3.2 Corticosteroids

High dose MDI inhaled corticosteroid devices should be prescribed with a spacer to reduce risk of oral candidiasis.

For information on corticosteroid inhaler preparations and their equivalent beclometasone dipropionate (BDP) see here

In the absence of a clinical or dexterity reason for the choice of inhaler, the product which has the cheapest acquisition cost should be chosen.

Placebo inhalers can be obtained from the NEW Devon CCG Medicines Optimisation Team, please contact: d-ccg.medicinesoptimisation@nhs.net

Beclometasone
  • Clenil® modulite aerosol inhalation 50 micrograms/ metered inhalation, 100 micrograms/ metered inhalation, 200 micrograms/ metered inhalation, 250 micrograms/ metered inhalation (£16.17 = 200 micrograms x 200 doses)
  • Qvar® aerosol inhalation 50 micrograms/ metered inhalation, 100 micrograms/ metered inhalation (£17.21 = 100 micrograms x 200 doses)
  • Qvar Autohaler® breath-actuated aerosol inhalation 50 micrograms/ metered inhalation, 100 micrograms/ metered inhalation (£17.21 = 100 micrograms x 200 doses)
  • Qvar Easi-breathe® breath-actuated aerosol inhalation 50 micrograms, 100 micrograms/ metered inhalation (£16.95 = 100 micrograms x 200 doses)

Indications

Notes

  1. BDP inhalers should be brand prescribed since they are not interchangeable. Qvar® is an extra-fine particle formulation and is approximately twice as potent as Clenil Modulite®
  2. Clenil Modulite® is recommended as an option for controlling asthma in patients aged 2 years or older (See Children's BNF section 3.2).
  3. Qvar ® is licensed for adults and children over 12 years.
Budesonide
  • Pulmicort Turbohaler® dry powder inhaler 100 micrograms/ metered inhalation, 200 micrograms/ metered inhalation, 400 micrograms/ metered inhalation (£14.25 = 200 micrograms x 100 doses)
  • Nebuliser solution 250 micrograms/mL, 500 micrograms/mL (£24.86 = 500 micrograms/ml, 20 x 2ml)

Indications

Fluticasone propionate
  • Aerosol inhalation 50 micrograms/ metered inhalation, 125 micrograms/ metered inhalation, 250 micrograms/ metered inhalation (£20.00 = 250 micrograms x 120 doses)
  • Accuhaler® dry powder for inhalation 50 micrograms/ blister, 100 micrograms/ blister, 250 micrograms/ blister, 500 micrograms/ blister (£25.51 = 250 micrograms x 60 doses)

Indications

Notes

  1. Fluticasone propionate is licensed for adults, only the 50 and 100 micrograms are indicated for children over 4 years of age

 

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