Formulary Chapter 3: Respiratory system - Full Chapter
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Chapter Links... |
NICE CG115: Chronic obstructive pulmonary disease in over 16s: diagnosis and management |
NICE TA10: Guidance on the use of inhaler systems (devices) in children under the age of 5 years with chronic asthma |
NICE TA138: Inhaled corticosteroids for the treatment of chronic asthma in adults and in children aged 12 years and over |
NICE TA38: Inhaler devices for routine treatment of chronic asthma in older children (aged 5–15 years) |
BCICB Asthma Treatment Guidelines - Adolescents 12-17 years old |
BCICB Asthma Treatment Guidelines - Adults 18+ |
BCICB Asthma Treatment Guidelines For Children Under 12 |
BCICB COPD Inhaler Treatment Guidelines |
BCICB Difficult Asthma Referral Pathway - Adults 18+ |
Greener Inhaler Guide Switching Information |
How to improve respiratory control in asthma and COPD |
COVID-19: information for the respiratory community |
Details... |
03.02 |
Corticosteroids |
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Beclometasone and formoterol (Fostair®)
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Formulary
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Licensed for both asthma and COPD Asthma - use lowest effective dose. Consider step down at each review. Consider switch if appropriate
Alternative to Seretide Evohaler / Seretide 250 Accuhaler
Note: when switching patients already using Beclometasone 250mcg CFC inhaler (e.g. Clenil), Fostair 100/6 can be prescribed and dose adjusted according to response
How to use a Metered Dose Inhaler How to use a Metered Dose Inhaler with a Large Volume Spacer Device How to use a Metered Dose Inhaler with a Small Volume Spacer Device
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Beclometasone and formoterol (Fostair® NEXThaler®)
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Formulary
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How to use a NEXThaler Inhaler
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Beclometasone Dipropionate (Clenil Modulite®)
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Formulary
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May 2020 - see Clenil® Modulite® 100mcg (beclometasone): release of batch specific variation
How to use a Metered Dose Inhaler How to use a Metered Dose Inhaler with a Large Volume Spacer Device How to use a Metered Dose Inhaler with a Small Volume Spacer Device
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Budesonide (Nebuliser Liquid)
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Formulary
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Budesonide
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Formulary
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- Dry powder Inhaler
- Easyhaler
- Prescribe by brand
How to use a Turbohaler Inhaler
How to use an Easyhaler Inhaler
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Budesonide (Easyhaler® )
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Formulary
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How to use an Easyhaler Inhaler
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Budesonide (Pulmicort Respules®) (Nebuliser Liquid)
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Formulary
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Budesonide (Pulmicort Turbohaler®)
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Formulary
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How to use a Turbohaler Inhaler
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Budesonide and Formoterol (Fobumix Easyhaler®)
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Formulary
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How to use an Easyhaler Inhaler
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Budesonide and Formoterol 100/6 (Symbicort Turbohaler®)
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Formulary
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- For treatment of asthma only
- Use lowest effective dose. Consider step down at each review.
- Prescribe by brand to ensure patient receives the device they are used to.
How to use a Turbohaler Inhaler
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Budesonide and Formoterol 200/6 (Symbicort Turbohaler®)
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Formulary
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For Asthma, maintenance and reliever therapy in adults and adolescents (12 years and older) with mild asthma
How to use a Turbohaler Inhaler
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Fluticasone
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Formulary
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- Flixonase Nasal Drops
- Flixotide Nebuliser Liquid
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Fluticasone and salmeterol (Seretide®) (Inhaler)
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Formulary
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For paediatric use ONLY (i.e. up to 18 years of age)
- Seretide Evohaler- 50mg and 125mg only .
- Should be prescribed by the intended brand to ensure patients are maintained on the formulation they are used to.
How to use an Accuhaler Inhaler How to use a Metered Dose Inhaler How to use a Metered Dose Inhaler with a Large Volume Spacer Device How to use a Metered Dose Inhaler with a Small Volume Spacer Device
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Fluticasone furoate & vilanterol (Relvar Ellipta®)
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Formulary
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How to use an Ellipta Inhaler
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Fluticasone Nasal Spray
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Formulary
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BRANDS
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Fluticasone Nasal Spray (Avamys®)
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Formulary
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Fluticasone propionate (Flixotide®)
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Formulary
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How to use an Accuhaler Inhaler How to use a Metered Dose Inhaler How to use a Metered Dose Inhaler with a Large Volume Spacer Device How to use a Metered Dose Inhaler with a Small Volume Spacer Device
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Mometasone (Spray)
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Formulary
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Prednisolone
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Formulary
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UKMI Q&A: Is there any evidence to support the use of enteric coated (EC) over uncoated prednisolone tablets?
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03.02.01 |
Inhaled Corticosteroids |
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03.02.02 |
Combination products (ICS+LABA) for asthma |
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03.02.02 |
Low dose |
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03.02.02 |
Moderate dose |
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03.02.02 |
High dose |
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03.02.03 |
Combination products (ICS+LABA) for COPD |
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03.02.03 |
Triple Therapy products for COPD |
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Beclometasone/formoterol/glycopyrronium (Trimbow 87/5/9 ®)
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Formulary
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Trimbow 87/5/9 is licensed for Moderate-to-severe chronic obstructive pulmonary disease and Asthma maintenance therapy
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How to use a Metered Dose Inhaler
How to use a Metered Dose Inhaler with a Large Volume Spacer Device
How to use a Metered Dose Inhaler with a Small Volume Spacer Device
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Beclometasone/formoterol/glycopyrronium
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Formulary
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How to use a Metered Dose Inhaler
How to use a Metered Dose Inhaler with a Large Volume Spacer Device
How to use a Metered Dose Inhaler with a Small Volume Spacer Device
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Beclometasone/formoterol/glycopyrronium (Trimbow 172/5/9 ®)
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Formulary
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Note:
-Two strengths of Trimbow available
* Trimbow 172/5/9
* Trimbow 87/5/9
-Trimbow 172/5/9 is licensed for Asthma maintenance therapy only
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How to use a Metered Dose Inhaler
How to use a Metered Dose Inhaler with a Large Volume Spacer Device
How to use a Metered Dose Inhaler with a Small Volume Spacer Device
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Beclometasone/formoterol/glycopyrronium (Trimbow NEXThaler®)
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Formulary
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How to use a NEXThaler Inhaler
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Fluticasone/vilanterol/Umeclidinium (Trelegy Ellipta®)
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Formulary
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How to use an Ellipta Inhaler
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Non Formulary Items |
Beclometasone (Clipper®)
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Non Formulary
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Modified release tablets |
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Beclometasone and formoterol (Luforbec®)
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Non Formulary
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Beclometasone Dipropionate (Easyhaler® )
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Non Formulary
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How to use an Easyhaler Inhaler
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Beclometasone Dipropionate (Kelhale® )
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Non Formulary
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How to use a Metered Dose Inhaler How to use a Metered Dose Inhaler with a Large Volume Spacer Device How to use a Metered Dose Inhaler with a Small Volume Spacer Device
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Beclometasone Dipropionate (Qvar®)
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Non Formulary
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- Qvar
- Qvar Autohaler
- Qvar Easi-Breathe
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Beclometasone Dipropionate (Soprobec ®)
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Non Formulary
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How to use a Metered Dose Inhaler How to use a Metered Dose Inhaler with a Large Volume Spacer Device How to use a Metered Dose Inhaler with a Small Volume Spacer Device
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Budesonide (Spray)
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Non Formulary
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Budesonide (Budelin Novolizer®)
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Non Formulary
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How to use a Turbohaler Inhaler
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Budesonide and formoterol (DuoResp Spiromax®)
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Non Formulary
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- DuoResp Spiromax 160/4.5 is therapeutically equivalent to Symbicort Turbohaler 200/6
- DuoResp Spiromax 320/9 is therapeutically equivalent to Symbicort Turbohaler 400/12
- Prescribe by brand to ensure patient receives the device they are used to
How to use a Spiromax Inhaler
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Budesonide and Formoterol (Symbicort pMDI®)
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Non Formulary
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Budesonide and Formoterol (WockAIR®)
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Non Formulary
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Ciclesonide (Alvesco®) (Inhaler)
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Non Formulary
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How to use a Metered Dose Inhaler
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Fluticasone and formoterol (Flutiform®)
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Non Formulary
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How to use a Metered Dose Inhaler How to use a Metered Dose Inhaler with a Large Volume Spacer Device How to use a Metered Dose Inhaler with a Small Volume Spacer Device |
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Fluticasone and salmeterol (Pressurised inhalation)
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Non Formulary
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BRANDS
- Airflusal
- Aloflute
- Avenor
- Combisal
- Sirdupla- No dose counter although cost effective
- Sereflo -Even though cost effective and has dose counter, licensed for >18 yrs and clinicians would rather have patients on formoterol rather than salmeterol
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Fluticasone and salmeterol (Inhalation powder)
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Non Formulary
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BRANDS
- Airflusal Forspiro
- Fixkoh Airmaster
- Fusacomb Easyhaler
- Seretide Accuhaler
- Stalpex
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Fluticasone and salmeterol (Seretide 500 Accuhaler®)
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Non Formulary
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Fluticasone and salmeterol (Seretide®) (Inhaler)
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Non Formulary
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Seretide 250 Evohaler- Black from 23rd May 2023.
Ok for historic patients
- Should be prescribed by the intended brand to ensure patients are maintained on the formulation they are used to.
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Mometasone (Asmanex®)
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Non Formulary
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Mometasone Furoate (Nasonex Spray®)
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Non Formulary
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Prescribe generically |
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Montelukast (Singulair® ) (Oral presentations)
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Non Formulary
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Use in line with recommendations in BTS-SIGN asthma guideline |
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Key |
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Restricted Drug |
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Unlicensed |
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Link to adult BNF
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Link to children's BNF
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Link to SPCs
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Cytotoxic Drug |
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Controlled Drug |
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High Cost Medicine |
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Cancer Drugs Fund |
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NHS England |
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Homecare |
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ICB |
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Low carbon footprint |
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Medium carbon footprint |
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High carbon footprint |
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Status |
Description |
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Medicines which are suitable for initiation and maintenance prescribing by primary and secondary care clinicians. These medicines should be initiated and prescribed within their licensed indications |
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Amber Specialist Initiation: Initiation and maintenance of prescribing by Specialists and transfer to Primary Care prescribing when appropriate. This may be supported by a RICaD, annotated within the formulary entry. |
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Amber Shared Care: Initiation and maintenance of prescribing by Specialists and transfer to Primary Care prescribing, in accordance with an ESCA, annotated within the formulary entry. |
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Amber Specialist Recommendation: Initiation and maintenance of prescribing in Primary Care following recommendation from a specialist. |
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Medicines for initiation and maintenance prescribing by Specialists (hospital or GPs with Special Interest) only |
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Positive NICE TA and /or awaiting local clarification on place in therapy; Please contact your Medicines Optimisation team for more information. |
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Non-formulary Medicines which APC/Trust DTC has actively reviewed and do not recommend for use. |
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Check Notes as varies across the area |
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