Dry Salbutamol Beclometasone 100 SECOND LINE is Seretide® 500 Accuhaler powder Easyhaler 100mcg Easyhaler 1p bd (£5.36)4 or Symbicort® 200/6 1 blister bd (£40.92)4 inhaler (£3.31/inhaler) Budesonide 100 Easyhaler Turbohaler 2p BD (£38)4 Terbutaline 500mcg 1p bd (£8.86)4 or > 18yrs = 1p bd Symbicort® 400/12 Turbohaler 1 puff Budesonide 100 Turbohaler and prn (12p max/day) (£76) Turbohaler 2p bd prn up to qds Seretide® 100 to 250 1p bd (£11/inhaler)4 (£6.92/inhaler) Accuhaler, 1p bd (£18 - £35)4 Always review diagnosis (consider COPD or dysfunctional breathing), encourage smoking cessation and consider treating rhinitis before stepping up. INHALER TECHNIQUE, EXPOSURE TO NEW OR EXISTING TRIGGERS and CONCORDANCE AT EACH REVIEW AND PRIOR TO STEPPING UP Use inhaler-training tool e.g. InCHECK Dial to check correct inspiratory flow rates *Move up to step 2 if: *Beclometasone diproprionate equivalent 1. Inhaled short acting agonist needed three times a week or more. β2 time symptoms more than once per week 3.Symptomatic 3 times per week or more 4.Has had an exacerbation in last 2 years
Dry powder inhaler Salbutamol Easyhaler 100mcg (£3.31/inhaler) Terbutaline 500mcg Turbohaler 1 puff prn up to qds (£6.92/inhaler) Beclometasone 100 Easyhaler 1p bd (£5.36)4 or Budesonide 100 Easyhaler 1p bd (£8.86)4 or Budesonide 100 Turbohaler 1p bd (£11/inhaler)4 SECOND LINE is Symbicort® 200/6 Turbohaler 2p BD (£38)4 > 18yrs = 1p bd and prn (12p max/day) Seretide® 100 to 250 Accuhaler, 1p bd (£18 - £35)4 Seretide® 500 Accuhaler 1 blister bd (£40.92)4 Symbicort® 400/12 Turbohaler 2p bd (£76) Always review diagnosis (consider COPD or dysfunctional breathing), encourage smoking cessation and consider treating rhinitis before stepping up. INHALER TECHNIQUE, EXPOSURE TO NEW OR EXISTING TRIGGERS and CONCORDANCE AT EACH REVIEW AND PRIOR TO STEPPING UP Use inhaler-training tool e.g. InCHECK Dial to check correct inspiratory flow rates *Move up to step 2 if: 1. Inhaled short acting β2 agonist needed three times a week or more. time symptoms more than once per week 3.Symptomatic 3 times per week or more 4.Has had an exacerbation in last 2 years *Beclometasone diproprionate equivalent