When I write about asthma, I often assume (wrongly) that you’ve been dealing with the disease for 8 long years, same as me. I also sometimes leave out information in the interests of space and time and the desire not to repeat what you already know. However, my blog stats reveal searches for info about pediatric use of meds like Serevent, and in the wake of a new FDA review, who isn’t concerned? Here’s more about Serevent, Advair, and Foradil and the FDA’s concern about children using them. If you already know what I’m talking about, just ignore this post for something more interesting.
1. Serevent, Advair, and Foradil are long-acting beta 2-agonists (LABA’s), meaning they relax smooth muscles around the bronchial tubes to open airways the way albuterol does, only they do it over the long term to help control asthma. Albuterol, on the other hand, takes around 5 to 20 minutes for immediate relief.
2. That means LABA’s will not stop an asthma flare. Although they are bronchodilators, they are maintenance inhalers rather than quick-relief ones.
3. Serevent, Advair, and Foradil are approved for children over the age of 4 and adults, but are only prescribed for moderate to severe asthma that will not respond to inhaled corticosteroids alone. Doctors consider them an *add-on* treatment and like inhaled corticosteroids best for preventation.
4. The recent study that has the FDA concerned about asthma-related deaths in children was for salmeterol, the active ingredient in Serevent and one of 2 active ingredients in Advair. Foradil uses formoterol, which was not studied. The FDA wants a further review of pediatric use of all 3.
For more information, check out these places:
More About the FDA Decision (scroll to the end)
Mayo Clinic Asthma Medications List
Advair Prescribing Information (pdf)
Serevent Prescribing Information (pdf)
Foradil Prescribing Information (pdf)
The Severent/Advair debate has been going on for quite a while now for asthmatic adults, Im glad they’re finally studying the effects in children.
Did you know that in some people, beta agonists (ie albuterol, salbuterol, ect), can actually make their asthma worse.
There is now a DNA test to check for that specific genetic defect. It’s called the “beta adrenergic receptor genotype” .
It’s not widely available yet, but in a few years I think it will be a standard test for those with severe asthma.
( I was tested last year… the results came back normal)
Hi Steve,
I used to know another mom whose son had very severe asthma–the drs. finally figured out the problems stemmed from his inability to tolerate beta agonists and a previously undiagnosed heart issue. My daughter’s asthma took so long to get under control–I really can’t imagine dealing with it without albuterol.
I had no idea, though, that a DNA test for the condition exists–I think her son’s doctors figured it out through trial and error. Thanks for posting this!
I think/hope it will be so much easier to parent an child with asthma 10 or 20 years from now, when diagnostic tests are widely available–gives me hope for my potential grandchildren, who obviously have a higher risk of developing asthma. Now if researchers could just get that asthma vaccine figured out………
My mom mentioned something about this yesterday, but I just now was able to get on the computer and saw your post about it. For us this is a huge issue. Alorah is going to be 7 next month. She failed pulmicort, she failed Flovent, she is now on Advair 250/50-her asthma IS that bad. She went from blowing 150’s on her peak flow to 240. She has not needed her albuterol in 2 weeks. For us we have seen a HUGE improvement in a) her energy b) her lung function and c) her flares. There is no doubt it is working. After she had 3 attacks in three weeks all needing 4-6 days of Pediapred (and all the risks that med carries with it) and doing Flovent for 2 months and having another major flare we have finally found something that works. I give it to her an hour before she goes to school so I can watch her. I give it to her at least an hour, sometimes 2, before bed so I can watch her. So far, so good. I honest to goodness do not know what we will do if they pull this med for kids. She was on the verge of ending up in the hospital in September, now she can run and play like a normal kiddo, no albuterol. I will be on pins and needles until we get the decision of the board. I’m glad they are being cautious but I am absolutely freaked out about going through another trial with med after med to find something else that works….