BNF for Children 2011-2012

150 3.2 Corticosteroids BNFC 2011–2012CICLESONIDECautions see notes abovePregnancy see p. 133Breast-feeding see p. 133Side-effects see notes aboveIndication and doseProphylaxis of asthma. By aerosol inhalationChild 12–18 years 160 micrograms daily as asingle dose reduced to 80 micrograms daily ifcontrol maintainedNebules c (= single-dose units for nebulisation)fluticasone propionate 250 micrograms/mL, net price10 2-mL (500-microgram) unit = £9.34; 1 mg/mL,10 2-mL (2-mg) unit = £37.35. 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 4–16 years 1 mg twice dailyChild 16–18 years 0.5–2 mg twice daily3 Respiratory systemAlvesco c (Nycomed) AAerosol inhalation, ciclesonide 80 micrograms/metered inhalation, net price 120-dose unit = £32.83;160 micrograms/metered inhalation, 60-dose unit =£19.31, 120-dose unit = £38.62. Label: 8, counselling,administrationFLUTICASONE PROPIONATECautions see notes abovePregnancy see p. 133Breast-feeding see p. 133Side-effects see notes above; also very rarely dyspepsia,hyperglycaemia, and arthralgiaIndication and doseProphylaxis of asthma see Management ofChronic Asthma table, p. 135, and preparationsbelowFlixotide c (A&H) AAccuhaler c (dry powder for inhalation), disk containing60 blisters of fluticasone propionate 50 micrograms/blisterwith Accuhaler c device, net price =£6.38; 100 micrograms/blister with Accuhaler cdevice = £8.93; 250 micrograms/blister withAccuhaler c device = £21.26; 500 micrograms/blisterwith Accuhaler c device = £36.14. Label: 8, counselling,administration; also 10 and steroid card with highdosesDoseProphylaxis of asthma. By inhalation of powderChild 5–16 years 50–100 micrograms twice dailyadjusted as necessary; max. 200 micrograms twice dailyChild 16–18 years 100–500 micrograms twice daily,adjusted as necessary; max. 1 mg twice daily (dosesabove 500 micrograms twice daily initiated by a specialist)Evohaler c (aerosol inhalation), fluticasone propionate50 micrograms/metered inhalation, net price 120-dose unit = £5.44; 125 micrograms/metered inhalation,120-dose unit = £21.26; 250 micrograms/metered inhalation, 120-dose unit = £36.14. Label: 8,counselling, administration; also 10 and steroid cardwith high dosesDoseProphylaxis of asthma. By aerosol inhalationChild 4–16 years 50–100 micrograms twice dailyadjusted as necessary; max. 200 micrograms twice dailyChild 16–18 years 100–500 micrograms twice dailyadjusted as necessary; max. 1 mg twice daily (dosesabove 500 micrograms twice daily initiated by a specialist)Compound preparationsFor prescribing information on salmeterol, see section3.1.1.1Seretide c (A&H) ASeretide 100 Accuhaler c (dry powder for inhalation),disk containing 60 blisters of fluticasonepropionate 100 micrograms, salmeterol (as xinafoate)50 micrograms/blister with Accuhaler c device, netprice = £31.19. Label: 8, counselling, administrationDoseProphylaxis of asthma. By inhalation of powderChild 5–18 years 1 blister twice daily, reduced to 1blister once daily if control maintainedSeretide 250 Accuhaler c (dry powder for inhalation),disk containing 60 blisters of fluticasonepropionate 250 micrograms, salmeterol (as xinafoate)50 micrograms/blister with Accuhaler c device, netprice = £35.00. Label: 8, counselling, administration,10, steroid cardDoseProphylaxis of asthma. By inhalation of powderChild 12–18 years 1 blister twice dailySeretide 500 Accuhaler c (dry powder for inhalation),disk containing 60 blisters of fluticasonepropionate 500 micrograms, salmeterol (as xinafoate)50 micrograms/blister with Accuhaler c device, netprice = £40.92. Label: 8, counselling, administration,10, steroid cardDoseProphylaxis of asthma. By inhalation of powderChild 12–18 years 1 blister twice dailySeretide 50 Evohaler c (aerosol inhalation), fluticasonepropionate 50 micrograms, salmeterol (asxinafoate) 25 micrograms/metered inhalation, netprice 120-dose unit = £18.00. Label: 8, counselling,administrationDoseProphylaxis of asthma. By aerosol inhalationChild 5–18 years 2 puffs twice daily, reduced to 2 puffsonce daily if control maintainedSeretide 125 Evohaler c (aerosol inhalation), fluticasonepropionate 125 micrograms, salmeterol (asxinafoate) 25 micrograms/metered inhalation, net