For
UK
audiences
The professional's guide to product selection
The professional's guide to product selection
For severe asthma in patients 12 years of age and older only where use of a combination product (long-acting beta2 agonist and inhaled corticosteroid) is appropriate: patients not adequately controlled on a lower strength corticosteroid combination product or patients already adequately controlled on an inhaled corticosteroid in a high strength and a long-acting beta2 agonist.
For symptomatic treatment of COPD with a FEV1 <60% predicted normal (pre-bronchodilator) and a history of repeated exacerbations, who have significant symptoms despite regular bronchodilator therapy.
For severe asthma in patients 12 years of age and older. For symptomatic treatment of COPD.
The Scottish Medicine Consortium has decided that combination salmeterol and fluticasone inhalers are not recommended in the treatment of people with COPD. For further information see: https://www.scottishmedicines.org.uk/medicines-advice/salmeterol-xinafoate-fluticasone-propionate-combination-inhaler-seretide-resubmission-45008/
Inhalation powder
Stalpex 500 mcg/50 mcg/dose, 60 doses
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 long-acting muscarinic antagonist.
Adult: one inhalation twice daily.
Long-acting selective beta2 agonist with corticosteroid.
Symbicort 100/3 pressurised inhaler
Asthma, maintenance therapy
• Child 12–17 years: Initially 2–4 inhalations twice daily; reduced to 1 inhalation daily, dose reduced only if control is maintained.
• Adult: Initially 2–4 inhalations twice daily, increased if necessary up to 8 inhalations twice daily; reduced to 1 inhalation daily, dose reduced only if control is maintained.
Asthma, maintenance and reliever therapy
• Over 12 years: Maintenance 4 inhalations daily in 1–2 divided doses, increased if necessary up to 4 inhalations twice daily; 2 inhalations as required for relief of symptoms, increased if necessary up to 12 inhalations as required, usual max. 16 inhalations per day; up to 24 inhalations daily can be used for a limited time under medical supervision.
Symbicort 200/6 Pressurised inhaler
COPD
• Adult: 2 inhalations 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