Here, youll find everything from short acting beta agonists (aka SABAs) to long acting anticholenergics (aka LAMAs). From pills to inhalers to injectables and everything in between. If its related to the treatment of Asthma or COPD, chances are you’ll find it on my shelves.
Except for prednisone, various antibiotics, allergy pills and supplements like Magnesium, most of the asthma drugs I take are in the inhalable form. I take 4 different solutions via nebulizer, plus Albuterol inhaler in between neb treatments for breakthrough chest tightness or when I’m not near a neb machine. On average I use my nebulizer 6 times during the day and a couple times at night.
Newcomers to my list include: Perforomist (Fomoterol) a long acting beta agonist, Yupelri (Revefenacin) a long acting muscarinic agonist similar to Spiriva, and finally Budesonide, a nebulized steroid. Having started this new treament regimen I noticed that Perforomist (Fomoteral) was sometimes makes me even more short of breath ( what they call paradoxical bronchospasm.) My lung doctor thinks it an allergic reaction to one of the components in the solution, so Im on hold with this particular drug for the time being and am making up for it by using the Albuterol more often.
You can get a lot of these drugs in either a 2- way or 3-way combo inhaler form and 3-way combo inhaler but I find that using the nebulizer version of these drugs separately, gives me better coverage and gets the drugs deeper into my lungs. Not only that, but most respiratory medications that are designed to be used in nebulizers, are covered by Medicare part B. If you have Medicare and a Medigap plan, these drugs are essentially free. Not so with inhaler medications. Even with a part D Medicare prescription plan, private medical insurance or employer provided insurance, there’s usually a co-pay and/or deductables for inhaler medications.
Conspicuously missing from my current drug inventory, are Biologics and Leukotriene inhibitors.
Ive been on several Leukotriene blocker medications like Singulair (Montelukast), Accolate (Zafirlukast) and Zyflo (Zileuton) on and off throughout the years. I stopped taking them because I was experiencing too many side effects for the minimal improvement in my symptoms.
As far Biologics, the only two I’ve been on are, Dupilumab (Dupixent)and Xolair (Omalizumab). Neither were the magic bullet for my type of asthma. In all fairness though, I wasn’t on either one of them very long. I received Xolair injections for one year and Dupilumab for only two months. I hope to try a new biologic called Tezepelumab when it becomes available later this year. In clinical trials Tezepelumab appeared to be more effective in treating a broader range of asthmatic subtype..
Just a word of caution to others who take a ton of inhaled medications. When youre juggling lots of inhaler and nebulizer meds, be careful that youre not duplicating, or what I call “double dipping” a particular medication. For example, if youre using a long- acting anticholinergic drug like Yupelri, you probably shouldnt use Spiriva,which is essentially the same drug. Likewise, if youre using a nebulized steroid like Budnesonide, you probably should be using Flovent or any other steroid inhaler. If youre unsure about how your asthma drugs interact with each other, check with your Pharmacist. Better still, do your homework. Learn what each drug is for, how oftern to use it and and how it might interact with the other drugs.