Advair..for child with chronic cough???

[momof2inohio]

Took my 9 year old DD to her pediatrician yesterday because DD has had a cough off and on for the past few months. No other symptoms..it is just a dry cough. Once in a while she has congestion with it but nothing else.

Dr. quickly just decided to put her on Advair. After filling it at the pharmacy and getting sticker shock at the price even with my copay I read more about it. First, I am not sure why she prescribed an inhaler when she does not have asthma. Second, it seems as though there are a lot of side effects. I am just not comfortable with her using this monthly. I thought the Dr. would put her on some kind of pills for allergies.

I am not pleased with her pediatrician and in fact I just made her an appt. to my family Dr. to get a second opinion...but until then any thoughts from anyone who has been on Advair??

[lasab]

I don't have experience with Advair, but my 5 year old DS is on Flovent. It is also an asthma controller. For us it has been a miracle drug. My son does have asthma and in the past it has been very hard to control his asthma once he gets a flare-up. We would usually end up in the ER and he would have to go on oral steroids because the asthma treatment inhaler would not be effective. During the winter months he would have to go on oral steroids 4 or 5 times. Flovent has changed all of that. He has now gone over a year without oral steroids. For me, I know that flovent has side effects, but they far outway the pattern of being on steroids so much. BTW his asthma has always presented as a cough instead of a wheez.

I think I would have had reservations about putting him on a daily preventative treatment if we didn't have such a long history...and it sounds like you don't have much of a history where they have not yet even diagnosed asthma. I would probably get a second opinion too.

[momof2inohio]

Thanks for your help! Glad that your son finally found something that helps him. I know how frustrating that can be when nothing helps. We do not have any family history of asthma although when I was little I always had a hard time breathing. They never diagnosed me with asthma but just allergies and I had to take shots. Almost everyone in our family including DH and I have allergies.

I think I may take her to an allergy specialist to get her tested to see what she is allergic to so we know. I just hope its not our dog that she is allergic to.

[abond0017]

I don't know much about children taking advair, however my mom takes it. It has been a godsend for her but she has very severe asthma. Since this is not the case for your little one, I would be hesitant and get a second opinion too. I do know though that asthma is not just the kind that makes it hard to breathe...there is a type of asthma called cough variant asthma where a dry persistent cough is the only symptom. I have a pretty constant cough that is dry about half of the time and it is due mostly to bronchitis and a little bit to post nasal drip from allergies.

Good luck on the second opinion.

[amylynne01]

Just happened on this post because the title caught my eye. My hubby is a respiratory therapist and deals with these situations all the time. I asked him for his advice.

He said that with your daughter's symptoms, the use of Advair is not indicated. Advair is used as a maintenance drug for people with asthma if a rescue inhaler does not work. If your daughter has a cough, the cause of it needs to be determined BEFORE giving any drugs. If the cough is from an allergy (pet dander, dust, mold, perfume, etc), then the Advair will do more harm than good.

He recommended either seeing an allergist or doing some experimenting on your own. When her cough starts, is she around the dog, in a dusty area, at a friend's, around a certain smell, exercising, etc? In essence figure out the triggers for her cough. The allergist can do a series of scratch tests to figure out what she might be allergic to.

[CW&M Mom]

I agree with the above.

Also advair can have very serious side effects. There's a reason they have to put in the commercials now...that it has caused deaths. My sister has permanent lung damage from it.

Advair is an option for someone who has asthma that can't be controlled any other way. It's a much safer route to go with albuterol and something like flovent as a preventative instead.

For my daughters the combo of. Flovent, reflux meds (she take's zantac) and zyrtec has what finally curbed her constant cough. we only use albuterol when she's sick. I agree an allergist and even an ENT, Asthma doc ect...would be a better choice to manage the cough...if you have a ped willing to throw advair at a young child...when nothing else with less side effects has been tried first.

[rebate_queen]

A couple of years ago, my DD had a cough and wheezing that wouldn't go away. Finally took her to the allergist, said she had all kinds of allergies, even though she'd never had any symptoms before the cough. He wanted to put her on 4 different meds and a rescue inhaler. I am not big on medicine, so I put her on one of them with the rescue inhaler. I ended up going to 2 medicines on the advice of her pediatrician, and it finally cleared it up.

I ended up taking her to another allergy doctor who thought she just had some kind of ongoing bronchitis thing instead of asthma, which is what the first doctor was saying she probably had. I never thought she had asthma, so I am glad I went to that doctor. He had her on Singulair and Zyrtec. She was doing well, so I decided to stop the Zyrtec. I finally ended up taking her off everything, and she was just using her rescue inhaler if she had a little bout with it. She recently had a little longer bout over the winter, but that's the worst it's gotten.

I agree with amylynne and her DH. Try to figure out what's causing the cough first. I still don't fully know what triggers my DD when she has a little bout, but I firmly believe that when it was ongoing it was due to the Madagascar Hissing Cockroaches she had in her classroom at the time. That was one of the things she was allergic to, and she started to get better after the school year was over and she was out of that classroom. The teacher wasn't willing to remove them, and I didn't push because the doctor didn't think that small amount of exposure would cause her to cough like that.

I just don't think I would do the Advair......get another opinion for sure. My DD is 10 now but this all happened when she was 8 going on 9, so I understand what you're going through.

[momof2inohio]

I am just really mad that her pediatrician did not try anything else first! I have been going to this group of Dr's since my DS was born and they have always been great but this one Dr. that we see in the group I do not like and that is who we saw yesterday at my DD's appt. She asked my DD a few questions and then wrote the script for Advair. After that she says "Oh yeah, we should do the spyrometer (sp?) test" So she tested my DD and said her lungs were fine so no asthma.

I am going to take her to my Dr. and then after he checks her I will get a referral to an allergist. I will also try to pinpoint what could be causing her to cough. The only thing I can think of is our dog, but we have had her for 4 years. The Dr. said it could be dust mites. We took all of her stuffed animals out of her room and put an air purifier in her room. I am going to get her a mattress cover as well.

I know that I am allergic to cats, horses, dust, mold, pollen, ragweed and just about anything outside so she probably has several allergies like me.

[lasab]

One other thought...I am not a doctor, BUT...It seems weird to me that the doc would put your daughter on a preventative drug to treat a more active episode. The preventative, controler type drugs are very specific that they are not to be used to treat a flare-up. It just seems backwards to me that the preventative drug would be used to help her current cough. If she has asthma, it would seem that they would need to treat the current asthma with albuterol or oral steroids and then if indicated, use a preventative drug to keep it from happening again. I also wanted to mention something about allergies...there is a very strong connection between allergies and asthma. Often an allergy will be the trigger of an asthma attack. Just my two cents.

[CW&M Mom]

The one thing we found flovent to do...is help curb the cough...because it's an inhaled steroid it stops the inflammation that is going on. For my daughter...because she was either coughing or clearing her throat all the time..even if we could get the allergies under control...the coughing/clearing throat kept everything inflamed. Flovent will stop that inflammation...AND it can help the inflammation of upper airway and not just the lungs (two different area's). Advair sole help is for the lungs.

So yes preventative medication can help a current cough...especially when your speaking in a steroid sense...flovent and similar drugs only work as a steroid for those area's though...so they are considered much much safer then regular steroids and don't have the side effects of predisone or similar drugs.

Advair though just has too many risks involved to be thrown at something not severe and when you have no idea what the problem is.

As for allergies...they can get worse over time. My oldest didn't really show any symptoms until age 2...with it getting worse at age 4. Also with dogs...sometimes the problem isn't actually the dog they are allergic too...but what they get themselves into. So if your daughter is allergic to ragweed as an example...and the dog is running and jumping into ragweed and then bringing it home...viola you have a way she is exposed to it.