American Thoracic Society Quick-Reference GUIDELINES Apps
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12 Treatment Table 9. Combined Long-Acting Beta Agonist Plus Inhaled Corticosteroid – Comparative Daily Dosages Generic (Brand) Dosage Form Dose a Combinations Budesonide/ Formoterol b (Symbicort ® ) MDI: 80/4.5 mcg/dose 160/4.5 mcg/dose 1–2 inh bid (dose depends on asthma severity and current inhaled corticosteroid therapy) to maximum 2 inh bid (160/4.5 mcg/dose) Fluticasone/ Salmeterol b (Advair Diskus ® ) c DPI: 100/50 mcg/dose 250/50 mcg/dose 500/50 mcg/dose 1 inh q12h Max dose: 500/50 mcg bid Fluticasone/ Salmeterol b (Advair HFA ® ) c MDI: 45/21 mcg/dose 115/21 mcg/dose 230/21 mcg/dose 1 inh bid 12 h apart Max dose: 230/21 mcg 2 inh bid Mometasone/ Formoterol † (Dulera ® ) MDI: 100/5 mcg/dose 200/5 mcg/dose 2 inh bid a See product labeling for complete prescribing information. b BLACK BOX WARNING: Long-acting β 2 -adrenergic agonists may increase the risk of asthma- related death. ey should never be used alone in children or adults with asthma. Please see product labeling for information on this warning. An FDA Medication Guide should be distributed to patients starting a new prescription. c Do not use with spacer device. Table 10. Long-Term Control Medications Generic (Brand) Dosage Form Dose Systemic corticosteroids Methylprednisolone (Medrol ® ) 2, 4, 8, 16, 32 mg tablets 40 mg qd × 5 days to treat an exacerbation OR 40 mg qd × 5 days, then 30 mg qd × 3 days, then 20 mg qd × 3 days, then 10 mg qd × 3 days, then stop to treat an exacerbation OR 5–10 mg qd for chronic control. Prednisolone (Prelone ® , Flo-Pred ® ) 5 mg tablets; 5 mg/5 mL, 15 mg/5 mL syrup Prednisone (Deltasone ® ) 2.5, 5, 10, 20, 50 mg tablets 1 mg/mL solution IgG1 k monoclonal antibody/IgE blocker Omalizumab (Xolair ® ) 150 mg in 1.2 mL/vial (aer reconstitution with 1.4 mL sterile water for SC injection) 150–375 mg SC q2–4wk; doses/ frequency determined by pretreatment serum IgE (IU/mL) and body weight (kg ) Max dose: 150 mg per injection site