My ds Zack has been on advair disk for about 2 years now to control his allergies and asthma.
Yesterday he had an appointment with the allergist and my dh and I asked him to change Zacks meds.
We have had no problems with it except that it is a steroid and I feel that it is delaying his growth.(This is a known side effect of the medication I was told , though the kids eventually do "catch up" with their growth ,not until they are quite older though)
He has just recently complained that he gets teased by some of the other kids at school.
So ,anyway my question is ,has any of you or your your kids ever been on advair then switch to a different med.???
Zack is taking singular now.
I remember that we had taken him off the advair before and he had a horrible time and had to go back on it.
It seems that we should have weaned him off the advair first ,though his allergist said no , that it wouldn`t be necessary.
Just wondered if any of your had any experience with this kind of situation.
Thankyou , Sue

By Heaventree on Friday, January 14, 2005 - 10:27 am:

Hi Sue,

I don't have a child with Asthma. I did work in the pharma industry for many years and Advair was one the the products we worked on. Just for the record I'm not an expert on Advair, however, I did work with Respiratory Specialists and one of the common complaints they had was that other physicians did not understand the drugs as well as they did and there was a lot of confusion about dosing, especialy with Advair. It was not entirely clear as to what the proper dosage was. I'm not sure if your allergist is a physician or not, my suggestion to you is if you have any concerns at all about your child's meds and you don't entirely trust the information you are given, ask for a referal to a specialist for a consultation, preferably a respiralogist. Good luck and keep us posted.

By Debbie on Friday, January 14, 2005 - 10:42 am:

My youngest ds has asthma. However, I don't have any experience with Advair. My ds is on Flovent for maintance of his asthma. My understanding is that this is not a steroid. He does use Albuterol for flair ups, which is. My ped. does not want him to use this often and told me to call if he is using it a lot. He actually has been having a hard time lately, so they put him on Singulair along with the Flovent. My ped. said that she does not want him to use the Albuterol alot because it is a steroid, so she is trying to control it with other medications. Has your doctor tried any other type of medicine besides the Advair?? I don't know much about it since we haven't used it. However, I do know that my ped. wants my ds to avoid using a steroid if possible.

By Trina~moderator on Friday, January 14, 2005 - 12:25 pm:

Lots of info here:
Asthma Treatments

I have no experience with Singulair or Advair, but my DS (8) has asthma and uses a Pulmicort turbo inhaler daily as a maintenance med. He goes off it during summer months and starts back on it in the fall when his asthma flares up. Yes, Pulmicort is a steroid, but he is SO much healthier on it. It's the lesser of two evils. Before his asthma was diagnosed he was sick A LOT. Since starting treatment and following his asthma action plan he has only gotten slight colds. Taken from the link above:

While there are some concerns about high doses of inhaled steroids affecting children's growth, having uncontrolled or poorly controlled asthma can also lead to many side effects, including poor growth, hospitalizations and even death. Your Pediatrician will monitor your child's growth closely while he is on a steroid inhaler. In general, if needed, it is much safer to use a steroid inhaler than to have uncontrolled or poorly controlled asthma.

I'm curious about the teasing. Does your son get teased about having asthma, taking meds or about his size??

By Pamt on Friday, January 14, 2005 - 01:39 pm:

My DS is on Advair and Singulair, plus Clarinex daily and then albuterol for flare-ups. He was on this many meds (but different ones like flovent, pulmicort, flonase, etc.) and hadn't had an asthma attack in over a year so we dropped one drug at a time untill he was only on an antihistimine. You don't need to wean off the dosage, just the # of meds. Anyway, he had maybe 2-3 flare-ups in a year, but this fall he was really started to have chronic problems, so he's back on all of the meds again and doing well. We'll start weaning him again in a year or so and start the process again. The good thing is that a lot of children's asthma symptoms decrease as they get older.

P.S. My DS is average height. He has put on a little weight, but he tends to do that right before he has a big growth spurt. He'll be 11 in March.

By Lauram on Friday, January 14, 2005 - 02:07 pm:

Interesting discussion. I feel like I have to do more research now! My youngest son (classic asthma) takes Flovent, ALbuterol (though he's only on one puf twice a day now), Zyrtec and Nasonex. When he had his attack and had to go to the ER on Christmas and go on Orapred, I was told that he couldn't take Flovent because it WAS a steroid. The ped disagreed that he couldn't take it, but did confirm it was a steroid- a low dose of one. My other son (Croup/asthma) takes Flovent as well and did take Zyrtec for awhile. I'm taking them both to the allergist in Feb.

By Debbie on Friday, January 14, 2005 - 02:58 pm:

Laura, it is very possible that I could have misunderstood about the Flovent. I do know that he is on the lowest dose of Flovent. However, his albuterol is a high dose. Maybe, that is why she would rather him not use the Albuterol as much. I will have to ask her when we go for our check-up next month. The sad part about my ds is that he is having major issues with his reflux. He saw a specialist last week who is going to perform an endioscope (spelling). They think he may have a hiatal hernia. The gi doctor said that it is possible that he doesn't have asthma at all and it could all be from the digestive problems he is having. I can't wait until he has his test in a few months.

By Lauram on Friday, January 14, 2005 - 03:11 pm:

About the Albuterol, from what I understand (I'm still learning all of this) it is a rescue med and only to be used for breathing difficulties. My youngest son has been on it daily since November. We were up to four times a day for about a month. From what I understand, the problem with using it so frequently is there is "nowhere to go" when there is an asthma attack. That is why we ended up in the ER. It's so hard to figure all of this out. BTW- my son is 2- he'll be three in Feb.

I have heard about that reflux issue though. Good luck figuring that out.

By Pamt on Friday, January 14, 2005 - 04:17 pm:

Laura, I am very surprised that your DS is on albuterol every day b/c it is a rescue med. We've had to use it several times a day for a 1-2 week period when getting over a cold or something, but not for months at a time. I would definitely check into that.

Debbie, my youngest DS has had reflux since birth, but only *officially* diagnosed and finally treated at age 4. He had incredible damage to esophagus at age 4 when he was scoped. He was put on meds and I wasn't noticing a difference and I strongly disliked his arrogant butt-headed ped. GI specialist, so we changed doctors. Then, we did a 24 hr pH probe (they inserted a tube through the nose into the esophagus, he wore a monitor, and it measured how much stomach acid came up into the esophagus over a 24 hour period). He refluxed like 80-something times in 24 hours and that was only considered mild-mod!!! His meds were changed and after several months on new meds he was re-scoped and there is no more scarring or esophageal damage. It did take awhile to get just the right dosage of just the right drugs. He takes Prevacid and Reglan twice a day. This is my DS who has never been dx'd with asthma, but has frequent "reactive airway disease" and gets really bad croup (hospitalized once for it) 3-5 times a year that requires albuterol via nebulizer and oral steroids to get it under control. He also has a chronic cough, esp. at night, and a hoarse voice. For him it is all reflux and allergy related. I told my ped. that I am so tired of the coughing and that one day I was going to lock him (my ped.), the ENT, and the ped GI in a room and let them sort out the precise reason for the cough and fix it. *sigh*

With one asthmatic son and one reflux son, all I can say is thank goodness for good prescription benefits with my insurance. Otherwise, meds alone would run over $1000/month.

By Sue3 on Friday, January 14, 2005 - 04:40 pm:

Trina,
My son gets teased about his size ,he is the smallest child in his second grade class.
Thankyou everyone for your input and links to the asthma and meds ,I am going to research them
later tonight.
Btw , my neighbors son has been on advair ever since he was 2 ,he is 14 now and
his size is also an issue with them.He gets teased often for being so small.
She has tried to take him off it only to deal with horrible flare ups so they don`t take him off it anymore.

By Kaye on Friday, January 14, 2005 - 05:23 pm:

Your initial question is do you have to wean off advair? When we quit taking it we just quit, we also went to singulair. My son had bad bad asthma issues when he was 2-5. He is 9 now and we are mostly med free. I monitor his peak flows about once a week and only use xopenex ( a cleaner form of albuterol). In the peak of his sickness we did use albuterol daily, it was because he was never at full lung capacity.

By Trina~moderator on Friday, January 14, 2005 - 05:31 pm:

Laura, like Pam, I am also surprised your DS is using Albuterol so often. DS has an albuterol inhaler but he is only to use it when his peak flow readings drop into the yellow (cautionary) zone. As mentioned, it is considered a rescue med, which means it's not supposed to be used on a regular, daily basis. I would speak with your doctor about this. Do you have an Asthma/Allergy specialist?

Tons of Asthma info here:
KeepKidsHealthy.com - Asthma Center

Sue, My DS has been on Pulmicort for 2 yrs. now, minus this past Summer, and he is average sized. My DD is small for her age, but doesn't have asthma. I guess the point I'm trying to make is that your son's size isn't necessarily related to the steroids.

By Debbie on Saturday, January 15, 2005 - 09:17 am:

Pam, I really think that ds has had reflux since he was a baby. He was not diagnosed with it until he was 3. We had lots of problems feeding him when he was little. They blamed it on a lactose intolerance. But, thinking back, it was probably reflux. He was just diagnosed with asthma last spring. He just has a chronic cough, he doesn't get short of breath. I have noticed that the cough gets worse when his reflux is acting up, so I really think it may not be asthma at all. I love his new ped. GI. She is wonderful. Unfortunately, we have to wait 3 weeks for his test. But, I am hoping we will finally know what is going on with him. I just feel so bad for him right now because he is just so fatigued these days and his eating is terrible.

By Karen~moderator on Saturday, January 15, 2005 - 11:17 am:

Flovent is a steriod, albuterol is a broncho-dialator of sorts - "Albuterol is in a class of medications called beta-agonists. It works by relaxing and opening air passages in the lungs, making it easier to breathe."

I myself used to use flovent and serevent but now use Advair twice daily, and Albuterol for rescue.

Definitely do your own research and insist on being given the time to really talk with your son's doctor about his condition and meds. If you don't get satisfaction, definitely get a second opinion.

Unfortunately, if the steriods *are* a factor in his growth, you will have to weigh out the positive side of him being on meds which are necessary for him to breathe and be healthy.

By Lauram on Saturday, January 15, 2005 - 12:44 pm:

Pam and Trina- The drs are very aware about the issue with the ALbuterol. Everytime we were trying to wean him off, he would go and catch a cold- the final time we ended up in the ER. He was really wheezing all the time. He would run (in the house) and start wheezing and coughing. It was REALLY bad from about Thanksgiving to Christmas (Christmas night was the ER visit). RIght now, he's down to one puff of ALbuterol in the AM and one in the PM, 2 puffs of Flovent in the AM and PM and one squirt of Nasonex per nostril in each nose at night and one tsp of Zyrtec at night. I'm supposed to do this for another 2 weeks and then call again to see where to go from here. Morgan was really sick last winter too when he had brochiolitis (acute asthma from RSV) and was on Albuterol and Flovent then too. He was very close to being hospitalized and had to keep going to the ped. At one point they didn't charge me because "I had paid the rent that month!" I'm thinking it might be our cat. Since he's been banished (Christmas), his breathing has been much better. As I said, I am taking both boys to the allergist over Feb break to get a handle on it. I'm really scared to take MOrgan off the Zyrtec though- I have to do that 5 days before. SInce he's so young, we're still trying to figure all this out for him. From what I understand, avoiding the attacks are the key.

Yes- all the meds are very expensive. Thank goodness for insurance.

About the steroid issue, the drs say it is IMPERITIVE that both boys are on the Flovent (steroid). I'm wondering if you can actually avoid it at all?! It seems to me like that might not be safe. I know with both of them I can wean them off it in the summer though.

By Lauram on Saturday, January 15, 2005 - 12:46 pm:

Oh- and the way we finally got him down off the ALbuterol 4 times a day was to give him 110 Flovent (2 puffs twice a day). He was on that for a month too. He was supposed to only be on that for two weeks too. Like I said, it was a rough one!

By Imamommyx4 on Sunday, January 16, 2005 - 12:35 am:

FYI on the Zyrte liquid. They also make Zyrtec chewable grape flavored tabs. DD want take the Zyrtec liquid due to the taste, but will take the chew tab. I get the 10 mg tabs and cut them in half and it is such a little amount that she takes it really well.
Between the Singulair and Zyrted dd's asthma stays pretty controlled.

By Kernkate on Monday, January 17, 2005 - 08:07 am:

My DS who is 10 also has asthma. He was on the Serevent but it seemed to bother her throat, so my Ped. took him of of it. He does have the albuterol for use as a rescue inhaler. When his ashtma is acting up, the Ped. just tells me to use it 2x everyday for 5 days.
Right now he is on singulair, allegra 2x a day, flovent 2x a day and he seems to be doing great!
The cold weather had always seem to bother DS but this year we seem to have the asthma under control.

By Lauram on Tuesday, January 18, 2005 - 12:58 pm:

UGH. Ds has a cold (AGAIN). We're up to 3-4 times a day on Albuterol, Nasonex, Zyrtec and back on the 110 Flovent. Dr said he may need to stay on the 110 Flovent for the duration of the winter. Can't wait until this cold weather disappears! It is SOOOOO cold today!

By Kernkate on Tuesday, January 18, 2005 - 01:08 pm:

Laura my DS also stays on the flovent 110 all winter. And it really does help, come April we wean him off it until Oct.- Nov.
Good luck I know what its like. I have been going thru it with Brett for 7 years now

By Debbie on Tuesday, January 18, 2005 - 05:11 pm:

Laura, my ds was having to use his Albuterol a lot in Dec. The cold air makes his asthma so much worse. They put him on Singulair a few weeks ago, and he is doing much better. We haven't used his Alubterol in a couple of days. He is on 44 Flovent twice a day, Zyrtec and Singulair. We are going to use the Singulair through the winter and then take him off when it gets warmer {{{hugs}}} to you and your ds. I can totally relate!!

By Sue3 on Thursday, January 27, 2005 - 11:36 am:

Just an update on Zacks Dr. visit.Well,Dh and I took Zack to the allergist the 13th of Jan.He has been off the advair disk since then.
Yesterday ( the 26th) I took him in for his allergy shots and they decided to measure and weigh him again.
Well , since his last visit ,13 days ago , he has grown an inch and gained a pound.
I asked if this had something to do with Zack being taken off the advair and they said no it wasn`t , he just had a growth spurt
BUT , DH and I think it`s quite a coincidence since Zack has never grown a whole inch in such a short period ,or any period for that matter.
We go every six months and the most he has grown is a quarter of an inch.
Well, I just wanted to share.
I hope he contiues to do well on the singular.

By Feona on Thursday, January 27, 2005 - 11:55 am:

Ds is on singular too. It works very well for ds. We just take it when I see an allegy attack. The doctor said that was okay for ds.

By Kernkate on Thursday, January 27, 2005 - 02:24 pm:

Sue glad to hear your DS is doing well. Does he take singulair daily? My DS takes his everynight.

Feona, I am surprised your Dr. tells you to give it to him that way, Below is the lit. that came in the folder that my Ped. gave me. I guess all doctors are different. Just so it helps you DS thats all that matters.

SINGULAIR is a prescription medicine approved to help control asthma in adults and children as young as 12 months and to help relieve the symptoms of seasonal allergies in adults and children as young as 2 years.

SINGULAIR should NOT be used for the fast relief of a asthma attacks You should still have rescue medication available and continue to take your other asthma medications unless your doctor tells you to stop. For asthma, SINGULAIR should be taken once a day, in the evening as prescribed, whether or not you have asthma symptoms. If your symptoms get worse or you need to increase the use of your rescue inhaler, call your doctor at once.

By Debbie on Thursday, January 27, 2005 - 03:36 pm:

Sue, I am glad your ds is doing better. My ds was put on Singulair last month. He has been doing great on it. We haven't had to use his Albuterol since he started it.

By John on Thursday, January 27, 2005 - 04:40 pm:

Recent research has shown a protective effect from the consumption from milk fat (such as butter) in the frequency of asthma sympthoms in preschool children.

http://thorax.bmjjournals.com/cgi/content/full/58/7/567


This effect has also been confirmed in several other studies linked at the end of the article. Researchers believe it may be related to the beta-carotene present in milk fat.

Coverage by the BBC:

http://news.bbc.co.uk/1/hi/health/3030122.stm

By Feona on Friday, January 28, 2005 - 06:59 am:

Ds is getting it for fast relief of allergies.

But last night he was still itchy after taking it so we had to give him benadryl too. Before the sinular was enough. He has only taken like 10 sinuglar in like 6 months. His back gets itchy and he cough ALOT when he has an allergy attack.

By Kernkate on Friday, January 28, 2005 - 10:06 am:

Thanks John. That is very interesting.

By John on Friday, January 28, 2005 - 10:47 am:

Interesting side note on the article...
Our little guy used to love eating butter on everything!
He would even eat it by itself by licking the butter off bagels and leaving the bagel behind.
About a year ago we stopped eating bagels (during my diet) and DS stopped getting them causing his consumption of butter to drop significantly.

... and the allergy thing seems to have gotten progressively worse over the last year...
Hmmmm...

By Sue3 on Friday, January 28, 2005 - 08:58 pm:

Yes, Zack takes singular nightly.He made me nervous the other night because he was wheezy and needed his inhaler ,though I think it was because he had his allergy shots that day.
He is fine now.
What an ordeal I had to go through at his school so he could keep his inhaler on him (gym class).
Once I mentioned the student in California whom was denied her inhaler and resulted in her death they then
seemed to take me more serious.
All is well now with them and Zack can take his inhaler to gym class and keep one at his desk in school.
Great article John.We always use real butter at our house ,now after reading that I am wondering if I should buy whole milk
instead of 2%.
Maybe you should get some more bagels for your little guy ?

By John on Monday, January 31, 2005 - 04:15 pm:

I got him some more bagels and he liked one for breakfast this morning(with butter of course!) along with a glass of milk...
I'll let you know how it goes.