Easyhaler 100mcg per inhalation, 200mcg per inhalation, 400mcg per inhalation (asthma only)

Pulmicort® Turbohaler 100mcg per actuation, 200mcg per actuation, 400mcg per actuation (asthma only).                               

Pulmicort® respules 500mcg / 2ml, 1mg / 2ml (asthma / croup)

Flixotide Evohaler®  50mcg per actuation, 125mcg per actuation, 250mcg per actuation.

Flixotide Accuhaler® 50mcg per actuation, 100mcg per actuation, 250mcg per actuation, 500mcg per actuation. 

The maximum licensed dose in children is 200 micrograms twice daily.

Administration of doses above 1000 micrograms (500 micrograms twice daily) should be via a spacer device to help reduce side-effects in the mouth and throat. 

DuoResp Spiromax®  160 micrograms budesonide / 4.5 micrograms formoterol inhalation powder, 320 micrograms budesonide / 9mcg formoterol inhalation powder (asthma and COPD)

Fobumix Easyhaler® 80mcg budesonide / 4.5mcg formoterol per inhalation (asthma / over 18 years only), 160mcg budesonide / 4.5mcg formoterol per inhalation (asthma and COPD / over 18 years only), 320mcg budesonide / 9mcg formoterol per inhalation (asthma and COPD / over 18 years only)

Symbicort Turbohaler® 100mcg budesonide / 6mcg formoterol per inhalation (asthma only), 200mcg budesonide / 6mcg formoterol per inhalation (asthma and COPD), 400mcg budesonide / 12mcg formoterol per inhalation (asthma and COPD)

Symbicort® MDI 100mcg budesonide / 3mcg formoterol per actuation (asthma only), 200mcg budesonide / 6mcg formoterol per actuation (COPD only)

Fostair® / Luforbec® 100mcg beclometasone/6mcg formoterol metered dose inhalation (asthma and COPD)
Fostair® / Luforbec® 200mcg beclometasone/6mcg formoterol metered dose inhalation (asthma only)
Fostair / Luforbec are not recommended for children and young people under 18 years of age

Fostair NEXThaler®
Inhaler 100/6 micrograms per dose (asthma and COPD), 200/6 micrograms per dose (asthma only

The LSCMMG adult asthma guidelines only recommend triple inhalers to be initiated by a clinical expert in primary / secondary care, in those patients who are not adequately controlled with a maintenance combination of a long-acting beta 2-agonist and a high dose (Trimbow 172/5/9) or medium dose (Trimbow 87/5/9) of an inhaled corticosteroid, who have experienced one or more asthma exacerbations in the previous year.

In COPD Trimbow is only recommended for maintenance treatment in adult patients with moderate to severe COPD who are not adequately treated by a combination of an inhaled long-acting beta 2-agonist and corticosteroid.     

Trimbow pMDI 87 micrograms beclometasone/5 micrograms formoterol/9 micrograms glycopyrronium pressurised inhalation, solution (asthma and COPD),

Trimbow pMDI 172 micrograms beclometasone/5 micrograms formoterol/9 micrograms glycopyrronium pressurised inhalation, solution (asthma only),

Trimbow NEXThaler (DPI) 88 micrograms beclometasone /5 micrograms formoterol /9 micrograms glycopyrronium per actuation inhalation powder (COPD only)

Clenil Modulite 50mcg per inhalation, 100mcg per inhalation, 200mcg per inhalation, 250mg per inhalation (asthma only)

Easyhaler 200mcg per inhalation (asthma only)

QVAR® beclometasone inhalers are approximately twice as potent as Clenil Modulite® at the same microgram doses. They are not interchangeable and should be prescribed by brand name. 

QVAR Easi-Breathe 50mg per inhalation, 100mcg per inhalation (asthma / over 12 years only)

QVAR Autohaler 50mcg per inhalation, 100mcg per inhalation (asthma / 5 years and over)

QVAR MDI 50mcg per inhalation, 100mcg per inhalation (asthma / 5years and over).  

Administration of doses above 1000 micrograms (500 micrograms twice daily) should be via a VOLUMATIC spacer device to help reduce side-effects in the mouth and throat.                                                

(Trixeo Aerosphere® )
MDI - Each single actuation (delivered dose, ex-actuator) contains 5 micrograms of formoterol fumarate dihydrate, glycopyrronium bromide 9 micrograms, equivalent to 7.2 micrograms of glycopyrronium, and budesonide 160 micrograms.

Restriction: Triple therapy should be reserved for patients who have failed to achieve or maintain an adequate response to an appropriate course of dual therapy.

Alvesco® 80mcg per actuation, 160mcg per actuation (asthma / over 12 years only)

Flutiform® 50mcg fluticasone / 5mcg formoterol (asthma 5 years and above), 125 mcg fluticasone /5 mcg formoterol (asthma 12 years and above), 250mcg fluticasone / 10mcg formoterol per actuation (asthma adults only)

Relvar Ellipta® 92 micrograms fluticasone /22 micrograms vilanterol inhalation powder (asthma and COPD)

Relvar Ellipta® 184 micrograms fluticasone /22 micrograms vilanterol inhalation powder (asthma only)

(Trelegy Elipta®) Dry powder inhaler - Fluticasone furoate 92 microgram per 1 dose, Umeclidinium bromide 65 microgram per 1 dose, Vilanterol (as Vilanterol trifenatate) 22 microgram per 1 dose

Restriction: Triple therapy should be reserved for patients who have failed to achieve or maintain an adequate response to an appropriate course of dual therapy. The restriction should be the same for all triple inhalers for use in COPD. 

AirFlu Sal Forspiro® 50mcg salmeterol / 500mcg fluticasone per actuation (asthma and COPD / adults only)

AirFluSal® MDI 25mcg salmeterol / 125mcg fluticasone per inhalation (asthma / adults only), 25mcg salmeterol / 250mcg fluticasone per inhalation (asthma / adults only)

Seretide Accuhaler® (asthma and COPD) 50mcg salmeterol / 100mcg fluticasone per actuation, 50mcg salmeterol / 250mcg fluticasone per actuation, 50mcg salmeterol / 500mcg fluticasone per actuation

Seretide Evohaler® (asthma only) 25mcg salmeterol / 50mcg fluticasone per actuation, 25mcg salmeterol / 125mcg fluticasone per actuation, 25mcg salmeterol / 250mcg fluticasoneper actuation

Sirdupla®  (asthma only) 25mcg salmeterol / 125mcg fluticasone per inhalation, 25mcg salmeterol / 250mcg fluticasone per inhalation 

Atectura Breezhaler 125 micrograms indacaterol /62.5 micrograms mometasone inhalation powder, hard capsules

Atectura Breezhaler 125 micrograms indacaterol /127.5 micrograms mometasone inhalation powder, hard capsules

Atectura Breezhaler 125 micrograms indacaterol /260 micrograms mometasone inhalation powder, hard capsules

(Enerzair® Breezhaler® ) 114 micrograms/46 micrograms/136 micrograms inhalation powder, hard capsules 

The LSCMMG adult asthma guidelines only recommend triple inhalers to be initiated by a clinical expert in primary / secondary care, in those patients who are not adequately controlled with a maintenance combination of a long-acting beta 2-agonist and a high dose  of an inhaled corticosteroid, who have experienced one or more asthma exacerbations in the previous year