BNF for Children 2011-2012

148 3.2 Corticosteroids BNFC 2011–20123 Respiratory systemunit = £14.93; 400 micrograms/metered inhalation,100-dose unit = £19.61. Label: 8, counselling, administration;also 10 and steroid card with high dosesBrands include Pulvinal c Beclometasone Dipropionate, Easyhalerc Beclometasone DipropionateAsmabec Clickhaler c (UCB Pharma) ADry powder for inhalation, beclometasonedipropionate 50 micrograms/metered inhalation, netprice 200-dose unit = £6.42; 100 micrograms/metered inhalation, 200-dose unit = £9.43; 250 micrograms/meteredinhalation, 100-dose unit = £11.83.Label: 8, counselling, administration; also 10 andsteroid card with high dosesDoseProphylaxis of asthma. By inhalation of powderChild 6–12 years 50–200 micrograms twice daily,adjusted as necessaryChild 12–18 years 100–400 micrograms twice daily,adjusted as necessary; max. 1 mg twice dailyBecodisks c (A&H) ADry powder for inhalation, disks containing 8 blistersof beclometasone dipropionate 100 micrograms/blister,net price 15 disks with Diskhaler c device =£11.30, 15-disk refill = £10.76; 200 micrograms/blister, 15 disks with Diskhaler c device = £21.54, 15-disk refill = £20.99; 400 micrograms/blister, 15 diskswith Diskhaler c device = £42.52, 15-disk refill =£41.98. Label: 8, counselling, administration; also 10and steroid card with high dosesDoseProphylaxis of asthma. By inhalation of powderChild 5–12 years 100–200 micrograms twice daily,adjusted as necessaryChild 12–18 years 400–800 micrograms twice daily,adjusted as necessaryClenil Modulite c (Chiesi) AAerosol inhalation, beclometasone dipropionate50 micrograms/metered inhalation, net price 200-dose unit = £3.70; 100 micrograms/metered inhalation= £7.42; 200 micrograms/metered inhalation =£16.17; 250 micrograms/metered inhalation = £16.29.Label: 8, counselling, administration; also 10 andsteroid card with high dosesDoseProphylaxis of asthma. By aerosol inhalationChild 2–12 years 100–200 micrograms twice dailyChild 12–18 years 200–400 micrograms twice dailyadjusted as necessary up to 1 mg twice dailyNote Clenil Modulite c is not interchangeable with otherCFC-free beclometasone dipropionate inhalers; the MHRAhas advised (July 2008) that CFC-free beclometasonedipropionate inhalers should be prescribed by brand name,see p. 147Dental Prescribing on NHS Clenil Modulite c 50 micrograms/meteredinhalation may be prescribedQvar c (TEVA UK) AAerosol inhalation, beclometasone dipropionate50 micrograms/metered inhalation, net price 200-dose unit = £7.87; 100 micrograms/metered inhalation,200-dose unit = £17.21. Label: 8, counselling,administration; also 10 and steroid card with highdosesAutohaler c (breath-actuated aerosol inhalation),beclometasone dipropionate 50 micrograms/meteredinhalation, net price 200-dose unit = £7.87; 100 micrograms/meteredinhalation, 200-dose unit = £17.21.Label: 8, counselling, administration; also 10 andsteroid card with high dosesEasi-Breathe c (breath-actuated aerosol inhalation),beclometasone dipropionate 50 micrograms/meteredinhalation, net price 200-dose = £7.74; 100 micrograms/meteredinhalation, 200-dose = £16.95.Label: 8, counselling, administration; also 10 andsteroid card with high dosesDoseProphylaxis of asthma. By aerosol inhalationChild 12–18 years 50–200 micrograms twice daily,increased if necessary to max. 400 micrograms twicedailyImportant When switching a child with well-controlledasthma from another corticosteroid inhaler, initially a 100-microgram metered dose of Qvar c should be prescribed for:. 200–250 micrograms of beclometasone dipropionate or budesonide. 100 micrograms of fluticasone propionateWhen switching a child with poorly controlled asthma fromanother corticosteroid inhaler, initially a 100-microgrammetered dose of Qvar c should be prescribed for 100 microgramsof beclometasone dipropionate, budesonide, orfluticasone propionate; the dose of Qvar c should beadjusted according to responseNote Qvar c is not interchangeable with other CFC-freebeclometasone dipropionate inhalers; the MHRA hasadvised (July 2008) that beclometasone dipropionate CFCfreeinhalers should be prescribed by brand name, see p. 147BUDESONIDECautions see notes abovePregnancy see p. 133Breast-feeding see p. 133Side-effects see notes aboveLicensed use Pulmicort c nebuliser solution notlicensed for use in children under 3 months; notlicensed for use in bronchopulmonary dysplasia;Symbicort c not licensed for use in children forasthma maintenance and reliever therapyIndication and doseProphylaxis of asthma see Management ofChronic Asthma table, p. 135, and preparationsbelowCroup. By inhalation of nebuliser suspensionChild over 1 month 2 mg as single dose or in 2divided doses separated by 30 minutes; dose maybe repeated after 12 hours if necessaryBronchopulmonary dysplasia with assistedventilation. By aerosol inhalationNeonate 400 micrograms twice dailyChild 1–4 months 400 micrograms twice dailyBronchopulmonary dysplasia with spontaneousrespiration. By inhalation of nebuliser suspensionNeonate 500 micrograms twice daily