NICE guida nce

Inhale d corticosteroids for the treatme nt of

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-