Suffering from Candidiasis intestinally after taking high dose of prednisone for asthma control, what do you advise?

Posted on Thu, 23 Jan 2014

Question: Hi there, I've been taking Symbicort 200/6 for 18 months now. My asthma is worse not better, & I need prednisone at least 3/4 times per year just to get by. I'm 59 years of age & female & have gained a lot of weight since starting on this new regime. My GP has not discussed or provided me with an asthma action plan, & I recently have had a bad spell. I've been taking 4 puffs twice daily to maintain after a big hit of prednisone to get my asthma under control.but the website indicates this is far too much. I'm very worried about my respiratory health. I have a bad case of candiasis intestinally at present/ What do you advise?

Answered by Dr. Shruti Rijhwani (58 minutes later)

Brief Answer: Follows. Detailed Answer: Dear Madam, Thank you for posting your query on XXXXXXX Well looking into your problem I would like to tell you that using steroids lead to weight gain so it happens to be a much anticipated event . Symbicort contains Budesonide which is a steroid and Formoterol which is a long acting beta agonist . I would recommend Short-acting beta2-adrenoceptor agonists such as salbutamol inhalers as the first line management for acute attacks rather than prednisolone . Ipratropium bromide , Tiotropium bromide should be used in conjunction with salbutamol for effective management . You should stop taking excess steroid as you are suffering from candida infection but it needs to be tapered under supervision . I will advise you to discuss these possibilities with your treating physician as he remains the best judge for your treatment . Take care. Dr. Shruti

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Shruti Rijhwani (11 hours later)

Hi Dr XXXXXXX Thank you for your response to my question. I do use a salbutamol inhaler, ( Ventolin) when required. I've recently changed back from Respigen ( a generic brand here in NZ) which was causing acute hoarseness, to the point where I could barely talk. I discovered the Respigen was the culprit by accident when talking to another asthmatic. I understand this is not the only cause as the candiasis also causes loss of vocal performance. I have a cyst in my saliva gland which is to be removed on 23 XXXXXXX NZ time & am hoping to attend the asthma clinic post op. I used to use Flixotide preventer, with Oxis as a top up. Do you think I should revert back to Flixotide in a stronger dosage or use another preventer that is not a steroid? XXXXXXX

Answered by Dr. Shruti Rijhwani (4 hours later)

Brief Answer: Follows. Detailed Answer: Dear Madam, I will advise you to to talk to your doctor regarding ipotropium and yes you can use Flixotide once your candidiasis is resolved . But a stronger dose is not recommended . Dr. Shruti

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar