Selecting a Treatment Regimen
Table 5. Long-Term Inhaled Corticosteroids (most potent, and first-line anti-inflammatory therapy) – Comparative Daily Dosages
Refer to Table 4 for Long-Term Control Medications Generic (
)
Beclomethasone (QVAR HFA®
)
Budesonide (Pulmicort Flexhaler®
)
Budesonide (Pulmicort Turbuhaler®
) MDI: 200 mcg/dose )
Ciclesonide (Alvesco®
Flunisolide† (Aerobid®
)
Fluticasone (Flovent HFA®
)
Fluticasone (Flovent Diskus®
Mometasone (Asmanex Twisthaler®
)
Triamcinolone (Azmacort®
) Combinations
Budesonide/ Formoterol† (Symbicort®
)
Fluticasone/ Salmeterol† (Advair Diskus®
Fluticasone/ Salmeterol† (Advair HFA®
Mometasone/ Formoterol† (Dulera®
)
*See product labeling for complete prescribing information. †BLACK BOX WARNING: Long-acting β2
never be used alone in children or adults with asthma. Please see product labeling for information on this warning. An FDA Do not use with spacer device.
Medication Guide should be distributed to patients starting a new prescription. §
6 -adrenergic agonists may increase the risk of asthma-related death. They should )§ )§
DPI: 100/50 mcg/dose 250/50 mcg/dose 500/50 mcg/dose
DPI: 45/21 mcg/dose 115/21 mcg/dose 230/21 mcg/dose
MDI: 100/5 mcg/dose 200/5 mcg/dose
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)
1 inh q12h
Max dose: 500/50 mcg bid 1 inh bid 12 h apart
Max dose: 230/21 mcg 2 inh bid 2 inh bid
MDI: 75 mcg/dose
Previous Therapy Bronchodilator alone Inhaled corticosteroids Oral corticosteroids
4-10
1 qd in the evening 1 qd in the evening 2 bid
10-16
2 2 4
16
MDI: 44 mcg/dose 110 mcg/dose 220 mcg/dose
Powder: ) 50, 100, 250 mcg
DPI: 110 mcg/dose 220 mcg/dose
Daily Starting Dose
Highest Daily Dose
2-4 1-2 1
100 mcg bid
4-20 2-8 1-4
20-40 16 8
250-500 mcg bid 1000 mcg bid
DPI: 80 mcg/dose 160 mcg/dose
MDI: 250 mcg/dose
≥ 6 yrs: low dose 200 mcg bid; high dose 800 mcg bid Max dose: 800 mcg bid
2-4
1 inh bid to maximum of 320 mcg bid —
4-8 Dosage Form
DPI: 40 mcg/dose 80 mcg/dose
DPI: 90 mcg/dose 180 mcg/dose
Daily Dose (inh bid unless otherwise indicated)* Low
Medium
2-6 1-3
1-4 1-2
6-8 1-4
4-8 2-4
High
16 8
8-16 4-8
Br
and
