SYMBICORT 200/6 TURBOHALER®
Asthma, maintenance therapy
▶BY INHALATION OF POWDER
▶Child 12–17 years:Initially 1 – 2 puffs twice daily; reduced
to 1 puff daily, dose reduced only if control is
maintained
Asthma, maintenance and reliever therapy
▶BY INHALATION OF POWDER
▶Child 12–17 years:Maintenance 2 puffs daily in
1 – 2 divided doses, increased if necessary to 2 puffs
twice daily; 1 puff as required for relief of symptoms,
increased if necessary up to 6 puffs as required, max.
8 puffs per day; up to 12 puffs daily can be used for a
limited time but medical assessment is recommended
SYMBICORT 400/12 TURBOHALER®
Asthma, maintenance therapy
▶BY INHALATION OF POWDER
▶Child 12–17 years:Initially 1 puff twice daily; reduced to
1 puff daily, dose reduced only if control is maintainedlINTERACTIONS→Appendix 1 : beta 2 agonists.
corticosteroids
lPATIENT AND CARER ADVICEPatient counselling is advised
for budesonide with formoterol inhalation
(administration).
With high doses, a steroid card should be supplied.
lNATIONAL FUNDING/ACCESS DECISIONS
Scottish Medicines Consortium (SMC) Decisions
TheScottish Medicines Consortiumhas advised (June 2017 )
that budesonide/formoterol 100 micrograms/ 6 micrograms
and 200 micrograms/ 6 micrograms (Symbicort®SMART®)
is accepted for use within NHS Scotland for regular
treatment of asthma where use of a combination (inhaled
corticosteroid and a long-actingb 2 adrenoceptor agonist)
is appropriate: patients already adequately controlled on
both or patients not adequately controlled with inhaled
corticosteroids and“as needed”short-actingb 2
adrenoceptor agonists. This advice relates to the extension
of the license forSymbicortmaintenance and reliever
therapy (SMART®) to adolescents aged 12 years and over.lMEDICINAL FORMS
There can be variation in the licensing of different medicines
containing the same drug.
Inhalation powder
CAUTIONARY AND ADVISORY LABELS8, 10(high doses)
▶Symbicort Turbohaler(AstraZeneca UK Ltd)
Formoterol fumarate dihydrate 6 microgram per 1 dose,
Budesonide 100 microgram per 1 doseSymbicort 100 / 6
Turbohaler| 120 doseP£ 28. 00 DT = £ 28. 00
Formoterol fumarate dihydrate 6 microgram per 1 dose,
Budesonide 200 microgram per 1 doseSymbicort 200 / 6
Turbohaler| 120 doseP£ 28. 00 DT = £ 28. 00
Formoterol fumarate dihydrate 12 microgram per 1 dose,
Budesonide 400 microgram per 1 doseSymbicort 400 / 12
Turbohaler| 60 doseP£ 28. 00 DT = £ 28. 00eiiiiF 159Ciclesonide 21-Dec-2017
lINDICATIONS AND DOSE
Prophylaxis of asthma
▶BY INHALATION OF AEROSOL
▶Child 12–17 years: 160 micrograms once daily; reduced
to 80 micrograms daily, if control maintainedlINTERACTIONS→Appendix 1 : corticosteroids
lPATIENT AND CARER ADVICEPatients or carers should be
given advice on how to administer ciclesonide aerosol
inhaler.lMEDICINAL FORMS
There can be variation in the licensing of different medicines
containing the same drug.
Pressurised inhalation
CAUTIONARY AND ADVISORY LABELS 8
▶Alvesco(AstraZeneca UK Ltd)
Ciclesonide 80 microgram per 1 doseAlvesco 80 inhaler|
120 doseP£ 32. 83 DT = £ 32. 83
Ciclesonide 160 microgram per 1 doseAlvesco 160 inhaler|
60 doseP£ 19. 31 DT = £ 19. 31 | 120 doseP£ 38. 62 DT =
£ 38. 62
eiiiiF 159Fluticasone 21-Dec-2017
lINDICATIONS AND DOSE
Prophylaxis of asthma
▶BY INHALATION OF POWDER
▶Child 5–15 years:Initially 50 – 100 micrograms twice
daily (max. per dose 200 micrograms twice daily), dose
to be adjusted as necessary
▶Child 16–17 years:Initially 100 – 500 micrograms twice
daily (max. per dose 1 mg twice daily), dose may be
increased according to severity of asthma. Doses above
500 micrograms twice daily initiated by a specialist
▶BY INHALATION OF AEROSOL
▶Child 4–15 years:Initially 50 – 100 micrograms twice
daily (max. per dose 200 micrograms twice daily), dose
to be adjusted as necessary
▶Child 16–17 years:Initially 100 – 500 micrograms twice
daily (max. per dose 1 mg twice daily), dose may be
increased according to severity of asthma. Doses above
500 micrograms twice daily initiated by a specialist
▶BY INHALATION OF NEBULISED SUSPENSION
▶Child 4–15 years: 1 mg twice daily
▶Child 16–17 years: 0. 5 – 2 mg twice dailylINTERACTIONS→Appendix 1 : corticosteroids
lDIRECTIONS FOR ADMINISTRATIONFluticasone nebuliser
liquid may be diluted with sterile sodium chloride 0. 9 %. It
is not suitable for use in ultrasonic nebulisers.
lPATIENT AND CARER ADVICEPatients or carers should be
given advice on how to administer allfluticasone
inhalations preparations.
With high doses, a steroid card should be supplied.
Medicines for Children leaflet: Fluticasone inhaler for asthma
prevention (prophylaxis)www.medicinesforchildren.org.uk/
fluticasone-inhaler-for-asthma-preventionlMEDICINAL FORMS
There can be variation in the licensing of different medicines
containing the same drug.
Inhalation powder
CAUTIONARY AND ADVISORY LABELS8, 10
▶Flixotide Accuhaler(GlaxoSmithKline UK Ltd)
Fluticasone propionate 50 microgram per 1 doseFlixotide
50 micrograms/dose Accuhaler| 60 doseP£ 4. 00 DT = £ 4. 00
Fluticasone propionate 100 microgram per 1 doseFlixotide
100 micrograms/dose Accuhaler| 60 doseP£ 8. 00 DT = £ 8. 00
Fluticasone propionate 250 microgram per 1 doseFlixotide
250 micrograms/dose Accuhaler| 60 doseP£ 25. 51 DT = £ 25. 51
Fluticasone propionate 500 microgram per 1 doseFlixotide
500 micrograms/dose Accuhaler| 60 doseP£ 43. 37 DT = £ 43. 37
Pressurised inhalation
CAUTIONARY AND ADVISORY LABELS8, 10
▶Flixotide Evohaler(GlaxoSmithKline UK Ltd)
Fluticasone propionate 50 microgram per 1 doseFlixotide
50 micrograms/dose Evohaler| 120 doseP£ 5. 44 DT = £ 5. 44
Fluticasone propionate 125 microgram per 1 doseFlixotide
125 micrograms/dose Evohaler| 120 doseP£ 12. 50 DT = £ 12. 50
Fluticasone propionate 250 microgram per 1 doseFlixotide
250 micrograms/dose Evohaler| 120 doseP£ 20. 00 DT = £ 20. 00162 Airways disease, obstructive BNFC 2018 – 2019
Respiratory system3