<s>[INST] I suffer fro COPD. My Ige count is 599. I inhale one capsule of Indacetorol 300 in the morning followed by 2 puffs of Budecort 200 at 1100 am and again at 8:30 pm. I can also use Levolin as required, but to be restricted to once or twice a day. My breathing was reasonable as long as it was raining, but the moment rains stopped, I am miserable & can hardly walk & keep coughing up phlegm. My doctor has asked me to cahnga to Formonide 400 twice a day , in lieu of Budecort. Please advise. I am miserable. I live in Pune, Maharashtra, India. [/INST] Yhanks for your question on HCM.In my opinion you should get done chest x ray first to rule out chest infection. As infections are the most common cause for COPD worsening. And you are having phlegm also, which favours infection.So better to start antibiotics also to supress infection.And formonide 400 is having steroid in higher dose. So no harm in taking it.Also start mucolytic snd cough expectorant. Start anti inflammatory drug too. </s>