BNF for Children 2011-2012

BNFC 2011–2012 3.2 Corticosteroids 149Child 1–4 months 500 micrograms twice daily;for severe symptoms in child body-weight 2.5 kg orover, 1 mg twice dailyAdministration For aerosol inhalation in ventilatedbabies with bronchopulmonary dysplasia, use medium-volumespacer (section 3.1.5) attached directly toendotracheal tube; hand-ventilate through spacer,using a bag system; inflate chest 10 times betweenactivations of inhalerBudesonide (Non-proprietary) ADry powder for inhalation, budesonide 100 micrograms/meteredinhalation, net price 200-dose unit =£8.86; 200 micrograms/metered inhalation 200-doseunit = £17.71; 400 micrograms/metered inhalation100-dose unit = £17.71. Label: 8, counselling, administration;also 10 and steroid card with high dosesBrands include Easyhaler c BudesonideDoseProphylaxis of asthma. By inhalation of powderChild 6–12 years 100–400 micrograms twice daily,adjusted as necessary; alternatively, in mild to moderateasthma, 200–400 micrograms as a single dose each eveningif stabilised on daily dose given in 2 divided dosesChild 12–18 years 100–800 micrograms twice daily,adjusted as necessary; alternatively, in mild to moderateasthma, 200–400 micrograms as a single dose each eveningif stabilised on daily dose given in 2 divided doses(max. 800 micrograms)Budelin Novolizer c (Meda) ADry powder for inhalation, budesonide 200 micrograms,net price refillable inhaler device and 100-dose cartridge = £14.86; 100-dose refill cartridge =£9.59. Label: 8, counselling, administration; also 10and steroid card with high dosesDoseProphylaxis of asthma. By inhalation of powderChild 6–12 years 200–400 micrograms twice daily,adjusted as necessary; alternatively, in mild to moderateasthma, 200–400 micrograms as a single dose each eveningif stabilised on daily dose given in 2 divided dosesChild 12–18 years 200–800 micrograms twice daily,adjusted as necessary; alternatively, in mild to moderateasthma, 200–400 micrograms as a single dose each eveningif stabilised on daily dose given in 2 divided doses(max. 800 micrograms)Pulmicort c (AstraZeneca) ATurbohaler c (= dry powder inhaler), budesonide100 micrograms/metered inhalation, net price 200-dose unit = £11.84; 200 micrograms/metered inhalation,100-dose unit = £11.84; 400 micrograms/metered inhalation, 50-dose unit = £13.86. Label: 8,counselling, administration; also 10 and steroid cardwith high dosesDoseProphylaxis of asthma. By inhalation of powderChild 6–12 years 100–400 micrograms twice daily,adjusted as necessary; alternatively, in mild to moderateasthma, 200–400 micrograms as a single dose each eveningif stabilised on daily dose given in 2 divided dosesChild 12–18 years 100–800 micrograms twice daily,adjusted as necessary; alternatively, in mild to moderateasthma, 200–400 micrograms as a single dose each eveningif stabilised on daily dose given in 2 divided doses(max. 800 micrograms)Respules c (= single-dose units for nebulisation),budesonide 250 micrograms/mL, net price 20 2-mL(500-microgram) unit = £20.02; 500 micrograms/mL,20 2-mL (1-mg) unit = £30.30. May be diluted withsterile sodium chloride 0.9%. Label: 8, counselling,administration, 10, steroid cardNote Not suitable for use in ultrasonic nebulisersDoseProphylaxis of asthma. By inhalation of nebuliser suspensionChild 3 months–12 years initially 0.5–1 mg twice daily,reduced to 250–500 micrograms twice dailyChild 12–18 years initially 1–2 mg twice daily, reducedto 0.5–1 mg twice dailyCompound preparationsFor prescribing information on formoterol fumarate,see section 3.1.1.1Symbicort c (AstraZeneca) ASymbicort 100/6 Turbohaler c (= dry powderinhaler), budesonide 100 micrograms, formoterolfumarate 6 micrograms/metered inhalation, net price120-dose unit = £33.00. Label: 8, counselling,administrationDoseAsthma, maintenance therapy. By inhalation of powderChild 6–12 years 1–2 puffs twice daily reduced to 1 puffonce daily if control maintainedChild 12–18 years 1–2 puffs twice daily reduced to 1puff once daily if control maintainedAsthma, maintenance and reliever therapy (but seenotes above, p. 146). By inhalation of powderChild 12–18 years 2 puffs daily in 1–2 divided doses; forrelief of symptoms, 1 puff as needed up to max. 6 puffs ata time; max. 8 puffs dailySymbicort 200/6 Turbohaler c (= dry powderinhaler), budesonide 200 micrograms, formoterolfumarate 6 micrograms/metered inhalation, net price120-dose unit = £38.00. Label: 8, counselling,administration; also 10 and steroid card with highdosesDoseAsthma, maintenance therapy. By inhalation of powderChild 12–18 years 1–2 puffs twice daily reduced in wellcontrolledasthma to 1 puff once dailyAsthma, maintenance and reliever therapy (but seenotes above, p. 146). By inhalation of powderChild 12–18 years 2 puffs daily in 1–2 divided doses,increased if necessary to 2 puffs twice daily; for relief ofsymptoms, 1 puff as needed up to max. 6 puffs at a time;max. 8 puffs dailySymbicort 400/12 Turbohaler c (= dry powderinhaler), budesonide 400 micrograms, formoterolfumarate 12 micrograms/metered inhalation, netprice 60-dose unit = £38.00. Label: 8, counselling,administration; also 10 and steroid card with highdosesDoseAsthma, maintenance therapy. By inhalation of powderChild 12–18 years 1 puff twice daily; may be reduced inwell-controlled asthma to 1 puff once daily3 Respiratory system