12/2/2023 0 Comments Trelogy ics laba lama![]() pMDIs have a significantly higher carbon footprint than DPIs and SMIs (refer to the environmental impact of inhalers).In adults with asthma, high dose ICS (such as Luforbec 200/6 pMDI - 2 puffs twice a day see Inhaled Corticosteroid Dose Comparison in Asthma) should only be used after referring the patient to secondary care. ![]() Luforbec 100/6 may be used as regular maintenance treatment and as needed in response to asthma symptoms (MART regimen), refer to Asthma - adult treatment guidance, Initial add on therapy for further details.The manufacturer states that 100 micrograms of BDP extrafine in Luforbec are equivalent to 250 micrograms of BDP in a non-extrafine formulation.Luforbec contains extrafine beclometasone particles and is more potent than traditional beclometasone dipropionate CFC-free inhalers (Clenil).100 micrograms / 6 micrograms two inhalations twice daily.Asthma, adults (maintenance therapy, aged ≥ 18 years):.Aerosol inhalation 200 micrograms / 6 micrograms / metered dose ( pMDI) (£20.52 = 120 doses) ( specialist, see note 4).Aerosol inhalation 100 micrograms / 6 micrograms / metered dose ( pMDI) (£20.52 = 120 doses).Luforbec(combination of BDP (extrafine) and formoterol fumarate) DPIs have a significantly lower carbon footprint than pMDIs and BAIs (refer to the environmental impact of inhalers).In adults with asthma, high dose ICS (such as Fostair NEXThaler 200/6 - 2 puffs twice a day see Inhaled Corticosteroid Dose Comparison in Asthma) should only be used after referring the patient to secondary care.Fostair NEXThaler 100/6 may be used as regular maintenance treatment and as needed in response to asthma symptoms (MART regimen), refer to Asthma - adult treatment guidance, Initial add on therapy for further details.The manufacturer states that 100 micrograms of BDP extrafine in Fostair NEXThaler are equivalent to 250 micrograms of BDP in a non-extrafine formulation.Fostair NEXThaler contains extrafine beclometasone particles and is more potent than traditional beclometasone dipropionate CFC-free inhalers (Clenil).100 micrograms / 6 micrograms: two inhalations twice daily.Chronic obstructive pulmonary disease (aged ≥ 18 years):.200 micrograms / 6 micrograms: two inhalations twice daily (see note 4).100 micrograms / 6 micrograms: one or two inhalations twice daily.Dry powder inhalation 200 micrograms / 6 micrograms / metered inhalation ( DPI) (£29.32 = 120 inhalations) (see note 4).Dry powder inhalation 100 micrograms / 6 micrograms / metered inhalation ( DPI) (£29.32 = 120 inhalations).(combination of BDP (extrafine) and formoterol fumarate) Inhaled corticosteroid (ICS) / Long-acting beta 2 agonists (LABA) BDP and formoterol fumarate See MHRA Drug Safety Alert July 2018 for further details. To prevent objects entering the mouthpiece during storage, the mouthpiece cover should be replaced securely after use. When prescribing a pressurised MDI, remind patients to check and remove the mouthpiece cover fully, shake the inhaler to remove loose objects that may not be visible, and check the inside and outside of the mouthpiece are clear before inhaling a dose. PMDI = Pressurised metered dose inhaler DPI = Dry powder inhaler SMI = Soft mist inhaler BDP = Beclometasone dipropionate NICE has produced a patient decision aid to help people with asthma and their healthcare professionals discuss their options for inhaler devices (available here) it is suitable for use by people aged 17 years and over, and many of the considerations are also applicable to patients with COPD.Īdvice on how to obtain placebo inhalers can be obtained from the NHS Devon ICB Medicines Optimisation Team, please contact: information on inhaled corticosteroid dose comparisons in asthma see here When discussing inhaled treatment options, consideration should also be given to the environmental impact of inhalers. Adherence to treatment regimens should also be checked. It is essential that patients can demonstrate the proper inhaler technique when prescribing an inhaler device recheck patient technique at each visit to ensure continued correct use of the inhaler. Patient preference should be considered when prescribing treatments. Prior to prescribing, the relevant Summary of Product Characteristics (SPC) should be checked. Generic prescribing of inhalers should be avoided as this might lead to patients being given an unfamiliar inhaler device which they are not able to use properly in addition, not all inhalers with the same primary ingredient are interchangeable due to differences in particle size.ĭifferent products and doses are licensed for different age groups and some may be applicable only to older children or adults (aged 18 years and over). All combination inhalers included in the formulary are included as branded products.
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