Brief Answer:
Proper inhaler technique, add montelukast

Detailed Answer:
Hello.

Thank you for asking at HCM.

I went through your history and would like to make following suggestions to you:

1. Muscle cramps are unusual but possible side effects of Foracort, however, leg cramps are more commonly seen. Stomach or chest muscle cramps are even rare. Yes, sometimes stomach irritation is possible due to drug entering into stomach.

2. Muscle cramps due to Foracort are sometimes due to sodium and potassium disturbances in body. I usually advise plenty of fluids to avoid dehydration and adequate green vegetables and fruits (which are rich in electrolytes) to my patients to avoid cramps.

3. Were I treating you, I would suggest you to use combination of Budesonide 400 + Formoterol one puff twice a day. This will reduce your formoterol dose per day and will maintain your budesonide 800 mcg per day.

4. Please get your technique of inhaler use reviewed. Side effects of inhaled drugs are more common if technique is not proper and they reach more into stomach instead of lungs.

Please follow each and every step properly to ensure adequate delivery to lungs and please rinse after every use to reduce drug entry into stomach.

5. Were I treating you, I would add montelukast to your daily treatment, which will reduce your inhaler dose.

6. I would also suggest you regular breathing exercises (including Yoga & Pranayama) which will improve your lung capacity in a long run.

7. As an Allergist-Immunologist, I would suggest you allergy testing which will help you identifying the substances causing allergies to you and also to know the measures to avoid them.

Based on the report, an Allergist may prescribe you allergen specific immunotherapy which works on your immune system to improve your allergy symptoms on long term basis.

Hope above suggestions will be helpful to you.

Should you have any further query, please feel free to ask on follow-up.

Wish you the best of the health.

Thank you & Regards,

Dr. Parin N. Parmar

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