Fostair 200/6 as MART

[GR1Z1]

Hello everyone Try and make this short, I am currently on a MART programme with fostair 200/6- 1 puff morning and evening and 2 rescue doses as needed. I was on fostair 200/6- 2 puffs morning and evening with a blue inhaler to control symptoms. I went for my asthma review 6 weeks after being changed to the MART system and wanted to move down to Fostair 100/6 MART but was refused because it was hay-fever season and was told to come back in September. I can't really find anything which recommends using fostair 200/6 for MART. The asthma nurse is also refusing to pescribe any blue inhalers because I am on MART. I understand that reliever inhalers arent normally prescribed with MART but i seem to been medicated outside of the general guidelines? Is this normal? Any advice or experiences would be great. Thanks. 😊

[Homely2 Administrator]

As far as I am aware, fostair 200 is not licensed for mart. So as you suggest you are not really on mart.

My GP asthma nurse did much the same as your nurse, however she did not call it mart, and kept me on salamol. She also did it knowing that I had a hospital appointment coming up to sort it out. After hospital appointment I was put on fostair 100 mart, at my request, which I love.

If you have not got a coming up hospital appointment I would ring asthma UK on 0300 2225800, office hours. They can help you with it and help you with what to say to your Asthma nurse. I normally ring them if I have med issues.

Re salamol, yes in theory mart gets rid of the need for salamol. I still have it, but use it much less. It is useful for exercise induced asthma, it is also useful for sudden random attacks as I always have it in my pocket, and cannot risk losing my fostair by keeping it in a pocket. Sometimes I just cannot get to my fostair.

[peege]

Hi, I didn't think the Fostair 200 was licensed for MART therapy either. I'm so pleased with my 100 MDI with a spacer, for me its perfect and rarely need all 8 puffs or ventolin (only with a nasty infection have I needed ventolin (or Salamol as given now). I'm much better in late spring/summer/early autumn luckily when one puff am&pm is sufficient plus an extra puff before a walk in a park or an incline. When first prescribed it I had to sign a declaration at the pharmacist to say I understood what the licence was for and also given a glossy little booklet.

I think your asthma nurse may have made a mistake, some do unfortunately. I recall one telling me it was impossible for inhalers to have any effect in bruising, thinning & easily ripped skin (she'd also never heard of BLF (British Lung Foundation) as this forum used to be called. I continued to get ripped skin & severe bruising until an excellent respiratory nurse changed Seretide to Fostair100 MART . Miraculously the skin issue cleared up .

Perhaps speak to a pharmacist for confirmation to take to go & get the prescription changed.

[peege in reply to peege]

Just found this:

Can FOSTAIR 200 be used as mart?

Dose recommendations for adults 18 years and above:

Two inhalations twice daily. The maximum daily dose is 4 inhalations. Fostair 200/6 should be used as maintenance therapy only. A lower strength (Fostair 100/6) is available for maintenance and reliever therapy.

medicines.org.uk › smpc

Fostair 200/6 micrograms per actuation pressurised inhalation ...

[bluessapphire]

I am on fostair 200/6 and since nov my asthma nurse and hospital have told me to take 2x puffs morning 2x lunch time and 2x evening till i see my resp cons this month

[Chip_y2kuk]

You should Always have salbutamol (salamol, ventolin or one of the powder alternatives) even on mart .. for the "what if's" fostair 100 is licenced for mart because you can start on a relatively low dose 1 puff twice a day and take a maximum of 8 per day (which gives you a bit of wiggle room) with the fostair 200 already gives you the equivalent of 4 puffs a day of 100 (taking 2 puffs a day of 200 ) so there is much less "leeway" .. the reason for the 8 puffs is that its well researched that beclomethasone is one of the better tolerated inhaled steroids and side effects are normally minnimal up to 800mcg per day (8 puffs of 100) . ....... also most of the time people are started on clenil or one of the qvar ... which are becloemthasone so the next logical step is the addition of formoterol (fostair)..... plus i heard they had a massive marketing budget and got them selves in front of every GP in the country and suddenly fostair was heavily prescribed.

I think the theory is sound behind mart your airways are reacting to something and we know that asthma is an inflammatory condition ... so adding a bit more steroid while opening the airways should give quick short term relief (the formoterol) and longer term inflamation busting power from the beclomethasone steroid.

But if you've got a cold or other temporary issue (flu, havfever etc) you may still need a bit of short term relief (salbutamol) to see you to the other side and 8 puffs of fostair 100 may not be enough.... I would be demanding the salbutamol back.

[Pipsqueak77]

Hi GR1Z1

Agree with others re: mart with Fostair but it’s not unheard of for hospital teams/cons to prescribe any inhaler ‘off licence’ if they see a benefit to you.

Did this instruction to your nurse come from your hospital team?

😊👍

[GR1Z1 in reply to Pipsqueak77]

The asthma nurse at the GP made the decision to put me on this. I think I may just get a GP appointment and see of i can get a reason / rationale for it all. Thanks for responding to the question, it's appreciated

[GR1Z1]

Hi everyone, many thanks for all the advice and input it's much appreciated! I'm going to call the asthma helpline and then get a GP appointment to see if I can get some answers or rationale to it all! Thanks again!