powder for inhalation), fluticasone furoate 92 micrograms, vilanterol (as trifen

atate) 22 micrograms/
inhalation (delivered dose), net price 30-dose unit =
27.80. Label: 8, counselling, administration, 10,
steroid card
Cautions see notes above and also section 3.1.1.1
Pregnancy manufacturer advises use only if potential
benefit outweighs risk
Breast-feeding manufacturer advises avoid no
information available
Side-effects see under Fluticasone and also section
3.1.1.1; also abdominal pain, back pain
Dose
Prophylaxis of asthma
. By inhalation of powder
Child 12 18 years 1 inhalation once daily
Important 1 inhalation (delivered dose) of fluticasone furoate
92 micrograms once daily is approximately equivalent to
fluticasone propionate 250 micrograms twice daily
Relvar Ellipta 184 micrograms/22 micrograms (dry
powder for inhalation), fluticasone furoate 184 micrograms, vilanterol (as trife
natate) 22 micrograms/
inhalation (delivered dose), net price 30-dose unit =
38.87. Label: 8, counselling, administration, 10,
steroid card
Cautions see notes above and also section 3.1.1.1
Hepatic impairment avoid in moderate to severe
impairment; max. dose fluticasone furoate 92 micrograms,
vilanterol 22 micrograms
Pregnancy manufacturer advises use only if potential
benefit outweighs risk
Breast-feeding manufacturer advises avoid no
information available
Side-effects see under Fluticasone and also section
3.1.1.1; also abdominal pain, back pain
Dose
Prophylaxis of asthma
. By inhalation of powder
Child 12 18 years 1 inhalation once daily
Important 1 inhalation (delivered dose) of fluticasone furoate
184 micrograms once daily is approximately equivalent to
fluticasone propionate 500 micrograms twice daily
Seretide (A&H) A
Seretide 100 Accuhaler (dry powder for inhalation),
disk containing 60 blisters of fluticasone propionate
100 micrograms, salmeterol (as xinafoate) 50 micrograms/blister with Accuhaler de
vice, net price =
18.00. Label: 8, counselling, administration
Dose
Prophylaxis of asthma
. By inhalation of powder
Child 5 18 years 1 inhalation twice daily, reduced to 1
inhalation once daily if control maintained
Seretide 250 Accuhaler (dry powder for inhalation), disk containing 60 blisters o
f fluticasone
propionate 250 micrograms, salmeterol (as xinafoate) 50 micrograms/blister with
Accuhaler device,
net price = 35.00. Label: 8, counselling, administration, 10, steroid card
Dose
Prophylaxis of asthma

. By inhalation of powder
Child 12 18 years 1 inhalation twice daily
Seretide 500 Accuhaler (dry powder for inhalation), disk containing 60 blisters o
f fluticasone
propionate 500 micrograms, salmeterol (as xinafoate) 50 micrograms/blister with
Accuhaler device,
net price = 40.92. Label: 8, counselling, administration, 10, steroid card
Dose
Prophylaxis of asthma
. By inhalation of powder
Child 12 18 years 1 inhalation twice daily
Seretide 50 Evohaler (aerosol inhalation), fluticasone propionate 50 micrograms,
salmeterol (as
xinafoate) 25 micrograms/metered inhalation, net
price 120-dose unit = 18.00. Label: 8, counselling,
administration
Dose
Prophylaxis of asthma
. By aerosol inhalation
Child 5 18 years 2 puffs twice daily, reduced to 2 puffs
once daily if control maintained
Seretide 125 Evohaler (aerosol inhalation), fluticasone propionate 125 micrograms
, salmeterol (as
xinafoate) 25 micrograms/metered inhalation, net
price 120-dose unit = 35.00. Label: 8, counselling,
administration, 10, steroid card
Dose
Prophylaxis of asthma
. By aerosol inhalation
Child 12 18 years 2 puffs twice daily
Seretide 250 Evohaler (aerosol inhalation), fluticasone propionate 250 micrograms
, salmeterol (as
xinafoate) 25 micrograms/metered inhalation, net
price 120-dose unit = 59.48. Label: 8, counselling,
administration, 10, steroid card
Dose
Prophylaxis of asthma
. By aerosol inhalation
Child 12 18 years 2 puffs twice daily
MOMETASONE FUROATE
Cautions see notes above
Pregnancy see p. 131
Breast-feeding see p. 131
Side-effects see notes above; also headache; less
commonly dyspepsia, weight gain, palpitation
Indications and dose
Prophylaxis of asthma see also Management of
Chronic Asthma table, p. 133
. By inhalation of powder
Child 12 18 years 400 micrograms as a single
dose in the evening or in 2 divided doses, reduced
to 200 micrograms once daily if control maintained; dose may be increased to max
. 400 micrograms twice daily in severe asthma
BNFC 2014 2015 3.2 Cor ticosteroids 149
3Respiratory system
Asmanex (MSD) A
Twisthaler (= dry powder inhaler), mometasone furoate 200micrograms/metered inha
lation, net price
30-dose unit = 15.70, 60-dose unit = 23.54;
400micrograms/metered inhalation, 30-dose unit =

21.78, 60-dose unit = 36.05. Label: 8, counselling,

administration, 10, steroid card
Note The Scottish Medicines Consortium has advised
(November 2003) that Asmanex is restricted for use
following failure of first-line inhaled corticosteroids
3.3 Cromoglicate and related
therapy and leukotriene
receptor antagonists
3.3.1 Cromoglicate and related therapy
3.3.2 Leukotriene receptor antagonists
3.3.1 Cromoglicate and related
therapy
The mode of action of sodium cromoglicate and nedocromil is not completely under
stood; they may be of
value as prophylaxis in asthma with an allergic basis, but
the evidence for benefit of sodium cromoglicate in
children is contentious. Prophylaxis with cromoglicate
or nedocromil is less effective than with inhaled corticosteroids (see Managemen
t of Chronic Asthma table).
Withdrawal of sodium cromoglicate or nedocromil
should be done gradually over a period of one week
symptoms of asthma may recur.
Nedocromil may be of some benefit in the prophylaxis
of exercise-induced asthma.
For the use of sodium cromoglicate and nedocromil in
allergic conjunctivitis see section 11.4.2; sodium cromoglicate is used also in
allergic rhinitis (section 12.2.1)
and allergy-related diarrhoea (section 1.5.4).
Paradoxical bronchospasm If paradoxical bronchospasm occurs, a short-acting beta
2 agonist such as
salbutamol or terbutaline (section 3.1.1.1) should be
used to control symptoms; treatment with sodium cromoglicate or nedocromil shoul
d be discontinued.
Side-effects Side-effects associated with inhalation
of sodium cromoglicate and nedocromil include throat
irritation, cough, bronchospasm (including paradoxical
bronchospasm see above), and headache.
SODIUM CROMOGLICATE
(Sodium Cromoglycate)
Cautions see notes above; also discontinue if eosinophilic pneumonia occurs
Pregnancy see p. 131
Breast-feeding see p. 131
Side-effects see notes above; also rhinitis,eosinophilic pneumonia
Indications and dose
Prophylaxis of asthma (see also Management of
Chronic Asthma, p. 133)
. By aerosol inhalation
Child 5 18 years 10mg (2puffs) 4 times daily,
increased if necessary to 6 8 times daily; an
additional dose may also be taken before exercise;
maintenance, 5mg (1puff) 4 times daily
Food allergy section 1.5.4
Allergic conjunctivitis section 11.4.2
Allergic rhinitis section 12.2.1
Intal CFC-free inhaler (Sanofi-Aventis) A
Aerosol inhalation, sodium cromoglicate 5mg/
metered inhalation, net price 112-dose unit =
18.33. Label: 8, counselling, administration
NEDOCROMIL SODIUM
Cautions see notes above

Pregnancy see p. 131

Breast-feeding see p. 131
Side-effects see notes above; also nausea, vomiting,
dyspepsia, abdominal pain, pharyngitis; rarely taste
disturbances
Licensed use not licensed for use in children under 6
years
Indications and dose
Prophylaxis of asthma (but see notes above)
. By aerosol inhalation
Child 5 18 years 4mg (2 puffs) 4 times daily,
when control achieved may be possible to reduce
to twice daily
Counselling Regular use is necessary
Allergic conjunctivitis section 11.4.2
Tilade CFC-free inhaler (Sanofi-Aventis) A
Aerosol inhalation, mint-flavoured, nedocromil sodium 2mg/metered inhalation. Ne
t price 112-dose