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Suggest Treatment For Drug-induced Lung Fibrosis

Posted on Tue, 21 Jun 2016

Question: I was diagnosed with brown crackling in my left lung appox. 14years ago. It hasnt moved in all this time. It was caused by the use of an RA drug, Arava. I went through a complete body flush to rid my system of the drug, as I had been on it for six years. It has affected my breathing along with 2 small noduals in my right lung caused from Methotrexate. The noduals originally started my breathing problems but have not grown in size. My main concern is the crackling (fibrosis). It is not classified as idiopathic.
Yes I am on inhalers and sometimes prednisone if I get a bad cold or pneumonia.
Thank you, XXXXXXX

Answered by Dr. Drkaushal85 (1 hour later)

Brief Answer:
You are mostly having drug induced lung fibrosis.

Detailed Answer:
Thanks for your question on Healthcare Magic.
I can understand your concern.
In my opinion, you are mostly having drug induced pulmonary fibrosis.
Immunomodulator drugs (drugs used in connective tissue disease) can cause pulmonary fibrosis as a long term side effect
But with stoppage of drug, it will not worsen.
So it is static once we stop the offending drug.
So please let me know
1. Is your fibrosis static over the years?
2. Is your fibrosis is worsening over the years?
Please reply me answers of above asked questions, so that I can guide you better. I will be happy to help you further
Wish you good health. Thanks.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Drkaushal85 (25 minutes later)

Thank you so much,
I guess you could say my fibrosis is static as nothing has changed over the years. I do though, have symptomatic asthma attacts that are controlled by Allbuterall. If i have it to often I will use my Nebulizer treatment.
Once again Thank you.

Answered by Dr. Drkaushal85 (7 hours later)

Brief Answer:
You should start LABA and LAMA.

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
Yes, your fibrosis is static drug induced fibrosis. With stoppage of drug, it won't progress further and stays the same for rest of your life.
Why you are taking albuterol?.
It is short acting beta 2 agonist (SABA).
It is not fir regular control of asthma. It is basically rescue medicine for asthma.
According to standard guidelines for asthma, best treatment of asthma is inhaled corticosteroids (ICS) and inhaled bronchodilator (LABA and LAMA).
So please let me know
1. Are you consulting pulmonologist for your symptoms?
2. Have you ever undergone PFT (pulmonary function test)?
3. Do you take any other inhaler?
Please reply me answers of above asked questions, so that I can guide you better. I will be happy to help you further. Wish you good health. Thanks

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar