Symbicort - Budesonide with formoterol (1)

For the prophylaxis of asthma.
• Over 12 years: 160 micrograms once daily; reduced to 80 micrograms once daily, if control maintained; increased if necessary up to 320 micrograms twice daily, in severe asthma.

Budelin Novoliser for prophylaxis of asthma by inhalation of powder
• Adult: 200–800 mcg twice daily
Budelin Novoliser as an alternative in mild to moderate asthma by inhalation of powder, for patients previously stabilised on a twice-daily dose
• Adult: 200–400 mcg once daily to be taken in the evening. Maximum per dose 800 mcg.

For allergic rhinitis
• Over 12 years: one spray twice daily, dose to be administered into each nostril.

For the treatment of anaphylaxis and asthma.

By intravenous injection for acute hypersensitivity reactions
• Adult: 100–300 mg, to be administered as sodium succinate.

By intramuscular injection, or by intravenous injection for acute hypersensitivity reactions
• Child 1–5 months: initially 25 mg three times a day, adjust according to response.
• Child 6 months–5 years: initially 50 mg three times a day, adjust according to response.
• Child 6–11 years: initially 100 mg three times a day, adjust according to response.
• Child 12–17 years: initially 200 mg three times a day, adjust according to response.

By intravenous injection for severe acute asthma
• Child 1 month–1 year: 4 mg/kg every six hours. Maximum per dose 100 mg. Alternatively 25 mg every six hours until conversion to oral prednisolone. Preferably administer as sodium succinate.
• Child 2–4 years: 4 mg/kg every six hours. Maximum per dose 100 mg. Alternatively 50 mg every six hours until conversion to oral prednisolone. Preferably administer as sodium succinate.
• Child 5–11 years: 4 mg/kg every six hours. Maximum per dose 100 mg. Alternatively 100 mg every six hours until conversion to oral prednisolone. Preferably administer as sodium succinate.
• Child 12–17 years: 4 mg/kg every six hours. Maximum per dose 100 mg. Alternatively 100 mg every six hours until conversion to oral prednisolone. Preferably administer as sodium succinate.
• Adult: 100 mg every six hours until conversion to oral prednisolone. Preferably administer as sodium succinate.

For the treatment of anaphylaxis and asthma.

By intravenous injection for acute hypersensitivity reactions
• Adult: 100–300 mg, to be administered as sodium succinate.

By intramuscular injection, or by intravenous injection for acute hypersensitivity reactions
• Child 1–5 months: initially 25 mg three times a day, adjust according to response.
• Child 6 months–5 years: initially 50 mg three times a day, adjust according to response.
• Child 6–11 years: initially 100 mg three times a day, adjust according to response.
• Child 12–17 years: initially 200 mg three times a day, adjust according to response.

By intravenous injection for severe acute asthma
• Child 1 month–1 year: 4 mg/kg every six hours. Maximum per dose 100 mg. Alternatively 25 mg every six hours until conversion to oral prednisolone. Preferably administer as sodium succinate.
• Child 2–4 years: 4 mg/kg every six hours. Maximum per dose 100 mg. Alternatively 50 mg every six hours until conversion to oral prednisolone. Preferably administer as sodium succinate.
• Child 5–11 years: 4 mg/kg every six hours. Maximum per dose 100 mg. Alternatively 100 mg every six hours until conversion to oral prednisolone. Preferably administer as sodium succinate.
• Child 12–17 years: 4 mg/kg every six hours. Maximum per dose 100 mg. Alternatively 100 mg every six hours until conversion to oral prednisolone. Preferably administer as sodium succinate.
• Adult: 100 mg every six hours until conversion to oral prednisolone. Preferably administer as sodium succinate.

By mouth for acute exacerbation of chronic obstructive pulmonary disease
• Adult: 30 mg daily for 7–14 days.

By mouth for severe croup or mild croup that might cause complications (before transfer to hospital)
• Child: 1–2 mg/kg.

By mouth for mild to moderate acute asthma or severe or life-threatening asthma when oral corticosteroids have been taken for a few days
• Child 1 month–11 years: 2 mg/kg once daily (maximum dose 60 mg) for up to three days, longer if necessary.

By mouth for mild to moderate acute asthma or severe or life-threatening asthma
• Child 1 month–11 years: 1–2 mg/kg once daily (maximum dose 40 mg) for up to three days, longer if necessary.
• Over 12 years: 40–50 mg daily for at least five days.

By mouth for suppression of inflammatory and allergic disorders
• Adult: initially 10–20 mg daily, preferably taken in the morning after food. Can often be reduced after a few days but may need to be continued for a few weeks or months. Maintenance 2.5–15 mg daily. Cushingoid side-effects increase in likelihood with doses of over 7.5 mg daily.

By mouth for suppression of inflammatory and allergic disorders (initial dose in severe disease)
• Adult: initially up to 60 mg daily, dose preferably taken in the morning after food. Can often be reduced within a few days but may need to be continued for a few weeks or months.

By mouth for Covid-19 requiring supplementary oxygen
• Adult: 40 mg daily, for 10 days or until the day of discharge, whichever is sooner. 

Budelin Novoliser for prophylaxis of asthma by inhalation of powder
• Adult: 200–800 mcg twice daily
Budelin Novoliser as an alternative in mild to moderate asthma by inhalation of powder, for patients previously stabilised on a twice-daily dose
• Adult: 200–400 mcg once daily to be taken in the evening. Maximum per dose 800 mcg.

Prophylaxis and treatment of allergic rhinitis and nasal polyps by intranasal administration
• Over 6 years: 256 mcg once daily, to be administered as 2 sprays into each nostril in the morning, reduce dose when control achieved. Alternatively, 128 mcg twice daily, to be administered as 1 spray into each nostril in the morning and in the evening, reduce dose when control achieved.

Prophylaxis of asthma by nebulised suspension
• Child 6 months–11 years: 125–500 mcg twice daily, dose to be adjusted as required. Maximum 2 mg per day.
• Over 12 years: initially 0.25–1 mg twice daily, dose to be adjusted as required. Maximum 2 mg per day.

Prophylaxis of asthma by nebulised suspension
• Child 6 months–11 years: 125–500 mcg twice daily, dose to be adjusted as required. Maximum 2 mg per day.
• Over 12 years: initially 0.25–1 mg twice daily, dose to be adjusted as required. Maximum 2 mg per day.

Prophylaxis and treatment of allergic rhinitis and nasal polyps by intranasal administration
• Over 6 years: 256 mcg once daily, to be administered as 2 sprays into each nostril in the morning, reduce dose when control achieved. Alternatively, 128 mcg twice daily, to be administered as 1 spray into each nostril in the morning and in the evening, reduce dose when control achieved.

Prophylaxis of asthma by nebulised suspension
• Child 6 months–11 years: 125–500 mcg twice daily, dose to be adjusted as required. Maximum 2 mg per day.
• Over 12 years: initially 0.25–1 mg twice daily, dose to be adjusted as required. Maximum 2 mg per day.

Prophylaxis of mild to moderate asthma by inhalation of powder
• Child 6 months–11 years: 200–400 micrograms once daily, dose to be given in the evening.
• Over 12 years: 200–400 micrograms once daily (max. per dose 800 micrograms), dose to be given in the evening.

Prophylaxis of asthma by inhalation of powder
• Child 6 months–11 years: 100–400 micrograms twice daily, dose to be adjusted as necessary.
• Over 12 years: 100–800 micrograms twice daily, dose to be adjusted as necessary.

Prophylaxis as treatment of allergic and vasomotor rhinitis by intranasal administration
• Child 6-17 years: 256 micrograms once daily, to be administered as 2 sprays into each nostril in the morning, reduce dose when control achieved, alternatively 128 micrograms twice daily, to be administered as 1 spray into each nostril in the morning and in the evening, reduce dose when control achieved.
• Adult: 256 micrograms once daily, to be administered as 2 sprays into each nostril in the morning, reduce dose when control achieved, alternatively 128 micrograms twice daily, to be administered as 1 spray into each nostril in the morning and in the evening, reduce dose when control achieved.

Prophylaxis and treatment of allergic rhinitis and nasal polyps by intranasal administration
• Over 6 years: 256 mcg once daily, to be administered as 2 sprays into each nostril in the morning, reduce dose when control achieved. Alternatively, 128 mcg twice daily, to be administered as 1 spray into each nostril in the morning and in the evening, reduce dose when control achieved.

Prophylaxis of asthma by nebulised suspension
• Child 6 months–11 years: 125–500 mcg twice daily, dose to be adjusted as required. Maximum 2 mg per day.
• Over 12 years: initially 0.25–1 mg twice daily, dose to be adjusted as required. Maximum 2 mg per day.

Corticosteroid.

Pulmicort Respules for prophylaxis of asthma by inhalation of nebulised suspension
• Child 3 months–11 years: initially 0.5–1 mg twice daily then reduce to 250–500 mcg twice daily.
• Over 12 years: initially 1–2 mg twice daily then reduce to 0.5–1 mg twice daily.

Antimuscarinic bronchodilator.

• Over 18 years for maintenance of COPD: by inhalation of powder, one capsule, once daily.

Long-acting selective beta2 agonist with corticosteroid.

Prophylaxis of moderate-to-severe asthma for Aloflute® 25/125 by inhalation of aerosol
Adult: 2 inhalations twice daily.

Prophylaxis of moderate-to-severe asthma for Aloflute® 25/250 by inhalation of aerosol
Adult: 2 inhalations twice daily.

Long-acting selective beta2 agonist with long-acting muscarinic antagonist.

Adult: one inhalation twice daily. 

Antimuscarinic bronchodilator.

• Over 18 years: by inhalation of powder, 375 mcg (1 inhalation), twice daily.

Short-acting selective beta2 agonist.

For acute bronchospasm, Salbulin Novolizer® by inhalation of powder
Adult: Initially 100–200 micrograms, up to 800 micrograms daily for persistent symptoms.

For prophylaxis of allergen- or exercise-induced bronchospasm, Salbulin Novolizer® by inhalation of powder
Adult: 200 micrograms.

Short-acting selective beta2 agonist.

Oral
(Please note, inhalation route preferred over oral route in children.)
• Child 1 month–1 year: 100 mcg/kg (maximum 2 mg) 3–4 times daily
• Child 2–5 years: 1–2 mg, 3–4 times daily
• Child 6–11 years: 2 mg, 3–4 times daily
• Child 12–17 years: 2–4 mg, 3–4 times daily
• Over 18 years: 4 mg (elderly and sensitive patients initially 2 mg), 3–4 times daily, with a maximum single dose of 8 mg (but unlikely to provide much extra benefit or to be tolerated).

Moderate to severe or life-threatening acute asthma, treated by inhalation of nebulised solution. Give via a large volume spacer, and via a close-fitting face mask in children under 3 years.
• Child 1 month–4 years: 2.5 mg, repeat every 20–30 minutes or when required.
• Child 5–11 years: 2.5–5 mg, repeat every 20–30 minutes or when required.
• Over 12 years: 5 mg, repeat every 20–30 minutes or when required.

Long-acting selective beta2 agonist with corticosteroid.

Prophylaxis of moderate-to-severe asthma for Aloflute® 25/125 by inhalation of aerosol
Adult: 2 inhalations twice daily.

Prophylaxis of moderate-to-severe asthma for Aloflute® 25/250 by inhalation of aerosol
Adult: 2 inhalations twice daily.

Long-acting muscarinic antagonist, Long-acting beta 2 agonist.

Adult: two inhalations twice daily.

Long-acting selective beta2 agonist with corticosteroid.

Combisal 25/125
• Over 12 years for prophylaxis of asthma: two inhalations twice daily.
Combisal 25/50
• Over 4 years for prophylaxis of asthma: two inhalations twice daily, but can be reduced to two inhalations once daily.
Combisal 25/250
• Over 12 years for prophylaxis of asthma: two inhalations twice daily.

Long-acting selective beta2 agonist with long-acting muscarinic antagonist.

Adult: one inhalation twice daily. 

Long-acting selective beta2 agonist with corticosteroid.

Symbicort 100/6 Turbohaler
• 6–17 years for asthma maintenance: 1-2 inhalations twice daily, reduced to 1 inhalation daily if controlled.
• Adults for asthma maintenance: 1-2 inhalations daily, increased to up to 4 inhalations daily if needed, or reduced to 1 daily if controlled.
• Over 12 years for asthma maintenance and reliever therapy: 2 inhalations daily across one or two doses; 1 inhalation for relief of symptoms and increase to 6 if required. A maximum of 8 inhalations per day, but 12 can be given under medical supervision.

Symbicort 200/6 Turbohaler
• 12–17 years for asthma maintenance: 1-2 inhalations twice daily, reduced to 1 inhalation daily if controlled.
• Adults for asthma maintenance: 1-2 inhalations daily, increased to up to 4 inhalations daily if needed, or reduced to one daily if controlled.
• Over 12 years for asthma maintenance and reliever therapy: 2 inhalations daily across one or two doses but can be increased to 2 inhalations twice daily if needed; 1 inhalation for relief of symptoms and increase to 6 inhalations if required. A maximum of 8 inhalations per day, but 12 can be given for a limited time under medical supervision.
• Adult for COPD: 1 inhalation twice daily.

Symbicort 400/12 Turbohaler
• 12–17 years for asthma maintenance: 1 inhalation twice daily, but can be reduced to 1 inhalation daily.
• Adult for asthma maintenance: 1 inhalation twice daily, increased to 2 inhalations twice daily if required and decreased to 1 inhalation daily if controlled.
• Adult for COPD: 1 inhalation twice daily.

Long acting muscarinic antagonist, long-acting beta 2 agonist and inhaled corticosteroid.

Two inhalations twice daily