thrush from Advair

[rickyg]

I currently use Advair 100/50. I have been on it since last May. For the first 7 months I had no problems, then a visit to my doctor in Dec. revealed a mild case of thrush. He assumed it was from not rinsing my mouth well enough, though I stressed to him that I wasn’t doing anything different then I had been the first seven months. He prescribed Nystatin, which I used for 7 days and I was fine. After it went away, I was checking my mouth twice a day, I had also become a little obsessed with rinsing my mouth and was spending over five minutes rinsing and gargling with several glasses of water. In spite of this, I noticed a couple of small spots the first week in Jan. so again I used the Nystatin. Yesterday I again noticed another small spot. I KNOW it’s not from not rinsing well enough as I rinse for five minutes. I know that it can be caused simply by using the inhaler no matter how well you rinse, that the inhaler itself will upset the PH balance in your mouth and cause it to appear. What do people do who keep getting this but yet can’t stop using what’s causing it? Is there something else I can be doing to keep this from reappearing? I don’t like using the Nystatin because not only can it cause problems with my liver, the thrush itself can become immune to it. I can’t possibly be the only person who is this susceptible to it.  Are there other options I can try, or is there something else I can do to keep it from coming back?  Thank-you so much for any help you can give.

[National Jewish]

Thrush is an over growth of a fungus that is normally found in the mouth, called Candida albicans.  This generally looks like cheese curds, which when wiped off, leave a raw, bleeding surface.  This fungal infection can occur as a side effect of using inhaled steroids, like the Flovent® (fluticasone) contained in the Advair® fluticasone/salmeterol).  Generally rinsing your mouth after using the inhaled steroid prevents this.  Some people have found it more effective to rinse their mouth with an alcohol-based mouthwash rather than just water.  This is treated with Nystatin Oral Suspension or Mycelex® (clotrimazole) Troche.

Check with your doctor to see if you still need to take the Advair® (fluticasone/salmeterol) regularly.  Asthma can wax and wane.  You may be able to go for long stretches without an inhaled steroid.  If your asthma is mild, another option would be to treat it with Singulair® (montelukast), rather than Advair® (fluticasone/salmeterol).

[Concerned lady]

You will get good advice from the Lung Line nurses.

You can ask your doctor about Probiotics, which can gently get rid of Candida albicans (thrush). Two types of probiotics are Acidophilus & Bifidus. These are edible, beneficial bacteria, normally found in one's large intestine, but that are often killed off by antibiotics.

These beneficial bacteria (probiotics) are thought to either eat up bad yeast cells (the Candida), or, the probiotics may compete with the bad yeasts for a food supply--and the probiotics win, thereby gently getting rid of yeast infections.

Health food stores, and some good pharmacies, sell good quality probiotics, usually in the refrigerated section. You may want to buy a milk-free type, to avoid any extra mucus & congestion that milk can cause. Also, milk can increase acid production in the stomach, and this extra irritation can cause gastric reflux episodes, which then can worsen asthma.

You can also ask your asthma doc about whether Buteyko breathing methods may be good for you to try, since Buteyko breathing methods have helped many asthmatics.

Sincerely, Concerned lady
http://cantbreathesuspectvcd.com

[BUNNYBUD]

I HAVE USED ADVAIR FOR JUST OVER A YEAR AND HAD THE USUAL THRUSH REACTION BUT NOW I AM HAVING THOSE ALONG WITH SEVERE CONSTRICTION AND VOICE CHANGE DIFFICULTIES.  I CLEAN MY MOUTH QUITE WELL AND EAT ICE CHIPS RAVENOUSLY. I BEGAN TAKING ALLEGRA 180 4 WEEKS AGO AND AM WONDERING ABOUT THE MED. INTERACTIONS. MY DOCTORS TEND TO DISREGARD MY CONCERNS AND JUST ADD ONE MORE MED. TO COUNTER THE SITUATION. I NEED THE ADVAIR FOR LIFE THREATENING ASTHMA, I DON'T NEED MORE MEDS.THOUGH.

[Leesa1969]

I too get thrush from Advair, and yes I was rinsing my mouth really well.   I had been on Adviar for a few months when I first started getting the thrush (reddish patches surrounded by a creamy white color)   which at first my asthma/allergist Doc said didn't look like thrush.  I was prescribed Nystatin, went through a whole bottle with no help.   Finally I suggested to my Doctor that another drug might be better for me, so we tried Singulair for a little over a month which did not help. By this time the thrush was ALMOST gone.  
Due to the mouth sores (thrush) I was hesitant to go back to Advair, told my Doc this and he instead gave me Serevent/Flovent.  By this time, knowing I was again starting inhaled steroids, I started the routine of rinsing twice with water, brushing teeth and tongue, and  swish/gargle/swallow the Nystatin.  Still nothing was helping.  
  Two days ago after a really bad asthma night I went back to my Doc.  Got a RX for a nebulizer and meds for it, and told the Nurse practitioner I saw that Serevent/Flovent inhalers I had were not as effective with my asthma as the Advair had been and could I be switched back.  She agreed and gave me a helpful hint to TRY to get rid of the thrush.  Now I'm rinsing twice, brushing teeth and mouth, swish/gargle, swallowing the Nystatin, and after letting that set for awhile I'm rinsing my mouth with 1 part Apple Cider Vinegar and 2 parts Water. (Don't swallow this)  
   My primary Doc gave my Mycelex tablets when I mentioned the thrush to him, so I use a couple of those daily as well. Both of my Doctors say that yogurt with Active cultures won't help, but I bought some to try anyway.  Then I remembered my plan to stay away from as much dairy as possible.  
  Does anyone have any other methods that seem to work?   If the yogurt with active cultures or Acidopholus (sp?) pills won't help as my Doc's say... will Probiotics?

[taxigirl]

I dont understand why a Dr. would change you from Advair, to the Serevent/Flovent in reaction to your concern about thrush, as it is the Flovent (corticosteroid) that 'feeds' the thrush. I am on the Advair several months now. What helps me when thrush starts to take control, is putting about 10-15 drops of Tea Tree Oil in a small amount of water, maybe  a couple tablespoons (after brushing teeth and tongue and rinsing) and gargle, and swish this around. Do not swallow.
Tea tree oil is a natural antiseptic/antifungal.

[knerak]

A related discussion, knerak was started.

[Suzy56]

A related discussion, Advair and cause of thrush was started.