Combination of inhaled corticosteroid (budesonide) and long-acting beta-2 agonist bronchodilator (formoterol)
Indications
Long term treatment of chronic asthma(maintenance and symptomatic treatment)
Forms and strengths
Solution or suspension for inhalation in pressurised metered dose inhaler,delivering 80 micrograms of budesonide and 4.5 micrograms of formoterol fumarate/puff
Dosage
Start at the step most appropriate to initial severity.
Moderate persistent asthma
Child 6 to 11 years: 1 puff once daily (very low dose) and 1 puff when symptomatic (max. 8 puffs daily)
Severe persistent asthma
Child 6 to 11 years: 1puff 2 times daily (low dose) and 1 puff when symptomatic (max. 8 puffs daily)
Duration
As long as required.Re-evaluate after 2 to 3 months if doses are adequate or need to be increased or decreased.
Administration technique
Shake the inhaler. Remove the mouthpiece cover.
Breathe in and breathe out as completely as possible.Place the lips tightly around the mouthpiece. Inhale deeply while activating the inhaler. Hold breath 10 seconds before exhaling.
Hand-breath co-ordination is difficult in children. Use a spacer to facilitate administration and improve the efficacy of treatment.
Contra-indications, adverse effects, precautions
Do not administer to children with untreated respiratory infection.
May cause:
throat irritation, hoarseness and cough at the beginning of treatment; oro-pharyngeal candidiasis; adrenal suppression with high doses for prolonged periods;
headache, tremor and tachycardia, hyperglycaemia; hypokalaemia (after high doses).
Pregnancy: no contra-indication
Breast-feeding: no contra-indication
Remarks
Relief of symptoms may require several days or weeks of continuous therapy.
Clean the mouthpiece before and after each use.
Do not pierce or incinerate used aerosol containers (risk of explosion).
Budesonide/formoterol may also be available as a dry powder inhaler.Doses are the same as for metered dose inhaler.
Manufacturers may express the content per inhaler actuationin "metered dose" or "delivered dose".