Hi Kasiewith2,

Thank you for your question! First, Proventil is the brand name for albuterol, so you should not be using both of these inhalers at the same time. Overdosing on albuterol is not something that you want to do. Secondly, were you ever shown how to properly use all the different inhalers? Even though you've taken them for quite some time, if you're not using the right technique, all the medication may not even be getting in to your system (and therefore not helping). Talk to your doctor or pharmacist about the proper way to use each inhaler.

Has anything changed recently to send your asthma into overdrive? A new pet? Did the neighbor take up smoking? Did you forget to dust since last October? A new cologne or perfume? New construction nearby? Usually asthma involves a trigger. See if you can figure out what triggered your asthma, and then see if there's anything you can do to get rid of it.

If you're using all the inhalers the right way, the next step is to make sure you're on the best therapy available. What dose of Advair are you taking? Advair is available in three strengths (100/50, 250/50, and 500/50). No matter what the dose, you should only use one inhalation in the morning and one in the evening. Advair contains two medication (the two different numbers in the strength), and you shouldn't use more than 50mcg of salmeterol in a dose, which is equivalent to one inhalation. If you're on one of the lower doses, ask your doctor about getting a dose increase.

Same thing with the Flovent. The Flovent inhaler is available in 44mcg, 110mcg, and 220mcg doses. The maximum dose of Flovent is 880mcg twice a day, which would be four puffs in the morning and four puffs at night. Back to inhaler technique - make sure that you wait a minute or two between each puff. It may be inconvenient (four puffs of Flovent and a puff of Advair would take a full 10 minutes), but it's the best way to let the medication get into your system. If you're not waiting between puffs, your body can't absorb all the medication (not only is it not helping, it's wasting your money!).

The Proventil is a rescue inhaler, as you mentioned. If you are using the rescue inhaler more than 2-3 times per week, your asthma regimen should be adjusted to better control your symptoms. Since you stated that you're waking up about twice each night to use your rescue inhaler, you're in serious danger of having big problems that might require a trip to the ER. Talk to your doctor about what's going on, ask for a review of how to use each inhaler, and work on getting it under control!

Best of luck,

Casey