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Suggest Treatment For ABPA
Question: Hi, I am suffering from ABPA for last 30 years though the actual diagnosis was made 15 years earlier. In the initial 25 years, I had yearly bout and a prednisolone 12 day course resolved the matter. I used to take Serflo 125 twice B.D. irregularly - very irregularly indeed. For last 2 to 3 years, I am getting bouts every month or two. Doctor advises me to take Seroflow 250 twice BD. I wonder whether if there is any justification for increasing the dose when I have not been very regular even on Seroflow 125 earlier. Secondly, whether Serflow is more appropriate than Foracort for ABPA? My doctor is not very inclined to answer to these queries!
Brief Answer:
Better to get done PFT first.
Detailed Answer:
Thanks for your question on Health Care Magic.
I can understand your concern.
Long standing ABPA (allergic bronchopulmonary aspergillosis) can cause chronic bronchitis due to persistent inflammation.
And hence inhaled bronchodilators and inhaled corticosteroid are needed.
So in my opinion, you should first get done PFT (Pulmonary Function Test) for the diagnosis of bronchitis.
It will also tell you about severity of the disease.
And treatment of bronchitis is based on severity only.
Ideal dose of seroflo is twice daily. So you should take it twice daily even if you are asymptomatic.
Seroflo is having salmeterol and fluticasone.
Foracort is having formeterol and budesonide.
Salmeterol and formeterol are LABA (long acting beta 2 agonist). Fluticasone and budesonide are ICS (inhaled corticosteroid). In terms of efficacy, salmeterol and fluticasone are superior and hence seroflo is better than foracort.
So first get done PFT. On the basis of severity, you may need other bronchodilators also.
Hope I have solved your query.
I will be happy to help you further. Wish you good health. Thanks.
Better to get done PFT first.
Detailed Answer:
Thanks for your question on Health Care Magic.
I can understand your concern.
Long standing ABPA (allergic bronchopulmonary aspergillosis) can cause chronic bronchitis due to persistent inflammation.
And hence inhaled bronchodilators and inhaled corticosteroid are needed.
So in my opinion, you should first get done PFT (Pulmonary Function Test) for the diagnosis of bronchitis.
It will also tell you about severity of the disease.
And treatment of bronchitis is based on severity only.
Ideal dose of seroflo is twice daily. So you should take it twice daily even if you are asymptomatic.
Seroflo is having salmeterol and fluticasone.
Foracort is having formeterol and budesonide.
Salmeterol and formeterol are LABA (long acting beta 2 agonist). Fluticasone and budesonide are ICS (inhaled corticosteroid). In terms of efficacy, salmeterol and fluticasone are superior and hence seroflo is better than foracort.
So first get done PFT. On the basis of severity, you may need other bronchodilators also.
Hope I have solved your query.
I will be happy to help you further. Wish you good health. Thanks.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
PFT has been done around 2001,2007 and also 2015.
The position remains the same: MILD OBSTRUCTIVE DEFECT. NO SIGNIFICANT REVERSABILITY.
X-ray Reports also indicate CLEAR LUNGS.
My doctor has earlier advised Allegra which I found to lead to side effects without any positive preventive effect. Now he advises Montek -LC. I have not tried it as I don't find that the medical literature as I read seems to have indicated any utility for anything other than inhaler or Prednisolone in treatment of ABPA. Kindly opine.
I am satisfied with your advice regarding continuance with Seroflow. But I have doubts only about increasing it from 125 to 250 B.D. without any reason to do so. Will you like to comment on this?
My questions and queries may seem annoying and foolish at times but I do feel that a patient often needs psychological support more than medical support. No, doctor?
The position remains the same: MILD OBSTRUCTIVE DEFECT. NO SIGNIFICANT REVERSABILITY.
X-ray Reports also indicate CLEAR LUNGS.
My doctor has earlier advised Allegra which I found to lead to side effects without any positive preventive effect. Now he advises Montek -LC. I have not tried it as I don't find that the medical literature as I read seems to have indicated any utility for anything other than inhaler or Prednisolone in treatment of ABPA. Kindly opine.
I am satisfied with your advice regarding continuance with Seroflow. But I have doubts only about increasing it from 125 to 250 B.D. without any reason to do so. Will you like to comment on this?
My questions and queries may seem annoying and foolish at times but I do feel that a patient often needs psychological support more than medical support. No, doctor?
Brief Answer:
No need to take montek LC.
Detailed Answer:
Thanks for your follow up question on Health Care Magic.
I can understand your concern.
Montek LC is having montelukast and levocetrizine. Montelukast is anti allergic and levocetrizine is antihistamine drugs.
And they are not indicating in ABPA.
If you are having dry coughing than levocetrizine plain can be used.
You should take seroflo 125 twice daily . If you are controlled with regular twice daily seroflo 125 than no need for higher dose.
I advice you to take seroflo 125 twice daily for atleast 6 months and get done repeat PFT after 6 months.
And yes, you are right about psychological support. Chronic diseases do have psychological impact on patient. And hence psychological support and sometimes psychiatrist 's counselling is also needed.
Hope I have solved your query.
If you are not having further queries, then please close the conversation and rate my answer.
You can ask me directly on bit.ly/askdrkaushalbhavsar.
Wish you good health. Thanks.
No need to take montek LC.
Detailed Answer:
Thanks for your follow up question on Health Care Magic.
I can understand your concern.
Montek LC is having montelukast and levocetrizine. Montelukast is anti allergic and levocetrizine is antihistamine drugs.
And they are not indicating in ABPA.
If you are having dry coughing than levocetrizine plain can be used.
You should take seroflo 125 twice daily . If you are controlled with regular twice daily seroflo 125 than no need for higher dose.
I advice you to take seroflo 125 twice daily for atleast 6 months and get done repeat PFT after 6 months.
And yes, you are right about psychological support. Chronic diseases do have psychological impact on patient. And hence psychological support and sometimes psychiatrist 's counselling is also needed.
Hope I have solved your query.
If you are not having further queries, then please close the conversation and rate my answer.
You can ask me directly on bit.ly/askdrkaushalbhavsar.
Wish you good health. Thanks.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks. I am perfectly satisfied. But before I close, I wish to know if you can give me your contact details so that next time I can make a personal visit. I am located in XXXXXXX
Brief Answer:
Thanks for your kind words.
Detailed Answer:
Thanks for your follow up question on HCM.
It's always encouraging for doctors to hear positive feedback from patients.
Thanks for your kind words.
I am truely obliged.
My entire details are on HCM including contact number, email address and hospital address.
You can definitely contact me at anytime by clicking on this link.
bit.ly/askdrkaushalbhavsar.
Wish you good health. Thanks.
Thanks for your kind words.
Detailed Answer:
Thanks for your follow up question on HCM.
It's always encouraging for doctors to hear positive feedback from patients.
Thanks for your kind words.
I am truely obliged.
My entire details are on HCM including contact number, email address and hospital address.
You can definitely contact me at anytime by clicking on this link.
bit.ly/askdrkaushalbhavsar.
Wish you good health. Thanks.
Note: For further information on diet changes to reduce allergy symptoms or to boost your immunity, Ask here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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