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Gloucestershire Formulary Recommended First Choice October 2018 (In alphabetical order)

Anoro Ellipta ( 55mcg / LAMA/LABA DPI 22mcg)  Breath-actuated dry powder of long-acting plus long-acting beta-agonist

 Licensed for maintenance treatment to relieve symptoms in adult patients with COPD

 Hyperlink to SPC

Atimos Modulite ( fumarate dehydrate 12mcg) LABA MDI

 For the Prevention and treatment of bronchospasm in patients with obstructive Broncho pulmonary diseases, such as bronchial and chronic bronchitis.

 Hyperlink to SPC

Clenil Modulite ( 100mcg) (Beclometasone 200mcg) ICS MDI

 Metered dose inhaler MDI

 inhaled ICS

 A ‘preventer’ for regular use.

 Hyperlink to SPC

Page 1 of 5 Combisal MDI (25mcg / 50mcg ) ICS/LABA MDI (25mcg salmeterol / 125mcg fluticasone) (25mcg salmeterol / 250mcg fluticasone)  Metered aerosol inhaler of inhaled corticosteroid and long-acting beta- agonist  licensed for asthma  Hyperlink to 25/50 SPC  Hyperlink to 25/125 SPC  Hyperlink to 25/250 SPC

Easyhaler ( 200mcg or Beclometasone 200mcg or SABA –Salbutamol (blue) Formoterol 12mcg) ICS – Beclometasone (brown) LABA – Formoterol (green)  Dry Powder Inhaler DPI  Shake Click inhale  Available as a ‘reliever’ and as a ‘preventer’.  Hyperlink to SPC salbutamol  Hyperlink to SPC beclometasone  Hyperlink to SPC Formoterol

Fobumix Easyhaler ( 160mcg/formoterol 4.5mcg) ICS/LABA DPI (budesonide 320mcg/formoterol 9mcg)  Dry Powder Inhaler containing inhaled corticosteroid and long-acting beta- agonist  Shake Click inhale  Fobumix Easyhaler 160/4.5 licensed as maintenance and reliever (i.e. MART)  Fobumix Easyhaler 320/9 licensed as maintenance only  Hyperlink to 160/4.5 SPC  Hyperlink to 320/9 SPC

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Fostair Inhaler (Beclometasone 100mcg / Formoterol 6mcg) ICS/LABA MDI

 Metered aerosol inhaler of inhaled corticosteroid and long-acting beta- agonist  Licensed for maintenance and reliever therapy in asthma (i.e. MART)  Hyperlink to SPC Fostair 100/6

Incruse Ellipta (Umeclidinium Bromide 55mcg) LAMA DPI

 Breath-actuated dry powder inhaler of long-acting muscarinic antagonist

 Licensed as a maintenance bronchodilator treatment to relieve symptoms in adult patients with COPD

 Hyperlink to SPC

Ipratropium Inhaler 20mcg SAMA MDI

 Generic metered dose inhaler MDI

 Short Acting Muscarinic SAMA

 Hyperlink to SPC

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Relvar Ellipta ( 92 / vilanterol 22) ICS/LABA DPI (Fluticasone furoate 184 / vilanterol 22)  Breath-actuated dry powder inhaler

containing a corticosteroid and long- acting beta-agonist  Hyperlink to 92/22 SPC  Hyperlink to 184/22 SPC

Salbutamol Inhaler 100mcg

SABA MDI

 Generic metered dose inhaler MDI

 Short acting Beta Agonist SABA

 Hyperlink to SPC

Spiolto Respimat (tiotropium 2.5mg & 2.5mg) LABA/LAMA MDI

 Metered Dose Inhaler of long-acting muscarinic antagonist plus long-acting beta-agonist

 Licensed for COPD

 Hyperlink to SPC

Page 4 of 5 Spiriva Respimat (Tiotropium 2.5mcg) LAMA MDI

 Metered Dose inhaler  Long acting muscarinic  COPD: licensed as maintenance for relief symptoms of patients with COPD  Asthma: licensed as an add-on for adult asthmatics currently treated with ICS and LABA who experienced one or more severe exacerbations in the previous year  Hyperlink to SPC

Trelegy Ellipta (fluticasone/ umeclidinium / vilanterol) ICS/LAMA/LABA DPI  Breath-actuated dry powder inhaler containing an inhaled corticosteroid, long-acting muscarinic and long-acting beta-agonist  COPD: for patients whose COPD is not adequately controlled with a LAMA/LABA and who have demonstrated benefit from the addition of an ICS  Hyperlink to SPC

Trimbow (beclometasone / glycopyrronium / formoterol) ICS/LAMA/LABA MDI  Breath-actuated dry powder inhaler containing an inhaled corticosteroid, long-acting muscarinic and long-acting beta-agonist  COPD: for patients whose COPD is not adequately controlled with a LAMA/LABA and who have demonstrated benefit from the addition of an ICS  Hyperlink to SPC

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