Drug reference

Budesonide with formoterol

BNF 80 (2020–2021)

Source: BNF 80 (2020–2021)
PDF pages: 296, 297, 298

Review source pages for extracted sections and age labels. BNF dose snippets show only their first line.

Overview

Indications And Dose

DUORESP SPIROMAX ® 160MICROGRAMS/4.5MICROGRAMS Asthma, maintenance therapy ▶BY INHALATION OF POWDER ▶Adult: 1–2 inhalations twice daily, increased if necessary up to 4 inhalations twice daily Asthma, maintenance and reliever therapy ▶BY INHALATION OF POWDER ▶Adult: Maintenance 2 inhalations daily in 1–2 divided doses, increased if necessary to 2 inhalations twice daily. 1 inhalation as required, for relief of symptoms, increased if necessary up to 6 inhalations as required, max. 8 inhalations per day; up to 12 inhalations daily can be used for a limited time but medical assessment is recommended Chronic obstructive pulmonary disease with forced expiratory volume in 1 second <70% of predicted ▶BY INHALATION OF POWDER ▶Adult: 2 inhalations twice daily DUORESP SPIROMAX ® 320MICROGRAMS/9MICROGRAMS Asthma, maintenance therapy ▶BY INHALATION OF POWDER ▶Adult: 1 inhalation twice daily, increased if necessary up to 2 inhalations twice daily Chronic obstructive pulmonary disease with forced expiratory volume in 1 second < 70% of predicted ▶BY INHALATION OF POWDER ▶Adult: 1 inhalation twice daily FOBUMIX ® 160/4.5 EASYHALER Asthma, maintenance therapy ▶BY INHALATION OF POWDER ▶Adult: 1–2 inhalations twice daily, increased if necessary up to 4 inhalations twice daily Asthma, maintenance and reliever therapy ▶BY INHALATION OF POWDER ▶Adult: Maintenance 2 inhalations daily in 1–2 divided doses, increased if necessary to 2 inhalations twice daily. 1 inhalation as required for relief of symptoms, increased if necessary up to 6 inhalations as required, max. 8 inhalations per day; up to 12 inhalations daily can be used for a limited time but medical assessment is recommended Chronic obstructive pulmonary disease with forced expiratory volume in 1 second < 70% of predicted (post- bronchodilator) ▶BY INHALATION OF POWDER ▶Adult: 2 inhalations twice daily FOBUMIX ® 320/9 EASYHALER Asthma, maintenance therapy ▶BY INHALATION OF POWDER ▶Adult: 1 inhalation twice daily; increased if necessary up to 2 inhalations twice daily Chronic obstructive pulmonary disease with forced expiratory volume in 1 second < 70% of predicted (post- bronchodilator) ▶BY INHALATION OF POWDER ▶Adult: 1 inhalation twice daily FOBUMIX ® 80/4.5 EASYHALER Asthma, maintenance therapy ▶BY INHALATION OF POWDER ▶Adult: 1–2 inhalations twice daily, increased if necessary up to 4 inhalations twice daily Asthma, maintenance and reliever therapy ▶BY INHALATION OF POWDER ▶Adult: Maintenance 2 inhalations daily in 1–2 divided doses. 1 inhalation as required for relief of symptoms, increased if necessary up to 6 inhalations as required, max. 8 inhalations per day; up to 12 inhalations daily can be used for a limited time but medical assessment is recommended SYMBICORT 100/6 TURBOHALER ® Asthma, maintenance therapy ▶BY INHALATION OF POWDER ▶Child 6–17 years: Initially 1–2 puffs twice daily; reduced to 1 puff daily, dose reduced only if control is maintained ▶Adult: Initially 1–2 puffs twice daily, increased if necessary up to 4 puffs twice daily; reduced to 1 puff daily, dose reduced only if control is maintained Asthma, maintenance and reliever therapy ▶BY INHALATION OF POWDER ▶Child 12–17 years: Maintenance 2 puffs daily in 1–2 divided doses; 1 puff as required for relief of symptoms, increased if necessary up to 6 puffs as required, max. 8 puffs per day; up to 12 puffs daily can be used for a limited time but medical assessment is recommended ▶Adult: Maintenance 2 puffs daily in 1–2 divided doses; 1 puff as required for relief of symptoms, increased if necessary up to 6 puffs as required, max. 8 puffs per day; up to 12 puffs daily can be used for a limited time but medical assessment is recommended SYMBICORT 200/6 TURBOHALER ® Asthma, maintenance therapy ▶BY INHALATION OF POWDER ▶Child 12–17 years: Initially 1–2 puffs twice daily; reduced to 1 puff daily, dose reduced only if control is maintained ▶Adult: Initially 1–2 puffs twice daily, increased if necessary up to 4 puffs twice daily; reduced to 1 puff daily, dose reduced only if control is maintained Asthma, maintenance and reliever therapy ▶BY INHALATION OF POWDER ▶Child 12–17 years: Maintenance 2 puffs daily in 1–2 divided doses, increased if necessary to 2 puffs twice daily; 1 puff as required for relief of symptoms, increased if necessary up to 6 puffs as required, max. Respiratory system 8 puffs per day; up to 12 puffs daily can be used for a limited time but medical assessment is recommended ▶Adult: Maintenance 2 puffs daily in 1–2 divided doses, increased if necessary to 2 puffs twice daily; 1 puff as required for relief of symptoms, increased if necessary up to 6 puffs as required, max. 8 puffs per day; up to 12 puffs daily can be used for a limited time but medical assessment is recommended Chronic obstructive pulmonary disease with forced expiratory volume in 1 second < 70% of predicted (post bronchodilator) ▶BY INHALATION OF POWDER ▶Adult: 2 puffs twice daily SYMBICORT 400/12 TURBOHALER ® Asthma, maintenance therapy ▶BY INHALATION OF POWDER ▶Child 12–17 years: Initially 1 puff twice daily; reduced to 1 puff daily, dose reduced only if control is maintained ▶Adult: Initially 1 puff twice daily, increased if necessary up to 2 puffs twice daily; reduced to 1 puff daily, dose reduced only if control is maintained Chronic obstructive pulmonary disease with forced expiratory volume in 1 second < 70% of predicted (post bronchodilator) ▶BY INHALATION OF POWDER ▶Adult: 1 puff twice daily SYMBICORT ® 200/6 PRESSURISED INHALER Chronic obstructive pulmonary disease with forced expiratory volume in 1 second <70% of predicted (post bronchodilator) ▶BY INHALATION OF AEROSOL ▶Adult: 2 inhalations twice daily

PDF pages 296, 297

National Funding Access Decisions

Scottish Medicines Consortium (SMC) decisions ▶In adults The Scottish Medicines Consortium has advised (June 2007) that budesonide/formoterol 100 micrograms/6 micrograms and 200 micrograms/6 micrograms (Symbicort ® SMART ®) is accepted for use within NHS Scotland, in adults, for regular treatment of asthma where use of a combination (inhaled corticosteroid and a long-acting b2 agonist) is appropriate; Symbicort is taken as regular maintenance treatment and as needed in response to symptoms. ▶In children The Scottish Medicines Consortium has advised (June 2017) that budesonide/formoterol 100 micrograms/6 micrograms and 200 micrograms/6 micrograms (Symbicort ® SMART ®) is accepted for use within NHS Scotland for regular treatment of asthma where use of a combination (inhaled corticosteroid and a long-acting b2 adrenoceptor agonist) is appropriate: patients already adequately controlled on both or patients not adequately controlled with inhaled corticosteroids and “as needed” short-acting b2 adrenoceptor agonists. This advice relates to the extension of the license for Symbicort maintenance and reliever therapy (SMART ®) to adolescents aged 12 years and over.

PDF page 297

Safety

Interactions

→Appendix 1: beta2 agonists. corticosteroids

PDF page 297

Dose and formulations

Medicinal Forms

There can be variation in the licensing of different medicines containing the same drug. Inhalation powder CAUTIONARY AND ADVISORY LABELS 8, 10 (high doses) ▶DuoResp Spiromax (Teva UK Ltd) Formoterol fumarate dihydrate 6 microgram per 1 dose, Respiratory system Budesonide 200 microgram per 1 dose DuoResp Spiromax 160micrograms/dose / 4.5micrograms/dose dry powder inhaler | 120 dose P £27.97 DT = £28.00 Formoterol fumarate dihydrate 12 microgram per 1 dose, Budesonide 400 microgram per 1 dose DuoResp Spiromax 320micrograms/dose / 9micrograms/dose dry powder inhaler | 60 dose P £27.97 DT = £28.00 ▶Fobumix Easyhaler (Orion Pharma (UK) Ltd) Formoterol fumarate dihydrate 6 microgram per 1 dose, Budesonide 100 microgram per 1 dose Fobumix Easyhaler 80micrograms/dose / 4.5micrograms/dose dry powder inhaler | 120 dose P £21.50 DT = £28.00 Formoterol fumarate dihydrate 6 microgram per 1 dose, Budesonide 200 microgram per 1 dose Fobumix Easyhaler 160micrograms/dose / 4.5micrograms/dose dry powder inhaler | 60 dose P £10.75 | 120 dose P £21.50 DT = £28.00 Formoterol fumarate dihydrate 12 microgram per 1 dose, Budesonide 400 microgram per 1 dose Fobumix Easyhaler 320micrograms/dose / 9micrograms/dose dry powder inhaler | 60 dose P £21.50 DT = £28.00 ▶Symbicort Turbohaler (AstraZeneca UK Ltd) Formoterol fumarate dihydrate 6 microgram per 1 dose, Budesonide 100 microgram per 1 dose Symbicort 100/6 Turbohaler | 120 dose P £28.00 DT = £28.00 Formoterol fumarate dihydrate 6 microgram per 1 dose, Budesonide 200 microgram per 1 dose Symbicort 200/6 Turbohaler | 120 dose P £28.00 DT = £28.00 Formoterol fumarate dihydrate 12 microgram per 1 dose, Budesonide 400 microgram per 1 dose Symbicort 400/12 Turbohaler | 60 dose P £28.00 DT = £28.00 Pressurised inhalation CAUTIONARY AND ADVISORY LABELS 8, 10 (high doses) ▶Symbicort (AstraZeneca UK Ltd) Formoterol fumarate dihydrate 6 microgram per 1 dose, Budesonide 200 microgram per 1 dose Symbicort 200micrograms/dose / 6micrograms/dose pressurised inhaler | 120 dose P £28.00 DT = £28.00 eiiii F 270

PDF page 298

Clinical care

Patient And Carer Advice

Patient counselling is advised for budesonide with formoterol inhalation (administration). With high doses, a steroid card should be supplied.

PDF page 297

Dose text by age group

Adult

1–2 inhalations twice daily, increased if

First-line fragment. Read the complete Indications and Dose section above.

PDF page 296

Adult

Maintenance 2 inhalations daily in 1–2 divided

First-line fragment. Read the complete Indications and Dose section above.

PDF page 296

Adult

2 inhalations twice daily

First-line fragment. Read the complete Indications and Dose section above.

PDF page 296

Adult

1 inhalation twice daily, increased if necessary

First-line fragment. Read the complete Indications and Dose section above.

PDF page 296

Adult

1 inhalation twice daily

First-line fragment. Read the complete Indications and Dose section above.

PDF page 296

Adult

1–2 inhalations twice daily, increased if

First-line fragment. Read the complete Indications and Dose section above.

PDF page 296

Adult

Maintenance 2 inhalations daily in 1–2 divided

First-line fragment. Read the complete Indications and Dose section above.

PDF page 297

Adult

2 inhalations twice daily

First-line fragment. Read the complete Indications and Dose section above.

PDF page 297

Adult

1 inhalation twice daily; increased if necessary

First-line fragment. Read the complete Indications and Dose section above.

PDF page 297

Adult

1 inhalation twice daily

First-line fragment. Read the complete Indications and Dose section above.

PDF page 297

Adult

1–2 inhalations twice daily, increased if

First-line fragment. Read the complete Indications and Dose section above.

PDF page 297

Adult

Maintenance 2 inhalations daily in 1–2 divided

First-line fragment. Read the complete Indications and Dose section above.

PDF page 297

Adult

Initially 1–2 puffs twice daily, increased if

First-line fragment. Read the complete Indications and Dose section above.

PDF page 297

Adult

Maintenance 2 puffs daily in 1–2 divided doses;

First-line fragment. Read the complete Indications and Dose section above.

PDF page 297

Adult

Initially 1–2 puffs twice daily, increased if

First-line fragment. Read the complete Indications and Dose section above.

PDF page 297

Adult

Maintenance 2 puffs daily in 1–2 divided doses,

First-line fragment. Read the complete Indications and Dose section above.

PDF page 297

Adult

2 puffs twice daily

First-line fragment. Read the complete Indications and Dose section above.

PDF page 297

Adult

Initially 1 puff twice daily, increased if necessary

First-line fragment. Read the complete Indications and Dose section above.

PDF page 297

Adult

1 puff twice daily

First-line fragment. Read the complete Indications and Dose section above.

PDF page 297

Adult

2 inhalations twice daily

First-line fragment. Read the complete Indications and Dose section above.

PDF page 297

Age labels are extracted for navigation. Check the complete source section and current local guidance before clinical use.

Drug reference

Budesonide with formoterol

BNF 80 (2020–2021)

Source: BNF 80 (2020–2021)
PDF pages: 296, 297, 298

Review source pages for extracted sections and age labels. BNF dose snippets show only their first line.

Overview

Indications And Dose

PDF pages 296, 297

National Funding Access Decisions

PDF page 297

Safety

Interactions

→Appendix 1: beta2 agonists. corticosteroids

PDF page 297

Dose and formulations

Medicinal Forms

PDF page 298

Clinical care

Patient And Carer Advice

Patient counselling is advised for budesonide with formoterol inhalation (administration). With high doses, a steroid card should be supplied.

PDF page 297

Dose text by age group

Adult

1–2 inhalations twice daily, increased if

First-line fragment. Read the complete Indications and Dose section above.

PDF page 296

Adult

Maintenance 2 inhalations daily in 1–2 divided

First-line fragment. Read the complete Indications and Dose section above.

PDF page 296

Adult

2 inhalations twice daily

First-line fragment. Read the complete Indications and Dose section above.

PDF page 296

Adult

1 inhalation twice daily, increased if necessary

First-line fragment. Read the complete Indications and Dose section above.

PDF page 296

Adult

1 inhalation twice daily

First-line fragment. Read the complete Indications and Dose section above.

PDF page 296

Adult

1–2 inhalations twice daily, increased if

First-line fragment. Read the complete Indications and Dose section above.

PDF page 296

Adult

Maintenance 2 inhalations daily in 1–2 divided

First-line fragment. Read the complete Indications and Dose section above.

PDF page 297

Adult

2 inhalations twice daily

First-line fragment. Read the complete Indications and Dose section above.

PDF page 297

Adult

1 inhalation twice daily; increased if necessary

First-line fragment. Read the complete Indications and Dose section above.

PDF page 297

Adult

1 inhalation twice daily

First-line fragment. Read the complete Indications and Dose section above.

PDF page 297

Adult

1–2 inhalations twice daily, increased if

First-line fragment. Read the complete Indications and Dose section above.

PDF page 297

Adult

Maintenance 2 inhalations daily in 1–2 divided

First-line fragment. Read the complete Indications and Dose section above.

PDF page 297

Adult

Initially 1–2 puffs twice daily, increased if

First-line fragment. Read the complete Indications and Dose section above.

PDF page 297

Adult

Maintenance 2 puffs daily in 1–2 divided doses;

First-line fragment. Read the complete Indications and Dose section above.

PDF page 297

Adult

Initially 1–2 puffs twice daily, increased if

First-line fragment. Read the complete Indications and Dose section above.

PDF page 297

Adult

Maintenance 2 puffs daily in 1–2 divided doses,

First-line fragment. Read the complete Indications and Dose section above.

PDF page 297

Adult

2 puffs twice daily

First-line fragment. Read the complete Indications and Dose section above.

PDF page 297

Adult

Initially 1 puff twice daily, increased if necessary

First-line fragment. Read the complete Indications and Dose section above.

PDF page 297

Adult

1 puff twice daily

First-line fragment. Read the complete Indications and Dose section above.

PDF page 297

Adult

2 inhalations twice daily

First-line fragment. Read the complete Indications and Dose section above.

PDF page 297

Age labels are extracted for navigation. Check the complete source section and current local guidance before clinical use.