Asthma Medications: Side Effects and Alternatives

Questions regarding asthma medications?

Currently, the medications prescribed to me are as follows: "KODAPIN TAB," "COM-TRIMETON TABLETS 4MG," "MEPTIN-MINI 25UG TAB," "CEMINE 10MG F.C TAB," and "VOREN 50MG (WEREN) CAP." I feel okay without taking them, but I keep coughing and have a wheezing sound when breathing at night.
After taking the medications, I feel significantly fatigued, constantly wanting to sleep, and have a heavy head.
The side effects during the day are quite pronounced, so I only take them before bed.

(1) Why do I feel more fatigued after taking the medications? I feel dizzy, always wanting to lie down and sleep, and my legs feel weak when walking?
(2) What happens if I don't take them on schedule?
(3) Since I only take them before bed, am I at risk of taking too many medications at once? I'm concerned about the potential harm, as I can't carry so many medications with me; it feels odd, and the side effects are quite troublesome.

(4) Are there any convenient, quick, and simple medications with fewer side effects? Previously, my doctor prescribed me a corticosteroid nasal spray, which I never used and let expire, later returning it to the doctor for disposal.

(5) If I use corticosteroids, will I develop moon facies? If I do use them, how long will it take for my face to return to its original appearance?
I would appreciate your answers to these five questions.
Thank you!

aa, 20~29 year old female. Ask Date: 2005/01/20

Dr. Zhao Chongliang reply Internal Medicine

Hello! Regarding your medications, only Meptin-mini is an asthma medication.
Kodapin is a cough suppressant and is not recommended for long-term use in asthma patients.
Cemine is an antihistamine for allergies and should not be used unless you also have chronic sinusitis or post-nasal drip.
Voren is an antipyretic and analgesic, and should not be used unless you have an infection as well.
Com-Trimeton is not found in the current pharmacopoeia; is it Chlor-Trimeton? If so, it is also an antihistamine for allergies, which would be redundant and should only be used in cases of chronic sinusitis or post-nasal drip.
Antihistamines and antipyretics may be causing your current symptoms of fatigue, dizziness, and drowsiness.
Taking them at night would not change this, as Cemine is a long-acting medication meant to be taken once a day.
Meptin-mini can be used twice daily at most, and after taking it in the morning, you do not need to carry it with you.
Inhaled corticosteroids can also be used twice daily at most, and after using it in the morning, you do not need to carry it with you.
Long-term high-dose use of oral corticosteroids can lead to moon facies, with recovery time being variable depending on the dosage and individual constitution; some patients have taken up to six months to recover after discontinuation.
However, low-dose use, such as Prednisolone at one to two tablets a day or using inhaled corticosteroids, will not cause moon facies, but the latter may cause hoarseness and, if you do not rinse your mouth, can lead to oral thrush.

Reply Date: 2005/01/20

More Info

Understanding asthma medications and their side effects is crucial for managing the condition effectively. The medications you mentioned—KODAPIN TAB, COM-TRIMETON TABLETS, MEPTIN-MINI, CEMINE, and VOREN—are commonly prescribed for asthma and related respiratory issues. Let's address your questions one by one.

1. Why do I feel fatigued and dizzy after taking these medications?
The medications you are taking may have sedative effects or cause drowsiness, which can lead to feelings of fatigue and dizziness. For instance, COM-TRIMETON (an antihistamine) is known to cause sedation as a side effect. Similarly, KODAPIN, which may contain a combination of medications, can also contribute to these feelings. If you are experiencing significant fatigue and dizziness, it is important to discuss these symptoms with your healthcare provider, as they may need to adjust your medication regimen.

2. What happens if I don’t take my medications on time?
Asthma medications are designed to manage symptoms and prevent exacerbations. If you do not take them as prescribed, you may experience worsening symptoms, such as increased coughing, wheezing, and shortness of breath. It is essential to follow your doctor's instructions regarding timing and dosage to maintain optimal control of your asthma.

3. Is it safe to take multiple medications at once?
Taking multiple medications can be necessary for managing asthma, but it is crucial to ensure that they are prescribed appropriately and that you understand their purposes. If you are concerned about taking too many medications, discuss this with your doctor. They can help simplify your regimen or suggest combination therapies that may reduce the number of pills you need to take.

4. Are there simpler medications with fewer side effects?
There are various asthma medications available, including inhaled corticosteroids (ICS) and long-acting beta-agonists (LABAs), which may have fewer systemic side effects compared to oral medications. Inhalers can deliver medication directly to the lungs, minimizing side effects. Discuss with your doctor the possibility of using inhaled medications, as they can be effective and may reduce the need for multiple oral medications.

5. Will using corticosteroids lead to moon facies, and how long will it take for my face to return to normal?
Inhaled corticosteroids can cause side effects, but the systemic effects (like moon facies) are more commonly associated with high doses of oral corticosteroids taken over a long period. If you use inhaled corticosteroids as prescribed, the risk of significant side effects is lower. If you do experience moon facies from corticosteroid use, the duration for your face to return to its normal appearance can vary, but it typically takes weeks to months after discontinuation or reduction of the corticosteroid dose.

In summary, managing asthma effectively often requires a combination of medications, and it’s essential to communicate openly with your healthcare provider about any side effects you experience. They can help tailor your treatment plan to minimize side effects while effectively controlling your asthma symptoms. If you have concerns about your current medications or their side effects, do not hesitate to reach out to your doctor for a thorough review and possible adjustments to your treatment plan.

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