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Last updated: June 2023
Prescription under medical supervision
Therapeutic action
- Combination of inhaled corticosteroid (beclometasone) and long-acting beta-2 agonist bronchodilator (formoterol)
Indications
- Long term treatment of chronic asthma (maintenance and symptomatic treatment)
Forms and strengths
- Solution or suspension for inhalation in pressurised metered dose inhaler, delivering 100 micrograms of beclometasone dipropionate (extrafine particles) and 6 micrograms of formoterol fumarate/puff
Dosage
Start at the step most appropriate to initial severity.
- Child 12 years and over and adult:
Asthma severity | 100/6 micrograms per puff |
---|---|
Intermittent asthma |
Only when symptomatic: 1 puff |
Mild persistent asthma | |
Moderate persistent asthma |
1 puff (low dose) 2 times daily and 1 puff when symptomatic |
Severe persistent asthma |
2 puffs (medium dose) 2 times daily and 1 puff when symptomatic |
- In all cases, do not exceed 8 puffs/day
Duration
- As long as required. Re-evaluate after 2 to 3 months if doses are adequate or need to be increased or decreased.
Administration technique
- Shake the inhaler. Remove the mouthpiece cover.
- Breathe in and breathe out as completely as possible. Place the lips tightly around the mouthpiece. Inhale deeply while activating the inhaler. Hold breath 10 seconds before exhaling.
- Hand-breath co-ordination is very difficult in older patients and patients with severe dyspnoea. Use a spacer to facilitate administration and improve the efficacy of treatment.
Contra-indications, adverse effects, precautions
- Do not administer to patients with untreated respiratory infection.
- May cause:
- throat irritation, hoarseness and cough at the beginning of treatment; oro-pharyngeal candidiasis; adrenal suppression with high doses for prolonged periods;
- headache, tremor and tachycardia, hyperglycaemia; hypokalaemia (after high doses).
- Pregnancy: no contra-indication
- Breast-feeding: no contra-indication
Remarks
- 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 (risk of explosion).
- 100 micrograms of beclometasone dipropionate extrafine particles is equivalent to 250 micrograms of beclometasone dipropionate non-extrafine particles.
- Beclometasone/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".
Storage
- Before use: between 2 ºC and 8 °C. Do not freeze.
- After first use: below 25 ºC for 3 months maximum.