Respiratory Handbook
For UK audiences

The professional's guide to product selection

Luforbec - Beclometasone with formoterol
Bronchodilators Compound preparations Corticosteroids Beclomethasone dipropionate Lupin Healthcare UK

Luforbec - Beclometasone with formoterol

Long-acting selective beta2 agonist with corticosteroid.

Asthma maintenance therapy for Luforbec® 100/6 by inhalation of aerosol
Adult: 1–2 inhalations twice daily; maximum 4 inhalations per day.

Asthma, maintenance and reliever therapy for Luforbec® 100/6 by inhalation of aerosol
Adult: 1 inhalation twice daily; 1 inhalation as required, for relief of symptoms; maximum 8 inhalations per day.

Chronic obstructive pulmonary disease with forced expiratory volume in 1 second < 50% of predicted for Luforbec® 100/6 by inhalation of aerosol
Adult: 2 inhalations twice daily.

Asthma maintenance therapy for Luforbec® 200/6 by inhalation of aerosol
Adult: 2 inhalations twice daily, maximum 4 inhalations per day.

Children and adolescents aged less than 18 years must not take this medicine

Indications

Maintenance and reliever therapy for asthma.

Contraindications

Not intended for initial management of asthma. Treatment should not be initiated during an exacerbation, or during significant worsening or acutely deteriorating asthma.

Preparations Available

Pressurised inhalation

Sizes Available

Pressurised inhalation
Luforbec 100 mcg/6 mcg/dose, 120 doses 
Luforbec 200 mcg/6 mcg/dose, 120 doses 

Price

Bronchodilators

All Bronchodilators
Acopair - Tiotropium
Viatrus UK Healthcare Ltd

Acopair - Tiotropium

Antimuscarinic bronchodilator.

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

Aloflute and Sirdupla - Salmeterol and fluticasone propionate
Viatrus UK Healthcare Ltd

Aloflute and Sirdupla - Salmeterol and fluticasone propionate

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.

Duaklir - Aclidinium bromide with formoterol
Covis Pharma Europe B.V.

Duaklir - Aclidinium bromide with formoterol

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

Adult: one inhalation twice daily. 

Eklira Genuair - Aclidinium bromide
Covis Pharma Europe B.V.

Eklira Genuair - Aclidinium bromide

Antimuscarinic bronchodilator.

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

Salbulin Novolizer - Salbutamol
Viatrus UK Healthcare Ltd

Salbulin Novolizer - Salbutamol

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.

Salbutamol - AAH Pharmaceuticals Ltd
AAH Pharmaceuticals

Salbutamol - AAH Pharmaceuticals Ltd

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.

Compound preparations

All Compound preparations
Aloflute and Sirdupla - Salmeterol and fluticasone propionate
Viatrus UK Healthcare Ltd

Aloflute and Sirdupla - Salmeterol and fluticasone propionate

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.

Bevespi Aerosphere - Glycopyrronium with formoterol fumarate
AstraZeneca

Bevespi Aerosphere - Glycopyrronium with formoterol fumarate

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

Adult: two inhalations twice daily.

Duaklir - Aclidinium bromide with formoterol
Covis Pharma Europe B.V.

Duaklir - Aclidinium bromide with formoterol

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

Adult: one inhalation twice daily. 

Symbicort - Budesonide with formoterol (1)
AstraZeneca

Symbicort - Budesonide with formoterol (1)

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.

Symbicort Turbohaler - Budesonide with formetrol
AstraZeneca

Symbicort Turbohaler - Budesonide with formetrol

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.

Trixeo Aerosphere - Formoterol fumarate with glycopyrronium and budesonide
AstraZeneca

Trixeo Aerosphere - Formoterol fumarate with glycopyrronium and budesonide

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

Two inhalations twice daily

Corticosteroids

All Corticosteroids
Alvesco - Ciclesonide
Covis Pharma Europe B.V.

Alvesco - Ciclesonide

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 Novolizer - Budesonide
Viatrus UK Healthcare Ltd

Budelin Novolizer - Budesonide

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.

Dymista - Fluticasone with azelastine
Viatrus UK Healthcare Ltd

Dymista - Fluticasone with azelastine

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

Hydrocortisone - Creo Pharma
Creo Pharma Ltd

Hydrocortisone - Creo Pharma

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.

Hydrocortisone - Resolution Chemicals
Resolution Chemicals

Hydrocortisone - Resolution Chemicals

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.

Prednisolone - Aerona Clinical
Aerona Clinical

Prednisolone - Aerona Clinical

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. 

Beclomethasone dipropionate

All Beclomethasone dipropionate
Beconase Aqueous - Beclometasone (beclomethasone) dipropionate
Omega Pharma

Beconase Aqueous - Beclometasone (beclomethasone) dipropionate

For the prophylaxis and treatment of allergic and vasomotor rhinitis by intranasal administration
• Over 6 years: 100 mcg twice daily, dose to be administered into each nostril. Maximum of 400 mcg per day. Reduce if symptoms are controlled.

Beconase Hayfever - Beclometasone (beclomethasone) dipropionate
Omega Pharma

Beconase Hayfever - Beclometasone (beclomethasone) dipropionate

For the prophylaxis and treatment of asthma by inhalation of powder
• Child 5-11 years: 100–200 mcg twice daily, dose to be adjusted as necessary.
• Child 12–17 years: 200–400 mcg twice daily; increased if necessary up to 800 mcg twice daily, dose to be adjusted as necessary.
• Adult: 200–400 mcg twice daily; increased if necessary up to 800 mcg twice daily, dose to be adjusted as necessary.

For the prophylaxis and treatment of allergic and vasomotor rhinitis
• Over 6 years: 100 mcg twice daily, dose to be administered into each nostril. Maximum of 400 mcg per day. Reduce to 50 mcg twice daily if symptoms are controlled.

Beconase Hayfever Relief for Adults - Beclometasone (beclomethasone) dipropionate
Omega Pharma

Beconase Hayfever Relief for Adults - Beclometasone (beclomethasone) dipropionate

For the prophylaxis and treatment of asthma by inhalation of powder
• Child 5-11 years: 100–200 mcg twice daily, dose to be adjusted as necessary.
• Child 12–17 years: 200–400 mcg twice daily; increased if necessary up to 800 mcg twice daily, dose to be adjusted as necessary.
• Adult: 200–400 mcg twice daily; increased if necessary up to 800 mcg twice daily, dose to be adjusted as necessary.

For the prophylaxis and treatment of allergic and vasomotor rhinitis
• Over 6 years: 100 mcg twice daily, dose to be administered into each nostril. Maximum of 400 mcg per day. Reduce to 50 mcg twice daily if symptoms are controlled.

Clenil Modulite - Beclometasone (beclomethasone) dipropionate
Chiesi

Clenil Modulite - Beclometasone (beclomethasone) dipropionate

For prophylaxis of asthma by inhalation of aerosol
• Child 2–11 years: 100–200 mcg twice daily.
• Over 12 years: 200–400 mcg twice daily, increased if necessary up to 1 mg twice daily. Adjust according to response.

Kelhale - Beclometasone (beclomethasone) dipropionate
Cipla (EU) Limited

Kelhale - Beclometasone (beclomethasone) dipropionate

For prophylaxis of asthma by inhalation of aerosol. Kelhale has extra-fine particles and is more potent than traditional beclomethasone diproprionate inhalers.
• Adult: 50–200 mcg twice daily, increased if necessary to 400 mcg twice daily

Soprobec - beclometasone (beclomethasone) dipropionate
Glenmark Pharmaceuticals Europe Ltd.

Soprobec - beclometasone (beclomethasone) dipropionate

Soprobec is indicated for the maintenance treatment of asthma, when the use of pressurised metered dose inhaler is appropriate.

  • Child: 100 mcg twice daily, increased if necessary up to 400 mcg daily in 2–4 divided doses.
  • Adult: 200 mcg twice daily, increased if necessary up to this may be increased to 600-800 mcg daily in 2–4 divided doses.