Budesonide/Formoterol Metered Dose Inhaler: Asthma Dosing

Therapeutic action

Combination of inhaled corticosteroid (budesonide) and long-acting beta-2 agonist bronchodilator (formoterol).

Indications

Long-term treatment of chronic asthma, for 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 per puff.

Dosage

Start at the step most appropriate to initial severity.

Duration

As long as required. Re-evaluate after 2 to 3 months to determine whether doses are adequate or need to be increased or decreased.

Administration technique

• Shake the inhaler and remove the mouthpiece cover.
• Breathe in and breathe out as completely as possible, then place the lips tightly around the mouthpiece.
• Inhale deeply while activating the inhaler, then hold breath for 10 seconds before exhaling.
• Hand-breath coordination is difficult in children. Use a spacer to facilitate administration and improve treatment efficacy.

Contra-indications, adverse effects, precautions

• Do not administer to children with untreated respiratory infection.
• May cause throat irritation, hoarseness, cough at the beginning of treatment, oropharyngeal candidiasis, adrenal suppression with high doses for prolonged periods, headache, tremor, tachycardia, hyperglycaemia, and hypokalaemia after high doses.
• Pregnancy and breast-feeding: no contra-indication.
• 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 because of explosion risk.
• 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 actuation in metered dose or delivered dose.