Asthma/COPD:

Indications for PULMICORT FLEXHALER:

Maintenance treatment of asthma as prophylactic therapy. Asthma requiring systemic corticosteroid therapy, to reduce need for systemic corticosteroids.

Adult:

≥18yrs: Initially 360mcg twice daily; may consider starting at 180mcg twice daily, if appropriate. Max 720mcg twice daily. Rinse mouth after use.

Children:

<6yrs: not recommended. ≥6yrs: Initially 180mcg twice daily; may consider starting at 360mcg twice daily, if appropriate. Max 360mcg twice daily. Rinse mouth after use.

Contraindications:

Not for primary treatment of acute attack.

Warnings/Precautions:

Maintain regular regimen. Infections. If exposed to chickenpox or measles, consider antiinfective prophylactic therapy. Adrenal insufficiency may occur when transferring patients from systemic corticosteroids to inhaled corticosteroids: see literature. Monitor for growth suppression in children. Post-op or during stress: monitor adrenal response. Monitor for hypercorticism and HPA axis suppression (if occur discontinue gradually). Transferring from oral corticosteroids: see literature. Pregnancy (Cat.B). Nursing mothers: not recommended.

See Also:

Pharmacologic Class:

Steroid.

Interactions:

Caution with CYP3A4 inhibitors (eg, ketoconazole).

Adverse Reactions:

Pulmicort Flexhaler: nasal congestion, allergic rhinitis, viral upper respiratory tract infection, oral candidiasis, viral gastroenteritis, nausea, bronchospasm (rare). Pulmicort Respules: Respiratory or other infection, GI upset, moniliasis, fatigue, cough, dysphonia, rash, epistaxis, hypersensitivity reactions (discontinue if occurs).

Generic Availability:

Respules (YES); Flexhaler (NO)

How Supplied:

Flexhaler (90mcg/dose)—1 (60 inh); Flexhaler (180mcg/dose)—1 (120 inh); Respules—30