# Asthma Medication



## Amy35 (Mar 20, 2011)

Hi,

I am just preparing for IVF 2 and was wondering about my asthma meds. I know ventolin is safe, however, i was previously on Seretide and they changed it to clenil modulite as I ended up with damaged vocal cords and had months of vocal therapy despite rinsing with water. I am obviously doing everything i can to get prepared for round 2 but have just read conflicting advice on clenil modulite. Is there an inhaler which carries less risks?

Thanks for your help
Amy


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## mazv (Jul 31, 2006)

Hi Amy,

Not sure what you are referring to when saying less risks? Is this risks to you with vocal cord damage or risk to a potential pregnancy? If you are referring to pregnancy then the advise for women with asthma is absolutely to continue with current treatment at whatever level/amount of medicines you are taking. Risk to mother and baby from uncontrolled asthma far outweighs any potential risk from the medications used to treat the asthma. It is really important to get good control of asthma in pregnancy because of the strain put upon your heart and lungs.

Hope this is helpful
Maz x


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## Amy35 (Mar 20, 2011)

Hi Maz,

Thanks for your reply! Much appreciated..

I really didn't express myself very well. I had read that clenil modulite is contraindicated when trying to get pregnant. DO you think I should look into changing this to another steroid inhaler? Just worried as my previous inhalers have caused considerable damage to my vocal cords! Obviously baby is more important but having a voice is handy too 

Thanks for your help
Amy
xx


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## mazv (Jul 31, 2006)

Hi Amy,

Clenil modulite is a new(ish) brand of beclometasone dipropiaonate (BDP) which was produced for the EU market following the withdrawal of Becotide (the previously most commonly used steroid inhaler) The reason for the change was that Becotide contained CFC propellant to produce the aerosol and this was banned in the EU a number of years ago (due to side effect of casuing a gaping hole in the ozone layer) The company that made Becotide gave up trying to make a CFC free one (and b this time they had a chunk of the market share with different products, flixotide and seretide) So long story short... in the Uk we now have two types fo CFC free BDP inhalers in the market 'Clenil' and 'Qvar'

The active drug BDP has been used to treat asthma in pregnancy for many years. As it is a steroid it carries the same risk as any steroid in pregnancy, potential for growth retardation if used at high dose for long time. Generally though the risk from inhaled drug is lower as the amount that gets into the circulation is less than you would get taking a steroid orally.

In relation to Clenil itself it is not recommended for use in pregnancy by the manufacturer (it is not however contra-indicated; subtel difference  ) The actual prodcut hasn't been trialled in pregnancy (proper randomised trials etc..) because it isn't ethical to do this. The other issue is that the new compound used to propel the drug into the lungs hasn't been trialled in pregnancy either. In animal studies this was shown not to have any adverse effect on pregnancy.

Clenil is prescribed for pregnant women with asthma under medical supervision (which pretty much covers all pregnant women with asthma using it routinely) There are other steroid inhalers available in the UK but if Clenil is the most appropriate one for you then I'd have a frank discussion with your prescriber (GP or asthma specialist?) about the risks to you should you change this for another product. In terms of risk to baby then the risk is considered the same with all steroids and no difference between the different drugs.

This is a link to the British Asthma guidleines  CLICK HERE  Page 23 gives the summary of advice in pregnancy, the full guide with all the evidence (and scientific bits) can be found here  CLICK HERE  Page 89 onward (see Page 92 for info on steroids)

So in summary if you are concerned speak to prescriber 

Hope this helps
Maz x

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