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. 

Do most asthmatics avoid Advair like the plague?

Perhaps one of my fellow asthmatics can help me out with this one. I recently saw a new asthma doctor, and, when I asked to have my prescriptions refilled he said, "You like Advair?"

"Yes! I love it!" I said.

"Wow! You're one of the few asthmatics who can stand it!"

"What!"

"Yeah. Most of my other patients hate that medicine." I will assume that he is also referring to any medicine like Advair too, such as symbicort.

"What do they take for their asthma then."

He smirked and said, "Well, nothing. They come in every 6 months complaining of asthma problems."

"Interesting," I said. The conversation moved on from there, although the idea that Advair was as unpopular as he was saying is still wobbling around in my mind, hence this post. I guess the naive person inside my head "assumed" if there's a medicine that works as well as Advair and Symbicort do to control asthma, that most asthmatics would at least try to like it.

Although, according to doctor Axel, that's not the case. Yet I think one of the reasons this threw me off guard is because my old doctor, Dr. Best, told me the opposite: "Most of my patients love Advair."

It's interesting the different perspective a doctor can have on a medicine. Yet this latest discussion about Advair has me wondering: do most asthmatics remain ignorant and continue to have

I wonder, though, if most asthmatics hate Advair if it has to do with the long-acting beta adrenergic medicine (Serevent) in it. I wrote here how it actually took me 10 years to get used to Serevent, and that I actually had to wean myself onto Advair.

Yet I don't think most doctors think about weaning onto a medicine, and when a patient says they can't take it, that's the end of the discussion. Yet I will contend, if you have uncontrolled asthma, Advair may just be the key and you should wean yourself onto it. You should try gallantly to get your body used to the stuff.

So, facts confirm Advair works wonders for asthma. Yet, is it a fact that most asthmatics continue to avoid Advair (and Symbicort) like the plague? If you have any greater wisdom on this cue your wisdom into the comments below or email me. .

My experience with Singulair

So Advair worked wonders in helping me finally obtain good control of my asthma (as I wrote about here). Now it was time to get those dreaded allergies under control.

All my life there just seemed to be nothing available to control allergies. When I was really little my doctor wouldn't let me take anything for allergies, because on the box it said, "Do not take if you have asthma."

As I look back I think how stupid that was. There were many miserable nights for me because of that stupid wisdom. Later I was allowed to use antihistamines, although they did little good.

Pretty much the only thing that worked for allergies was avoidance. Yet it was hard to stay away from my brother's house, my friend's home, and the cabin where the guys hung out. It was no fun to avoid those places, yet that was often the only option, unless I wanted to take risks (which I often did).

And the boxes I set in the basement of my new home three years earlier were still sitting down there, because every time I tackled that job the allergies would strike, and quite often that also lead to an asthma attack (although now less severe due to Advair).

So along came Claritin. And then along came Singulair. Yet, because I didn't complain enough about my allergies to my doctor, these meds were around several years before I tried them.

One day, late 1997, this topic just happened to come up while I was having a friendly discussion with a doctor friend of mine at work. He said, "I think you definitely should be on Singulair. In fact, I think every asthmatic should be on Singulair."

I went home and researched the medicine. Of course I already knew that 70% of asthmatics have both allergies and asthma, and that quite often these allergies trigger asthma. So, if scientists could come up with a medicine to stop the allergy response, then they could control asthma.

Scientists also know that during an allergic reaction a chemical called leukotriene is released. This chemical causes bronchospasm. Finally, in 1998, after spending millions of dollars and 63 years researching leukotrienes and working on a way to block their release, Singulair was approved by the FDA.

Singulair has an active ingredient in it called Montelukast sodium, which blocks the action of leukotriene, thus preventing allergies, and preventing bronchospasm caused by allergies, and, in turn, preventing asthma.

So, new asthma wisdom in hand, I had a nice discussion with my asthma doctor during my next visit. He was skeptical at first. He asked me if I tried over the counter antihistamines like Drixoral or Clariton. I said I tried them all to no avail. "Nothing EVER worked," I said, "And I can't go through one more spring feeling miserable. I just can't!

He said he was "cautious" about starting me on newly released medicine. He didn't want his patients to be a guinea pig. But, being open minded, he said, "I'll let you try it for a month."

"Doc, " I said, "I think you should let me try it at least through spring. If I can make it through spring without having miserable allergies, I'll know this medicine is working."

Finally March arrived -- no allergies. April arrived -- no allergies. May arrived -- no allergies. June, July, August... No allergies at all that summer. In fact, I haven't had allergy symptoms at all since I started taking this asthma/allergy miracle medicine in January of 2008.

Obviously all medicines come with a risk of developing some side effects, but I developed none. Thank God, because allergies held me back for the first 38 years of my life. Not anymore! Now, with the combination of Advair and Singulair, I actually feel like a normal person for the first time in my life.

I have talked with doctors that say every asthmatic should be on Advair, and every allergic/asthmatic should be on Singulair.

By the way, another advantage I've come to enjoy regarding Singulair is it works well to prevent exercise induced bronchospasm. Now, thanks to Advair and Singulair, I'm actually able to run.

So, if you're an asthmatic and allergies continue to hold you back despite your best efforts, I highly recommend you talk to your doctor about Singulair.

Now, keep in mind that what works for me won't necessarily work for every asthmatic. Singulair is simply another option for us asthmatics to try. Thankfully, for me, it worked like a charm.