page207
Label:
8,
counselling,
administration;
also 10 and
steroid card with high doses
Dose
by aerosol inhalation,
200–400 micrograms twice daily,
adjusted as necessary up to 1 mg twice daily;
CHILD under 12
years 100–200 micrograms twice daily
Note
Clenil Modulite
c
is not interchangeable with other CFC-free
beclometasone dipropionate inhalers;
the MHRA has advised
(July 2008) that CFC-free beclometasone dipropionate inhalers
should be prescribed by brand name, see p.
185
Dental
prescribing on NHS
Clenil
Modulite
c
50 micrograms/
metered inhalation may be prescribed
Qvar
c
(TEVA UK) A
Aerosol inhalation
,
beclometasone dipropionate
50 micrograms/metered inhalation,
net price 200-
dose unit = £7.87;
100 micrograms/metered inhala-
tion,
200-dose unit = £17.21.
Label:
8,
counselling,
administration;
also 10 and steroid card with high
doses
Autohaler
c
(breath-actuated aerosol inhalation),
beclometasone dipropionate 50 micrograms/metered
inhalation, net price 200-dose unit = £7.87;
100 micr-
ograms/metered inhalation,
200-dose unit = £17.21.
Label:
8,
counselling,
administration;
also 10 and
steroid card with high doses
Easi-Breathe
c
(breath-actuated aerosol inhalation),
beclometasone dipropionate 50 micrograms/metered
inhalation,
net price 200-dose = £7.74;
100 micr-
ograms/metered inhalation,
200-dose = £16.95.
Label:
8,
counselling,
administration;
also 10 and
steroid card with high doses
Dose
by aerosol inhalation,
prophylaxis of asthma,
ADULT and
CHILD over 12 years, 50–200 micrograms twice daily, increased if
necessary to max.
400 micrograms twice daily
Important
When switching a patient with well-controlled asthma
from another corticosteroid inhaler,
initially a 100-microgram
metered dose of
Qvar
c
should be prescribed for:
.
200–250 micrograms of beclometasone dipropionate or bud-
esonide
.
100 micrograms of fluticasone propionate
When switching a patient with poorly controlled asthma from
another corticosteroid inhaler, initially a 100-microgram metered
dose of
Qvar
c
should be prescribed for 100 micrograms of
beclometasone dipropionate, budesonide, or fluticasone
propionate;
the dose of
Qvar
c
should be adjusted according to
response
Note
Qvar
c
is
not
interchangeable
with
other
CFC-free
beclometasone dipropionate inhalers;
the MHRA has advised
(July 2008) that beclometasone dipropionate CFC-free inhalers
should be prescribed by brand name, p.
185.
Compound preparations
For prescribing information on formoterol
fumarate,
see section 3.1.1.1
Fostair
c
(Chiesi) T A
Aerosol inhalation
,
beclometasone dipropionate
100 micrograms,
formoterol fumarate 6 micrograms/
metered inhalation, net price 120-dose unit = £29.32.
Label:
8,
counselling,
administration,
10, steroid card
with high doses
Dose
by aerosol inhalation,
asthma,
ADULT over 18 years, 1–2
puffs twice daily;
max.
4 puffs daily
When switching patients from other beclometasone dipropionate
and formoterol fumarate inhalers,
Fostair
c
100/6
can be
prescribed for patients already using beclometasone dipropionate
250 micrograms in another CFC-free inhaler; the dose of
Fostair
c
should be adjusted according to response
Note
The MHRA has advised (July 2008)
that
beclometasone
dipropionate CFC-free inhalers should be prescribed by brand
name, see p.
185
BUDESONIDE
Indications
prophylaxis of asthma (see also Manage-
ment of Chronic Asthma, p.
172);
croup
Cautions
see notes above
Pregnancy
see p.
170
Breast-feeding
see p.
170
Side-effects
see notes above
Dose
. See preparations below
Budesonide
(Non-proprietary) A
Dry powder for inhalation
,
budesonide 100 micr-
ograms/metered inhalation, net price 200-dose unit =
£8.86;
200 micrograms/metered inhalation,
200-dose
unit = £17.71;
400 micrograms/metered inhalation,
100-dose unit = £17.71.
Label: 8, counselling,
admin-
istration;
also 10 and steroid card with high doses
Brands include
Easyhaler
c
Budesonide
Inhalation powder, hard capsule
(for use with
Cyclohaler
c
device),
budesonide 200 micrograms,
net price 100-cap pack = £15.48; 400 micrograms, 50-
cap pack = £15.48.
Label:
8,
counselling,
administra-
tion;
also 10 and steroid card with high doses
Brands include
Budesonide Cyclocaps
c
Dose
by inhalation of powder,
ADULT and CHILD over 12 years,
100–800 micrograms twice daily,
adjusted as necessary;
alterna-
tively,
in mild to moderate asthma,
for patients previously stabi-
lised on a twice daily dose, 200–400 micrograms (max.
800 micr-
ograms) as a single dose in the evening;
CHILD 6–12 years 100–
400 micrograms twice daily,
adjusted as necessary;
alternatively,
in mild to moderate asthma, for patients previously stabilised on a
twice daily dose, 200–400 micrograms as a single dose in the
evening
Budelin Novolizer
c
(Meda) A
Dry powder for inhalation
,
budesonide 200 micr-
ograms,
net price refillable inhaler device and 100-
dose cartridge = £14.86;
100-dose refill cartridge =
£9.59.
Label:
8,
counselling,
administration;
also 10
and steroid card with high doses
Dose
by inhalation of powder,
ADULT and CHILD over 12 years,
200–800 micrograms twice daily,
adjusted as necessary;
alterna-
tively,
in mild to moderate asthma,
for patients previously stabi-
lised on a twice daily dose, 200–400 micrograms (max.
800 micr-
ograms) as a single dose in the evening;
CHILD 6–12 years 200–
400 micrograms twice daily,
adjusted as necessary;
alternatively,
in mild to moderate asthma, for patients previously stabilised on a
twice daily dose, 200–400 micrograms as a single dose in the
evening
Pulmicort
c
(AstraZeneca) A
Aerosol inhalation
T,
budesonide 100 micrograms/
metered inhalation,
net price 120-dose unit = £9.60;
200 micrograms/metered inhalation, 120-dose unit =
£13.20.
Label:
8,
counselling,
administration;
also 10
and steroid card with high doses
Dose
by aerosol inhalation,
ADULT and CHILD over 12 years,
100–400 micrograms twice daily,
adjusted as necessary;
max.
800 micrograms twice daily;
CHILD 2–12 years,
100–400 micr-
ograms twice daily adjusted as necessary
Turbohaler
c
(= dry powder inhaler),
budesonide
100 micrograms/metered inhalation,
net price 200-
dose unit = £11.84;
200 micrograms/metered inhala-
tion,
100-dose unit = £11.84;
400 micrograms/
metered inhalation,
50-dose unit = £13.86.
Label:
8,
counselling,
administration; also 10 and steroid card
with high doses
Dose
by inhalation of powder,
ADULT and CHILD over 12 years,
100–800 micrograms twice daily,
adjusted as necessary;
alterna-
tively,
in mild to moderate asthma,
for patients previously stabi-
lised on a twice daily dose, 200–400 micrograms (max.
800 micr-
ograms) as a single dose in the evening;
CHILD 5–12 years 100–
400 micrograms twice daily,
adjusted as necessary;
alternatively,
in mild to moderate asthma, for patients previously stabilised on a
twice daily dose, 200–400 micrograms as a single dose in the
evening
Respules
c
(= single-dose units for nebulisation),
budesonide 250 micrograms/mL, net price 20 2-mL
BNF 61
3.2 Corticosteroids
187
3
Respiratory system