Choose Your Weapon: Inhaler Device Preference
If all things were considered equal about what’s inside an inhaler… which it’s not but bear with me… what inhaler device would you choose? This is a conversation that Dia and I have had time and time again—Dia’s “weapon of choice” would be a dry powder turbuhaler; mine, the older-school pressurized metered dose inhaler.
Within a couple years of my diagnosis, I asked my doctor to switch me from my then controller medicine to another… Not because the dry powder inhaler, Symbicort, I was using didn’t work just fine, but because I liked the “normal” pressurized metered dose inhalers better. I can use the dry powder inhaler (turbuhaler, specifically) just fine, but between the noise of using it in public (aka in a public bathroom… ahem, all ya hiders, I am usually with you!) and the giant suck of air thing when I’m breathing cruddy, I like the inhaler and spacer combo better. (Yes, I actually like spacers, not that I use one alllll the time! I may be one of the few people on the planet who has not really ever been told to use a spacer by my doctors, and uses one anyways).
However, for some people, the compact size of a dry powder inhaler is key, because they’re not big spacer fans like I am. Or, it’s the fact that they don’t have coordinate their inhalation and the actuation (press down) on the inhaler. It’s as simple as the twist-and-click or pulling a lever (depending on what you’re using—some, like Spiriva have a capsule that needs to be crushed using a button), taking an appropriate inhalation in, holding your breath… and then you’re done. The reality is, the two devices are not a ton different to use aside from how you prime the device (if necessary) and take the dose—after that, it’s all the same. The effectiveness, I have read, of a dry powder inhaler device versus a metered dose inhaler with a spacer, is about the same—as in, a similar amount of medicine gets into your lungs.
For me, I switched to Advair because of the MDI and it definitely failed for me. I nearly landed myself on prednisone, except the night before I started pred, I forgot to take my Advair… and i felt better! Hmm… So, I switched myself back to Symbicort (which is a turbuhaler dry powder device here in Canada) and filled my doctor in the next time I went in. Things got better—a few years later—when Zenhale (or, Dulera outside of Canada/in the US) was released in Canada. Since I’d not reacted negatively to FloVent (the same steroid as in Advair) nor the formoterol component of Symbicort, I figured it was worth a shot switching to Zenhale. Sure enough, it has been a great choice for me. But, it just proves how important trial and error is—and why you shouldn’t pledge allegiance to any drug commercials (or inhaler colours—come on, I’m a big fan of the Advair purple, but my lungs don’t like it!)
Which inhaler device do you prefer using? Do you have any idea why you like it best, or is it because of the meds inside? I’d love to hear your take in the comments!
Have you ever gotten "moon face" as a side effect of prednisone?