My Dr. Told me yesterday use my nebulizer or ventolin inhaler first before taking the long acting medications because it helps open your airways to allow the other ones to work.Also said did not matter which inhaler I use first either the breo or the spiriva respimat.I wasn't sure with the Respimat being a mist and the Breo a powder.Hope everyone is having a great day

A lot of people do what SuZZ does: Symbicort first thing in the morning and Spiriva at some other time; consistently at that time every day. There are some folks who think that if you give yourself at least a couple of hours between meds, even if they target the same receptors in the lungs, the time will allow the first ones to wear off and the second ones to attach to the proper receptors.

And there are docs that will tell you that by doing your meds in that order, the Advair is not able to attach to the receptors because the albuterol got there first. You're right that Spiriva is a different sort of med and targets the smooth muscle in the bronchial tubes; it's a LAMA, while Advair is both a LABA and an ICS combined. That why it generally doesn't target the same receptors as bronchodilators like albuterol and the one in Advair. The order that we take our meds is something that really is debated a lot and people just don't agree on what's best. You do what works for you......

What does your doctor recommend, @A MyCOPDTeam Member?
Mine wrote my rx to take my 2 puffs from Symbicort right after my morning albuterol (rescue) inhaler. I repeat this in late afternoon, early evening. I use my Spiriva in middle of day...
SuZz
AND remember to rinse mouth well with water!

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A MyCOPDT...

I bothers me that so many people are on meds and have so many questions. It is something that is discussed with my Doc and/or Pulmonologist. Pharmacists know alot. Every prescription I get is always accompanied with information to be read every time.