chro nic asthma in children under 12 yea rs (Nove mber 2007) For children under 12 years with chronic asthma in whom treatment with an inhaled corticosteroid is considered appropriate, the least costly product that is suitable for an individual child (taking into consideration NICE TAs 38 and 1 0), within its marketing authorisation, is recommended. For children under 12 years with chronic asthma in whom treatment with an inhaled corticosteroid and a long-acting beta2 agonist is considered appropriate, the following apply: . the use of a combination inhaler within its marketing authorisation is recommended as an option; . the decision to use a combination inhaler or two agents in separate inhalers should be made on an individual basis, taking into consideration therapeutic need and the likelihood of treatment adherence; . if a combination inhaler is chosen, then the least costly inhaler that is suitable for the individual child is recommended. www.nice.org.uk/TA131 NICE guida nce Inhale d corticosteroids for the treatme nt of chro nic asthma in children over 12 years (March 2008 ) For children over 12 years with chronic asthma in whom treatment with an inhaled corticosteroid is considered appropriate, the least costly product that is suitable for an individual child (taking into consideration NICE TAs 38 and 1 0), within its marketing authorisation, is recommended. For children over 12 years with chronic asthma in whom treatment with an inhaled corticosteroid and a long-acting beta2 agonist is considered appropriate, the following apply: . the use of a combination inhaler within its marketing authorisation is recommended as an option; . the decision to use a combination inhaler or two agents in separate inhalers should be made on an individual basis, taking into consideration therapeutic need and the likelihood of treatment adherence; . if a combination inhaler is chosen, then the least costly inhaler that is suitable for the individual child is recommended. www.nice.org.uk/TA138 BECLOMETASONE DIPROPIONATE (Beclometh asone Dipropio nate) Cautions see notes above Pregnancy see p. 131 Breast-feeding see p. 131 Side-effects see notes above Licensed use Clenil Modulite -200 and -250, and Qvar are not licensed for use in children under 12 years; Easyhaler Beclometasone Dipropionate is not licensed for use in children under 18 years Indications and dose Prophylaxis of asthma
See Management of Chronic Asthma table, p. 133
Impor tant for Asmabec Clickhaler, Clenil, and Qvar doses, see under preparations below Beclomet asone (Non-proprietary) A Dry powder for inhalation, beclometasone dipropionate 100 micrograms/metered inhalation, net price 100-dose unit = 5.36; 200 micrograms/ metered inhalation, 100-dose unit = 9.89, 200-dose unit = 14.93; 400 micrograms/metered inhalation, 100-dose unit = 19.61. Label: 8, counselling, administration; also 10 and steroid card with high doses Brands include Pulvinal Beclometasone Dipropionate, Easyhaler Beclometasone Dipropionate Asmabec Clickhaler (RPH) A Dry powder for inhalation, beclometasone dipropionate 100 micrograms/metered inhalation, net price 200-dose unit = 9.81; 250 micrograms/ metered inhalation, 100-dose unit = 12.31. Label: 8, counselling, administration; also 10 and steroid card with high doses Dose Prophylaxis of asthma . By inhalation of powder Child 6 12 years 100 200 micrograms twice daily, adjusted as necessary Child 12 18 years 100 400 micrograms twice daily, adjusted as necessary; max. 1 mg twice daily Clenil Modu lite (Chiesi) A Aerosol inhalation, beclometasone dipropionate 50 micrograms/metered inhalation, net price 200dose unit = 3.70; 100 micrograms/metered inhalation = 7.42; 200 micrograms/metered inhalation = 16.17; 250 micrograms/metered inhalation = 16.29. Label: 8, counselling, administration; also 10 and steroid card with high doses Dose Prophylaxis of asthma . By aerosol inhalation Child 2 12 years 100 200 micrograms twice daily Child 12 18 years 200 400 micrograms twice daily adjusted as necessary up to 1 mg twice daily Note Clenil Modulite is not interchangeable with other CFC-free beclometasone dipropionate inhalers; the MHRA has advised (July 2008) that CFC-free beclometasone dipropionate inhalers should be prescribed by brand name, see p. 145 Dental Prescribing on NHS Clenil Modulite 50 micrograms/metered inhalation may be prescribed Qvar (TEVA UK) A Aerosol inhalation, beclometasone dipropionate 50 micrograms/metered inhalation, net price 200dose unit = 7.87; 100 micrograms/metered inhalation, 200-dose unit = 17.21. Label: 8, counselling, administration; also 10 and steroid card with high doses Autohaler (breath-actuated aerosol inhalation), beclometasone dipropionate 50 micrograms/ metered inhalation, net price 200-