Q: I am a 45 years old man who is suffering from breathing problems for the last five years. My problem aggravates during a cold and dusty weather. Initially, the doctor advised me Aerocort inhaler and now he is advising me to go in for Seroflo. I am fine with both the drugs but I want to know, which will be safer one, and which will have least adverse effects?

A:It appears that you have asthma triggered by dust and cold weather which is a common problem. The first inhaler you mention has a combination of an inhaled steroid beclomethasone and a short acting bronchodilator salbutamol. The inhaled steroid works by decreasing inflammation in the air passages which is a major cause of asthma. The short acting bronchodilator relaxes the air passage muscles and makes it easier to breathe. I usually would prescribe these two drugs separately since you probably do not need multiple doses of the steroid component if you are using the inhaler for the quick relief features of the salbutamol. The beclomethasone is for continued use and not intermittently.

The second inhaler also has the essential inhaled steroid to decrease inflammation and in this case is fluticasone. The second drug in this combination is salmeterol which is a long acting bronchodilator and is to be taken twice a day. It does not work as a rescue inhaler and is more of a maintenance inhaler. If you use the second inhaler you will need to keep a short acting bronchodilator on hand to decrease shortness of breath in an emergent manner. One choice is albuterol or salbutamol. It will be best if you discuss this with your doctor and make a decision based on your particular health situation. As always avoiding dust and smoke as well as continued maintenance with an inhaled steroid will help with your asthma.