Runwa Yilida
Hello, doctor.
I have a dust mite allergy, and I tend to cough when I catch a cold.
I need to use an inhaler to feel better.
Previously, I used Pulmicort, but this time the doctor prescribed me to use Roflumilast.
I started using Roflumilast on February 7 and continued until the 15th, but my child finished the medication.
On February 25, I picked up the medication again and have been using it since then.
During this period, my cough has improved, but it hasn't completely resolved.
On the 17th, after using the inhaler, I suddenly started coughing and felt like I was choking on water, with a sensation in my nasal passages.
Sometimes I experience a fever, and the coughing has become more frequent.
I am wondering if this is a side effect of Roflumilast.
Can I continue using the medication, or do I need to return for a follow-up appointment? Thank you.
Niming, 40~49 year old female. Ask Date: 2020/03/19
Dr. Yang Wenda reply Pulmonology
Hello: It is recommended not to inhale too forcefully (too deeply), and to observe the situation.
Some individuals may have a constitution that is less suitable for certain medications.
Reply Date: 2020/03/19
More Info
When it comes to asthma treatment, medications like Runva E-Lida (which contains the active ingredient budesonide/formoterol) are commonly prescribed to help manage symptoms. This medication is a combination inhaler that contains a corticosteroid (budesonide) to reduce inflammation in the airways and a long-acting beta-agonist (formoterol) to help relax the muscles around the airways, making it easier to breathe.
While many patients find relief from their asthma symptoms with this medication, it is important to be aware of potential side effects. Common side effects of inhaled corticosteroids and long-acting beta-agonists can include:
1. Throat Irritation: Some patients may experience a sore throat or irritation after using the inhaler. This can sometimes lead to coughing or a sensation of tightness in the throat.
2. Coughing: Although the medication is intended to alleviate coughing associated with asthma, some patients may experience increased coughing, particularly if the inhaler is not used correctly or if the medication irritates the throat.
3. Nasal Symptoms: Patients may experience nasal congestion, runny nose, or sinusitis. The sensation of having water in the nasal passages, as you described, could be related to nasal irritation or post-nasal drip.
4. Increased Heart Rate: Formoterol can sometimes cause palpitations or an increased heart rate, which might be perceived as a feeling of anxiety or discomfort.
5. Headaches: Some patients report headaches as a side effect of using inhaled corticosteroids.
6. Potential for Infection: Long-term use of corticosteroids can increase the risk of respiratory infections, including oral thrush (a fungal infection in the mouth) and pneumonia.
In your case, it seems that after using Runva E-Lida, you experienced a worsening of your cough and a sensation of choking, which could be attributed to throat irritation or an adverse reaction to the medication. The feeling of being "choked" could also indicate that the inhaler was not used properly, leading to improper delivery of the medication to the lungs.
Given that you have a history of dust mite allergies and asthma, it is crucial to monitor your symptoms closely. If you are experiencing persistent coughing, increased frequency of asthma symptoms, or any new symptoms such as fever, it is advisable to consult your physician. They may want to evaluate your technique in using the inhaler, check for any signs of infection, or consider adjusting your asthma management plan.
In the meantime, here are some recommendations:
- Proper Inhaler Technique: Ensure that you are using the inhaler correctly. This includes shaking the inhaler, exhaling fully before inhaling the medication, and holding your breath for a few seconds after inhalation to allow the medication to settle in your lungs.
- Rinse Your Mouth: After using the inhaler, rinse your mouth with water to help prevent throat irritation and reduce the risk of oral thrush.
- Monitor Symptoms: Keep a diary of your symptoms, noting when they occur and their severity. This information can be helpful for your doctor.
- Avoid Triggers: Continue to avoid known allergens and irritants that may exacerbate your asthma symptoms.
If your symptoms do not improve or worsen, it is essential to return to your healthcare provider for further evaluation and management. They may consider alternative treatments or additional medications to help control your asthma effectively.
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