heart tested, xrays, etc and was told heart was in good condition but i had copd... did not even know what it was. Also have not had any exacerbations since. I think only 2 were true exacerbations and the other two i panicked because i did not know what was happening to me and had not yet learned about breath control.(i did quit smoking immediately because i found this board.)never seen a pulmonary doctor and was sent home on spiriva and advair. After reading a lot on this board i got a pulmonary doctor and pft test.
Because of things i read about advair (steroid factor)i asked my pulmonary doctor 2 days ago if i could stop taking the advair and keep taking the spiriva. He gave me permission to try it. He also gave me combivent as a rescuer earlier.
Now i read that the combination of them both (spiriva and advair)is the best combination and can in some cases increase lung quality as opposed to taking only one of them? But i am confused because i also read that test show no increase in lung quality if both are used? I have stopped for 2 days now and do seem a bit more breathless than usual but am not sure. Does anyone have any experience with this or have any tests proven one or the other conclusively?
Thanx for any info.

Carolyn-Mi
Administrator

604 Posts

Posted - Jun 07 2008 :  08:35:42 AM  Show Profile  Reply with Quote
Jarity, Take a deep breathe and relax! There is no 1 magic bullet to treat COPD, what works best for 1 will not work for all.

It is easy to try and 2nd guess all of the meds, our drs and each other as we try to find what is best for us. But to do so to the point that our anxiety levels go up is counter productive!

So wait a couple of days and see if you do get more SOB without the Advair, if so then go back on it with your Dr's blessings.

As for tests again they are not conclusive, Advair works for many but not all. I know some folks who go off their Advair who could tell immediately that they messed up. Others feel no difference at all so they did what was good for them. Personally I tried to go without it one time with Dr's ok and I was good for about 1 week and then bammm! Needless to say I am back on Advair but at reduced script. Went from 500/50 to 250/50.

Good Luck

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PennyPA
Contributing Member

USA
4699 Posts

Posted - Jun 07 2008 :  09:06:14 AM  Show Profile  Reply with Quote
Jarity, until I had my LVRS, I had been on Spiriva and Advair (and before Spiriva, Atrovent and Advair) for about 10 years. I never had any problems with Advair.

****************************************************************

You canít change the past but you can ruin the present worrying about the future.

The Bad News: Time flies as you get older.
The Good News: Youíre still the pilot.

Penny's Lung Volume Reduction Surgery

And Our Travel Blog After LVRS




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jarity
Member

USA
42 Posts

Posted - Jun 07 2008 :  10:58:50 PM  Show Profile  Reply with Quote
ok guys,
i got it. What you are saying is this....i can tell you what happened to me but not what is gonna to happen to you. I can tell you what to watch for but it is not written in stone.
In a subtle way you are saying you are gonna have to find your own way but we will be there.
you guys are PRETTY!!!!
ps i kinda like Penny..is this in bad taste??? but i also love a few of you men!.....Heavens!!!!
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jarity
Member

USA
42 Posts

Posted - Jun 07 2008 :  11:32:28 PM  Show Profile  Reply with Quote
ok Carolyn-Mi,
i am gonna try it. Thanx for sharing your experience with me! since listening to you guys i got more nerve and am not as scares as i used to be
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Arkietwo
Rookie

USA
8 Posts

Posted - Jun 15 2008 :  10:06:33 PM  Show Profile  Reply with Quote
I really don't think a doctor would prescribe Advair and Spiriva concurrently. Spiriva is used once a day and Advair is used twice a day (max).

Check out http://www.medlineplus.gov/ for explanations of both drugs plus it's a good site for any medical information as it is posted by The National Institute of Health (NIH).

Arkietwo
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Dave-OH
Administrator

USA
3404 Posts

Posted - Jun 15 2008 :  11:42:28 PM  Show Profile  Reply with Quote
I used the drugs in Advair (Serevent and a steroid) and Spirivia. Many drugs prescribe both as they work differently. I can get it as a single drug, but choose to get it as two drugs. Once from Blue Cross and one from the VA.

Dave, Forum Administrator
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Carolyn-Mi
Administrator

604 Posts

Posted - Jun 16 2008 :  09:10:14 AM  Show Profile  Reply with Quote
Comparing Spiriva and Advair is like comparing apples and oranges. They are both medications to help our breathing but they are still different.

Spiriva prevents the narrowing of our airways and that helps to prevent bronchio-spasms. It is classified as an anticholinergic medication.

Advair,is combination of salmeterol, a bronchodilator of the beta-2 agonist type. Beta-2 agonists are medications that attach to beta-2 receptors on the smooth muscle cells that surround the airways, causing the muscle cells to relax and open the airways. This is a different area of the airways then Spiriva helps.

It also contains, Fluticasone propionate which is a synthetic (man-made) corticosteroid of the glucocorticoid family which is related to the natural hormone, cortisol or hydrocortisone, produced by the adrenal glands. Glucocorticoid steroids have potent anti-inflammatory actions. Again this helps to keep the airways from narrowing in yet a different manner.

So by taking both Spiriva and Advair (or it's components separately) we are getting the maximum maintenance meds to keep the airways open and us breathing as easy as we can.

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Carolt
Rookie

USA
1 Posts

Posted - Jun 16 2008 :  5:38:32 PM  Show Profile  Reply with Quote
Wow Carolyn, are you a nurse or doctor? You certainly know the medical differences between Advair and Spiriva. I take both each day and they seem to help my breathing. Advair is a steriod, so I have gained weight since taking it. Also, I gave up smoking last November (cold turkey) so that is probably why I have gained a total of 19 lbs. I went up to size 12 from 10. My doctor told me not to worry because my being a lung cancer patient, he said don't worry about gaining the weight, it's when you start losing the weight is when you should worry. So, I'll accept my new weight with grace and not complain.

Carol Twyon
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PennyPA
Contributing Member

USA
4699 Posts

Posted - Jun 16 2008 :  7:34:20 PM  Show Profile  Reply with Quote
Carolt, advair is not a steroid in it's whole; it has a steroid in it. Just make sure you keep track of your weight gain. Being overweight can cause problems with our breathing ... although I certainly wouldn't consider a size 12 an 'overweight' size!!

Arkietwo, most docs DO script advair and spiriva concurrently. It's the spiriva and atrovent that most do not script concurrently.

****************************************************************

You canít change the past but you can ruin the present worrying about the future.

The Bad News: Time flies as you get older.
The Good News: Youíre still the pilot.

Penny's Lung Volume Reduction Surgery

And Our Travel Blog After LVRS




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Carolyn-Mi
Administrator

604 Posts

Posted - Jun 16 2008 :  10:23:10 PM  Show Profile  Reply with Quote
CarolT, no I am not any sort of medical person, but when I see a question I don't have an answer to I look it up. And when I take a medication that folks say, will open my airways and there is more then 1, I like to know why so I look it up.

Finding out that Spririva and Advair work on different areas of the airway, made sense to me when prescribed both. I knew that whatever it was....was working but I was also thinking why take 2 when 1 does the same thing...but it doesn't. They work together.

Congrats on your non smoking status! And a 12 is NOT overweight<g>, I am a tad larger then that and it does wear on your breathing.

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jarity
Member

USA
42 Posts

Posted - Jun 17 2008 :  7:46:00 PM  Show Profile  Reply with Quote
Carolyn-Mi's message on the difference concerning spiriva and advair was very educational for me and has widened my understanding of what i am taking. I did read up on these drugs but Carolyn-Mi sort put them together as a whole and how they are working. thanx
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jarity
Member

USA
42 Posts

Posted - Aug 22 2008 :  06:53:18 AM  Show Profile  Reply with Quote
was off spiriva for 10 days and the breathing problems started on day 9. am back on for the last 3 days but no improvement in breathing. have to use combivent 3 or 4 times a day now. perhaps til the spiriva kicks in. Am going to try the salmeterol component by itself if my pulmo will prescribe it for me. fev is down from circa 55% to 45% before meds. Thanks again for all of the advice. ps i don't think i want to fight this thing all too long.
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Carolyn-Mi
Administrator

604 Posts

Posted - Aug 22 2008 :  07:47:19 AM  Show Profile  Reply with Quote
Jarity, it is my understanding that it can take up to 3 weeks to feel the full effects of Spiriva, and yes you may need more combivent during this time.

Also some folks do real well with just the Salmetrol, it is worth a try.

As for not wanting to fight this thing too long? Not sure what you mean. But a whole lot of folks have been fighting it for years and by accepting the fact that they have Copd and doing the things that they should, still lead full and productive lives. It may be a bit different from before, but it is still a good life.


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jarity
Member

USA
42 Posts

Posted - Aug 22 2008 :  5:59:48 PM  Show Profile  Reply with Quote
Well Carolyn,
I was on it prior to getting off 10 days ago since jan. So should it still take 3 weeks being that some of it should of still been in my system??? it has the longest half life of the oral steroids.
BTW does anyone know how often i can take combivent? My prescription says 2 puffs 4 times a day or "as needed".
well as needed means as many times as i think i need it.
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jarity
Member

USA
42 Posts

Posted - Aug 22 2008 :  6:07:48 PM  Show Profile  Reply with Quote
sorry
i meant longest half life of the inhaled steroids
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Gina-MI
Member

USA
84 Posts

Posted - Aug 30 2008 :  9:53:30 PM  Show Profile  Reply with Quote
Jarity,

As for combivent, the dosage is usually every 4-6 hours, and no more than 4-6x/day...you can't take it every, say, 1-2 hours. If you have to take it that often, then you need to hit the ER, something's happening, and a major exacerbation is either on it's way or there.

I also take spiriva and advair (was on spiriva, foradil, but was taken off foradil and put on advair. I don't see a lot of difference - but then again, my lungs are getting pretty bad - my last PFT's had taken a major nosedive south - most of the readings were within 75% of predicted in 06 and 07, but this year, they're a mere 20-30% of predicted, and have a definitive shift from obstructive (hence the COPD original diagnosis) to restrictive (potential IPF diagnosis, or some kind of fibrosis).

Have a safe and healthy Labor Day, everyone!

grannymac
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Carolyn-Mi
Administrator

604 Posts

Posted - Aug 31 2008 :  09:27:54 AM  Show Profile  Reply with Quote
Hi Jarity,

I am sorry, somehow I missed your reply and next question. It may not take the full month to get the effects of the spiriva since you have only been off of it for a few days. By now I hope it is helping you again since it has been so long since your post <G>

But I do want to point out that Spiriva is NOT an inhaled steroid. It is a class of drugs called Bronchiodialators, it dialates the bronchials to make it easier to breathe. It does this in a different way then the steroids do.

As for the Combivent, if you need it 4 x's a day on a regular basis you can do that. If you only feel the need for it occasionally then that is what is called as needed. If you need it more then 4x's a day you should contact your Dr because something is not working right for you or you have an infection that needs taken care of.

Combivent is your "rescue" inhaler that Dr's will give us for the times when we are extra SOB and our maintenance meds aren't doing the trick. Some folks use the rescue inhaler just before doing their exercises, and other folks like me, end up throwing out our rescues cause they expire before they are used up.

Since I have been on Spiriva and Advair, I have used my rescue inhalers only when I have an infection or the Asthma portion of my Copd is misbehaving. Before Spiriva I was using it almost daily.

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jarity
Member

USA
42 Posts

Posted - Sep 01 2008 :  04:40:39 AM  Show Profile  Reply with Quote
follow up


First off...Thanx everyone for the help
Second off i was in the hospital for three days and am at home now with 40mg prednisone for 3 days. I was off the advair for 9 days and began to have breathing difficulties. I started the advair back up again but after another 6 days the breathing was getting so the abuterol was not helping much. My friend took me to the em room and they gave me abuterol nebulizer treatments every 4 hours and then every 6 hours. Had xray and ekg but they saw infection no and heart was ok. I had an appointment with my pulmo the day before and told him how often i needed the abuterol but he said the advair will kick in soon and also this is the allergy season.I also told him about my fev1 nose diving and he said those home peak flow meters are not reliable.

The next day i was in hospital. Am seeking a new pulmo. I think i did not loose any lung function as within 2 days i was walking my normal 1 hour brisk walk. Have not tested myself yet with my peak flow meter. Just want to get away from all this reading and studying copd for awhile. It's always with me.

Was Sorry to hear about Gina-MI loosing lung function over such a short time!!!! When you also have copd..when someone gets in trouble you feel it yourself as if it happened to you!! YES?

Also thanx Carolyn-Mi for the info on the comparison of the two drugs. After that i began to really take these drugs under the loupe. Learning about the receptors, types of bronchodilators and how the drugs act.
You people male the going so much easier!!!
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Carolyn-Mi
Administrator

604 Posts

Posted - Sep 01 2008 :  09:44:12 AM  Show Profile  Reply with Quote
I am glad that you are home! But a bit on your FEV1, while we are experiencing a flare up or exacerbation of our copd we may lose some lung function. For some it is temporary and will go back to where it was before your flare. Sometimes it is permanent. So don't despair immediately if your FEV1 is lower for awhile. Wait until you have been over your flare up for at least 6 weeks to see if you have gone back to your base line.

Sometimes it takes longer then 6 weeks but that is ok too.

The key is not to despair over this. There is so much that we as copd folks can do, no matter where we are in our progression. No we will never be normal, but we can live to the best of our ability despite COPD.

I truly think, this is the key to having a happier, less stressful life. Do all you can to take care of you physically and mentally and that will make life with copd a whole lot easier.

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mg5ds
Rookie

2 Posts

Posted - Jul 14 2009 :  12:08:40 PM  Show Profile  Reply with Quote
Here's a $10 off Advair coupon if you're interested.
http://www.advaircoupon.com
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