Experiment results are in: Advair works best

If you continue to have trouble with your breathing despite being on a combination inhaler like Advair, Symbicort, or Dulera, you might want to try Breo. It's essentially the same type of medicine, but the theory is that each new long acting bronchodilator is a tad stronger. Breo worked great for controlling my asthma, with one caveat: it was a little bit too powerful, causing jitters and nervousness.

Truthfully, if there weren't other options I would probably stick to Breo. Here's a rundown of the product. Actually, allow me to compare it with Advair.

Advair: 

• Inhaled Corticosteroid: Fluticasone
• Long Acting Bronchodilator: Salmeterol
• Doses: 250/50, and 500/50

Breo: 

• Inhaled Corticosteroid: Fluticasone
• Long Acting Bronchodilator: Vilanterol
• Doses: 25/100, and 25/200

So, they both have the same inhaled steroid, although they both offer differing doses of each. So both should work the same for controlling chronic underlying airway inflammation. The only difference here is that Advair offers the 500/50 dose, and that's what I'm trying right now. 

The problem I had with Breo was vilanterol. It makes me feel as though a constant current was flowing through my body. Actually, that's the same feeling that I had when I tried Symbicort and Dulera, both of which have the same long acting bronchodilator (formoterol). 

I used to take the salmeterol (Serevent) metered dose inhaler (MDI) back in the late 1990s in combination with fluticasone (Flovent), the side effects were the same as with vilanterol and formoterol. However, for some reason, when taken as a dry powder inhaler (DPI) via the Advair Diskus, it doesn't cause this side effect. So, sometimes the delivery device makes a difference. And this is not uncommon for a medicine to offer a little different effect simply due to how it is delivered. 

I took Advair from around 2002 to 2014, when my doctor decided he wanted me to take another combination inhaler. I don't know what his bugaboo about Advair is, perhaps the link between pneumonia. I tried Dulera, Symbicort, and Breo. I tried the low and high doses of Breo. 

They all worked nice, but all made me jittery and nervous, except Advair. Therefore, I am going to end my combination inhaler experiment for the time being. I'm going to stick with Advair. I will continue to alter between Advair 250/50 and Advair 500/50, depending on how my asthma is doing. 

Now, let me say this. Just because Breo didn't work for me, that's no reason for you not to try it. Symbicort and Dulera caused jittery and nervousness in me too, although it works great for many of my friends. Asthma is a heterogenous disease, so what doesn't work for one person may work for another, and vice versa.