Written By: Hetal Dhruve, Specialist Respiratory Pharmacist

CHARM ASTHMA TREATMENT GUIDELINE

Written by: Hetal Dhruve, Specialist Respiratory Pharmacist Approved by: JPG City and Hackney and Homerton Hospital Date of Approval: 14th December 2015 Date of Review: 14th December 2016 Version: 1.2

Calculating Beclomethasone dipropionate (BDP) Equivalent These dosage equivalents are approximate and will depend on factors such as inhaler technique. Generic Brand Dose Daily BDP Price (Dec 2014) License Beclomethasone Clenil® MDI 100mcg 2p BD 400 £7.42/200 dose Asthma-adults and children Beclomethasone Clenil® MDI 200mcg 2p BD 800 £16.17/200 dose Asthma-adults and children Beclomethasone Clenil® MDI 250mcg 2p BD 1000 £16.29/200 dose Asthma-adults and children over 12 Beclomethasone QVAR® MDI (non- 50mcg 2p BD 400 £7.87/200 dose Asthma-adults and formulary) children over 12 Beclomethasone QVAR® MDI (non- 100mcg 2p BD 800 £17.21/200 dose Asthma-adults and formulary) children over 12 Beclomethasone QVAR® autohaler 50mcg 2p BD 400 £7.87/200 dose Asthma-adults and children over 12 Beclomethasone QVAR® autohaler 100mcg 1p BD 800 £17.21/200 dose Asthma-adults and children over 12 Budesonide Pulmicort® Turbohaler 100mcg 2p BD 400 £11.84/200 dose Asthma-adults and children over 12 Budesonide Pulmicort® Turbohaler 200mcg 2p BD 800 £11.84/100 dose Asthma-adults and children over 12 Budesonide Pulmicort® Turbohaler 400mcg 1p BD 800 £13.86/50 dose Asthma-adults and children over 12 Fluticasone Flixotide® Evohaler 50mcg 1-2p BD £5.44/120 dose Asthma-adults and children over 4 200-‐400

Fluticasone Flixotide® Evohaler 125mcg 2p BD 1000 £21.26/120 dose Asthma-adults and children over 16 Fluticasone Flixotide® Evohaler 250mcg 2p BD 2000 £36.14/120 dose Asthma-adults and children over 16 Fluticasone Flixotide® Accuhaler 50mcg 1p BD 200 £6.38/60 doses Asthma-adults and children over 5 Fluticasone Flixotide® Accuhaler 100mcg 1p BD 400 £8.93/60 doses Asthma-adults and children over 5 Fluticasone Flixotide® Accuhaler 250mcg 1p BD 1000 £21.26/60 doses Asthma-adults and children over 16 Fluticasone Flixotide® Accuhaler 500mcg 1p BD 2000 £36.14/60 doses Asthma-adults and children over 16

Combination ICS (Inhaled Corticosteroid)/ LABA (Long Acting Beta Agonist) Inhaler

Generic Brand Dose Daily BDP Price (Dec 2014) License Low strength Beclomethasone/formoterol Fostair® MDI 100/6mcg 1p BD 500 £14.66/60 dose Asthma-adults over 18 Beclomethasone/formoterol Fostair® 100/6mcg 1p BD 500 £14.66/60 dose Asthma-adults over Nexthaler 18 Fluticasone/formoterol Flutiform® MDI 50/5mcg 2p BD 400 £18/120 dose Asthma-adults and children over 12 Fluticasone/salmeterol Seretide® MDI 50/25mcg 2p BD 400 £18/120 dose Asthma-adults and children over 5 Fluticasone/salmeterol Seretide® 100/50mcg 1p BD 400 £18/60 dose Asthma-adults and Accuhaler children over 5 Budesonide/formoterol Symbicort® 100/6mcg 1-2p BD 200-400 £33/120 dose Asthma-adults and Turbohaler children over 6 Intermediate strength Beclomethasone/formoterol Fostair® MDI 100/6mcg 2p BD 1000 £29.32/120 Asthma-adults over dose 18 COPD-adults over 18 Beclomethasone/formoterol Fostair® 100/6mcg 2p BD 1000 £29.32/120 dose Asthma-adults over Nexthaler 18 COPD-adults over 18 Fluticasone/formoterol Flutiform® MDI 125/5mcg 2p BD 1000 £29.26/120 dose Asthma-adults and children over 12 Fluticasone/salmeterol Sirdupla® MDI 125/25mcg 2p BD 1000 £26.25/120 dose Asthma-adults over 18

Fluticasone/salmeterol Seretide® MDI 125/25mcg 2p BD 1000 £35/120 dose Asthma-adults and children over 12 Fluticasone/salmeterol Seretide® 250/50mcg 1p BD 1000 £35/60 dose Asthma-adults and Accuhaler children over 12 Fluticasone/vilanterol Relvar® Ellipta 92/22mcg 1p OD 1000 £27.80/30 dose Asthma-adults over 18 COPD-adults over 18 Budesonide/formoterol Duoresp® 160/4.5mcg 2p BD 800 £29.97/120 dose Asthma-adults over Spiromax 18 COPD-adults over 18 Budesonide/formoterol Symbicort® 200/6mcg 2p BD 800 £38/120 dose Asthma-adults and Turbohaler children over 12 Budesonide/formoterol Symbicort® 400/12mcg 1p BD 800 £38/60 dose Asthma-adults and Turbohaler children over 12 High strength Beclomethasone/formoterol Fostair® MDI 200/6mcg 2p BD 2000 £29.32/120dose Asthma-adults over 18 Beclomethasone/formoterol Fostair® MDI 200/6mcg 2p BD 2000 £29.32/120dose Asthma-adults over 18 Fluticasone/formoterol Flutiform® MDI 250/10mcg 2p BD 2000 £45.56/120 dose Asthma-adults over 18

Fluticasone/salmeterol Sirdupla® MDI 250/25mcg 2p BD 2000 £44.61/120 dose Asthma-adults over 18

Fluticasone/salmeterol Seretide® MDI 250/25mcg 2p BD 2000 £59.48/120 dose Asthma-adults and children over 12 Fluticasone/salmeterol Seretide® 500/50mcg 1p BD 2000 £40.92/60 dose Asthma-adults and Accuhaler children over 12 Budesonide/formoterol Duoresp® 320/9mcg 2p BD 1600 £59.57/120 dose Asthma-adults over Spiromax 18

Budesonide/formoterol Symbicort® 400/12mcg 2p BD 1600 £76/120 dose Asthma-adults over Turbohaler 18