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If A person didn’t respond to Accolate, but does have asthma triggered by allergies, will he/she be likely to respond to Singulaire or no?  Please post reply if you know the answer…sorry if this is an old question… Yana

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If A person didn’t respond to Accolate, but does have asthma triggered by allergies, will he/she be likely to respond to Singulaire or no?  Please post reply if you know the answer…sorry if this is an old question… Yana

Old but worth repeating. The two drugs havethe same mechanism of action, thus logic dictates that if one didn’t work, the other shouldn’t. However, people are very different in how they absorb, metabolize and excrete drugs.  We all know people for whom ibuprofen doenst help with a headache while aspirin does wonders — yet they share a common mechanism. No studies have been done to address your question.  There has been one post on this newsgroup from someone who had a beneficial response to Singulaire after expereiencing no benefit from Accolate.  Again – these two drugs are about as side-effect free as anything to come down the pike in ages, so, with the knowledge of your doctor, you are the best guinea pig.  The probability is – nope – if one didnt work, the other won’t … but with higher odds against, some people DO win the lottery.

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Accolate did not really work all that well for me,  Singulair is helping.  It is also keeping my nose from the dripping that goes on this time of year, so that useful too.

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If A person didn’t respond to Accolate, but does have asthma triggered by allergies, will he/she be likely to respond to Singulaire or no?  Please post reply if you know the answer…sorry if this is an old question… Yana

I was on accolate for about four months, but it didn’t help much.  This April my doctor switched me to Singulair and I could notice the difference in two days.  My peak flow has shot up from an 85% average to a 94% average. Serevent and Accolate may work on the same pincipal, but Singular sure works a lot better for me.

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If A person didn’t respond to Accolate, but does have asthma triggered by allergies, will he/she be likely to respond to Singulaire or no?  Please post reply if you know the answer…sorry if this is an old question… Yana I was on accolate for about four months, but it didn’t help much.  This April my doctor switched me to Singulair and I could notice the difference in two days.  My peak flow has shot up from an 85% average to a 94% average. Serevent and Accolate may work on the same pincipal, but Singular sure works a lot better for me.

I second that emotion. I have severe asthma, took Accolate for over 3 months with no benefit. Yesterday evening I took my very first  dose of Singulair and at bedtime my peak flow had improved by 7%. This morning it was still holding. Could be a fluke. My goal is to stabilize my asthma — which still requires short courses of prednisone a little too frequently –by taking only Serevent, theophylline, and a medium-low dose of Flovent, in addition to Singulair. Watch for subsequent posts. FC

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- Hide quoted text — Show quoted text – If A person didn’t respond to Accolate, but does have asthma triggered by allergies, will he/she be likely to respond to Singulaire or no?  Please post reply if you know the answer…sorry if this is an old question… Yana I was on accolate for about four months, but it didn’t help much.  This April my doctor switched me to Singulair and I could notice the difference in two days.  My peak flow has shot up from an 85% average to a 94% average. Serevent and Accolate may work on the same pincipal, but Singular sure works a lot better for me. I second that emotion. I have severe asthma, took Accolate for over 3 months with no benefit. Yesterday evening I took my very first  dose of Singulair and at bedtime my peak flow had improved by 7%. This morning it was still holding. Could be a fluke. My goal is to stabilize my asthma — which still requires short courses of prednisone a little too frequently –by taking only Serevent, theophylline, and a medium-low dose of Flovent, in addition to Singulair. Watch for subsequent posts. FC

I too just started Singulair, taking my first dose last nite (5-22). It seems to be helping so I cut my dose of Serevent from 2pfx2 to 1pfx2, and dose of Vanceril DS from 2pfx2 to 1pfx2; am still taking TheoDur 200mgx2. Peak flow is running over 100%, or so it seems. Time will tell, I’ll have a better feel for this after a week or so. It cost me $70 at Walgreen’s for a 30-day supply, well worth it if it continues to work this well. But I want to get my HMO to pay for it, like they do my other asthma meds (Vanceril DS, Ventolin, Serevent, Intal, TheoDur). It should be cost effective for them; I could probably drop the Intal and TheoDur, and reduce the Vanceril and Serevent. I understand I have to get my doctor to write a justification for Singulair, since its not on the formulary of my HMO, even with prior approval required; but have heard others got it approved after their doctor stated they are intolerant to Accolate, but a trial of Singulair works. Ellis

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– Hide quoted text — Show quoted text – If A person didn’t respond to Accolate, but does have asthma triggered by allergies, will he/she be likely to respond to Singulaire or no?  Please post reply if you know the answer…sorry if this is an old question… Yana I was on accolate for about four months, but it didn’t help much.  This April my doctor switched me to Singulair and I could notice the difference in two days.  My peak flow has shot up from an 85% average to a 94% average. Serevent and Accolate may work on the same pincipal, but Singular sure works a lot better for me. I second that emotion. I have severe asthma, took Accolate for over 3 months with no benefit. Yesterday evening I took my very first  dose of Singulair and at bedtime my peak flow had improved by 7%. This morning it was still holding. Could be a fluke. My goal is to stabilize my asthma — which still requires short courses of prednisone a little too frequently –by taking only Serevent, theophylline, and a medium-low dose of Flovent, in addition to Singulair. Watch for subsequent posts. FC I too just started Singulair, taking my first dose last nite (5-22). It seems to be helping so I cut my dose of Serevent from 2pfx2 to 1pfx2, and dose of Vanceril DS from 2pfx2 to 1pfx2; am still taking TheoDur 200mgx2. Peak flow is running over 100%, or so it seems. Time will tell, I’ll have a better feel for this after a week or so. It cost me $70 at Walgreen’s for a 30-day supply, well worth it if it continues to work this well. But I want to get my HMO to pay for it, like they do my other asthma meds (Vanceril DS, Ventolin, Serevent, Intal, TheoDur). It should be cost effective for them; I could probably drop the Intal and TheoDur, and reduce the Vanceril and Serevent. I understand I have to get my doctor to write a justification for Singulair, since its not on the formulary of my HMO, even with prior approval required; but have heard others got it approved after their doctor stated they are intolerant to Accolate, but a trial of Singulair works. Ellis

My second dose of Singulair maintained and slightly enhanced the effect of the first dose. I have been on a burst of 30 mg of prednisone for 7 days, with mediocre results and today I took 10 mg because I feel much better. Of course, it could very well be that the prednisone started kicking in right after the 7th day (grin]. What I noticed is that Singulair *seems*  to make the other medications work better. It takes 3 to 4 hrs for this drug to reach mean peak plasma concentration (Cmax). Theo-Dur takes about 4 hrs. I took Singulair 1 hr after my Theo-Dur and after 4 hrs my lungs, which generally are hyperinflated because of some trapped air, felt like a pricked ballon. Mucus seems to be less and thinner. All in all, my airways seem to be less irritable and reactive. Nothing miraculous, but quite significant. According to studies, it took 3 weeks for Singulair to improve peak flow to 12 per cent of baseline, 9 weeks to reach 14 per cent improvement. My insurance, an individual Blue Shield plan, will provide through its pharmacy a 3-month supply of Singulair for $55.00, because it’s non-formulary. BTW, Ellis, your condition seems to be what  the Italians call "asmetta", i.e., "baby asthma". You’re a lucky guy. On the other hand, I went from back-to-back hospitalizations and near respiratory arrest on my onset year  (1970) to complete freedom from symptoms *and* medication for sixteen years. After 1989 it’s been all downhill.  This is one crazy, unpredictable ailment, especially when it’s non-allergic like mine. FC

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If A person didn’t respond to Accolate, but does have asthma triggered by allergies, will he/she be likely to respond to Singulaire or no?  Yana I was on accolate for about four months, but it didn’t help much.  This April my doctor switched me to Singulair and I could notice the difference in two days.  My peak flow has shot up from an 85% average to a 94% average. I second that emotion. I have severe asthma, took Accolate for over 3 months with no benefit. Yesterday evening I took my very first  dose of Singulair and at bedtime my peak flow had improved by 7%. This morning it was still holding. Could be a fluke. My goal is to stabilize my asthma — which still requires short courses of prednisone a little too frequently –by taking only Serevent, theophylline, and a

medium-low dose of Flovent, in addition to Singulair. Watch for subsequent posts. FC – Hide quoted text — Show quoted text – I too just started Singulair, taking my first dose last nite (5-22). It seems to be helping so I cut my dose of Serevent from 2pfx2 to 1pfx2, and dose of Vanceril DS from 2pfx2 to 1pfx2; am still taking TheoDur 200mgx2. Peak flow is running over 100%, or so it seems. Time will tell, I’ll have a better feel for this after a week or so.—-cut—- Ellis My second dose of Singulair maintained and slightly enhanced the effect of the first dose. I have been on a burst of 30 mg of prednisone for 7 days, with mediocre results and today I took 10 mg because I feel much better. Of course, it could very well be that the prednisone started kicking in right after the 7th day (grin]. What I noticed is that Singulair *seems*  to make the other medications work better. It takes 3 to 4 hrs for this drug to reach mean peak plasma concentration (Cmax). Theo-Dur takes about 4 hrs. I took Singulair 1 hr after my Theo-Dur and after 4 hrs my lungs, which generally are hyperinflated because of some trapped air, felt like a pricked ballon. Mucus seems to be less and thinner. All in all, my airways seem to be less irritable and reactive. Nothing miraculous, but quite significant. According to studies, it took 3 weeks for Singulair to improve peak flow to 12 per cent of baseline, 9 weeks to reach 14 per cent improvement. My insurance, an individual Blue Shield plan, will provide through its pharmacy a 3-month supply of Singulair for $55.00, because it’s non-formulary. BTW, Ellis, your condition seems to be what  the Italians call "asmetta", i.e., "baby asthma". You’re a lucky guy. On the other hand, I went from back-to-back hospitalizations and near respiratory arrest on my onset year  (1970) to complete freedom from symptoms *and* medication for sixteen years. After 1989 it’s been all downhill.  This is one crazy, unpredictable ailment, especially when it’s non-allergic like mine. FC

FC, I’ve had seasonal asthma since age 9, came down with adult onset asthma in ‘89 after a bad case of bronchitis; ended up in ER for 7 hours with severe wheezing; needed IV steroids and aminophylline; was treated with steroid inhalers including 24 pf/day of Azmacort which gave me a ‘moon face’. The condition has gradually improved to the point I was using 4-6 pf/day of Vanceril DS etc. I had 5 yr of allergy shots (pollen, dust mites) At times my peak flows have dropped to 50% PB, but I have always been able to handle it with increased use of inhalers at home. So my asthma is apparently not as serious as those with the nonallergic variety. The lowest my peak flow has gone is to 100 L/min (20% PB) when I had an allergy shot on a day I hadn’t taken my asthma meds, a couple shots or epinephrine brought it back up, from the asthma doctor, 1 1/2 hr after the allergy shots. I have now taken 2 Singulair pills in 2 days, peak flow is 100%. And I have also stopped using the Vancenase nasal spray; was using 1 sniff/nostril. So I hope I can get the Health Net HMO to approve it, I have a $5 copayment for either a 30-day supply locally, or 90-day mailorder. Ellis

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– Hide quoted text — Show quoted text -FC, I’ve had seasonal asthma since age 9, came down with adult onset asthma in ‘89 after a bad case of bronchitis; ended up in ER for 7 hours with severe wheezing; needed IV steroids and aminophylline; was treated with steroid inhalers including 24 pf/day of Azmacort which gave me a ‘moon face’. The condition has gradually improved to the point I was using 4-6 pf/day of Vanceril DS etc. I had 5 yr of allergy shots (pollen, dust mites) At times my peak flows have dropped to 50% PB, but I have always been able to handle it with increased use of inhalers at home. So my asthma is apparently not as serious as those with the nonallergic variety. The lowest my peak flow has gone is to 100 L/min (20% PB) when I had an allergy shot on a day I hadn’t taken my asthma meds, a couple shots or epinephrine brought it back up, from the asthma doctor, 1 1/2 hr after the allergy shots. I have now taken 2 Singulair pills in 2 days, peak flow is 100%. And I have also stopped using the Vancenase nasal spray; was using 1 sniff/nostril. So I hope I can get the Health Net HMO to approve it, I have a $5 copayment for either a 30-day supply locally, or 90-day mailorder. Ellis

Interesting story, Ellis. Strictly speaking, though, yours is not adult-onset asthma, since  the first episodes occurred during your childhood, as is typical of allergic asthma. Then it just lay dormant until the infection rekindled it. My son, now 27, had asthma from age 8 months to 10 years. Finally turned out to be allergy to animals. Once he learned to avoid pets (and people who live with them) he’s been fine. He’s still sensitive to tobacco smoke, though, and to certain foods. So he’s still at risk, though medication-free. It was different for me. I had the first symptoms at age 32, when I barely knew there was such a thing as asthma. The rest is history. The blessing in disguise is that despite the rather frequent use of prednisone over the last 2 years everything is testing out normal – eyes, ABP, potassium, blood sugar, etc. No visible side effects either. Doctors had told me way back that I "hold steroids well". Still fear them, though. Third day on Singulair. Peak flow is 92% of my personal best for the last couple of years, a 9.3% improvement in three days. I cut the prednisone burst from 25 mg to 7.5 mg and will taper it by 2.5 mg per day before discontinuing. I will wait a few weeks before I venture to reduce the other meds, primarily the Flovent 240 2pf/bid. Not being a coffee or tea drinker, I will stick with the Theo-Dur 300/bid, my old mainstay. Serevent might be a second distant target for elimination. Inhalers tend to be irritants for me and contribute to the morbidity of my asthma. Will try and get an authorization for Singulair. The copayment would still be around $25 for a 90-day mail-order supply. It’s a raw deal when you’re self-employed. FC

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Tell us about the mail order house.  Is it only for BC/BS?  I pay $67 with a discount insurance card from Mutual of Omaha, on my private insurance.  Maybe I can get a better deal?? After about a month on Singulair, having switched from Accolate, it is definitely helping my cough varient type asthma, and much easier to administer.  I’m hardly using any inhalers now, and my problems with sinusitis seem gone. If I feel some sinus thing starting, I use the Waterpic with Grossan Nasal adapter once and it clears it up.  So far, so good. (Snip) Will try and get an authorization for Singulair. The copayment would still be

around $25 for a 90-day mail-order supply. It’s a raw deal when you’re self-employed. FC<< Sue M.

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