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 Formulary Chapter 3: Respiratory system - Full Chapter
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03.02  Expand sub section  Corticosteroids
 note 

Prescribe beclomethasone diproprionate by brand.
The MHRA has advised that beclomethasone diproprionate CFC-free inhalers should be prescribed by brand name. Clenil Modulite® and Qvar® are not interchangeable. Qvar® has extra fine particles and is approximately twice as potent as Clenil Modulite®.
 
Single component corticosteroid inhalers are only licensed for ASTHMA. COPD patients should be prescribed combination inhalers.

Beclometasone (Clenil Modulite)
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First Choice Metered Dose Inhaler (MDI) 
Beclometasone (Qvar)
View adult BNF View SPC online View childrens BNF  Track Changes
First Choice Metered Dose Inhaler (MDI)
Easi-breathe
Autohaler

note Not licensed for use in paediatrics. 
Budesonide
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary Dry powder inhaler (Easyhaler, Pulmicort Turbohaler)
Respules 
   
Fluticasone
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary Metered dose inhaler (Flixotide Evohaler)
Dry powder inhaler (Flixotide Accuhaler)
Nebules 
   
Beclometasone and formoterol (Fostair)
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Formulary
  • Metered dose inhaler (MDI)
  • Dry powder inhaler (NEXThaler®)


Combination ICS/LABA inhaler

Fostair® contains an extra-fine formulation of beclomethasone and is more potent than traditional CFC-containing beclomethasone inhalers - check dose.

note  200/6 strength only licensed in asthma

 
   
Budesonide and formoterol (DuoResp Spiromax)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary Dry powder inhaler

Combination ICS/LABA inhaler
 
   
Budesonide and formoterol (Fobumix )
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Formulary

Metered dose inhaler (Easyhaler®)

Combination ICS/LABA inhaler


note 80/4.5 strength only licensed in asthma

 
   
Fluticasone and formoterol (Flutiform)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary Metered dose inhaler

Combination ICS/LABA inhaler

note Licensed for ASTHMA only.  
   
Fluticasone and salmeterol (AirFluSal)
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Formulary

Dry powder inhaler (Forspiro®)

Combination ICS/LABA inhaler

 
   
Fluticasone and salmeterol (Sirdupla)
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Formulary

Metered dose inhaler

Combination ICS/LABA inhaler

note Only licensed for use in asthma

 
   
Fluticasone furoate & vilanterol (Relvar Ellipta)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary Dry powder inhaler

Combination ICS/LABA inhaler

note184/22 strength licensed for ASTHMA only 
   
Beclometasone / formoterol / glycopyrronium (Trimbow )
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary

Metered dose inhaler (MDI)


Combination ICS/LABA/LAMA inhaler

 
   
Fluticasone / umeclidinium / vilanterol (Trelegy Ellipta )
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary

Dry powder inhaler (DPI)


Combination ICS/LABA/LAMA inhaler

 
   
 ....
 Non Formulary Items
Budesonide and formoterol  (Symbicort Turbohaler)

View adult BNF View SPC online View childrens BNF Track Changes
Non Formulary

Dry powder inhaler

Combination ICS/LABA inhaler

Restricted Item Not to be initiated, but can be continued in established patients

 
Ciclesonide  (Alvesco)

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Non Formulary
 
Fluticasone and salmeterol  (Seretide)

View adult BNF View SPC online View childrens BNF Track Changes
Non Formulary

Metered dose inhaler (Seretide® Evohaler)
Dry powder inhaler (Seretide® Accuhaler)

Combination ICS/LABA inhaler

note Only the Seretide Accuhaler is licensed for use in COPD. Seretide Evohaler is very expensive - please consider alternatives where possible.

Restricted Item Not to be initiated, but can be continued in established patients.

 
Mometasone Furoate  (Asmanex)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Zafirlukast  (Accolate)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
  
Key
note Notes
Section Title Section Title (top level)
Section Title Section Title (sub level)
First Choice Item First Choice item
Non Formulary Item Non Formulary section
Restricted Drug
Restricted Drug
Unlicensed Drug
Unlicensed
Track Changes
Display tracking information
click to search medicines.org.uk
Link to adult BNF
click to search medicines.org.uk
Link to children's BNF
click to search medicines.org.uk
Link to SPCs
SMC
Scottish Medicines Consortium
Cytotoxic Drug
Cytotoxic Drug
CD
Controlled Drug
High Cost Medicine
High Cost Medicine
Cancer Drugs Fund
Cancer Drugs Fund
NHSE
NHS England
Homecare
Homecare
CCG
CCG

Traffic Light Status Information

Status Description

Amber

Drugs designated amber are suitable for shared care arrangements under a shared care protocol. Prescribing may be transferred from secondary to primary care once the patient is stabilised and agreed shared care arrangements have been established. Alternatively primary care may initiate under the supervision of secondary care if this option is given in the shared care document. It is recommended that shared care arrangements should be drawn up following local discussion and agreement by prescribing parties.   

Black

These products have been reviewed by the GM Joint Formulary Group and have been deemed not suitable for prescribing for adults in primary or secondary care within Greater Manchester. These decisions have been made on the basis of safety, efficacy and cost-effectiveness of the products.  

Green

Not used   

Green 1

Drugs designated green1 are suitable for initiation and ongoing prescribing within primary care.   

Green 2

Drugs designated green2 can be initiated by primary care following written or verbal advice from a specialist and then be subsequently safely prescribed in primary care with little or no monitoring required.  

Green 3

Drugs designated green3 are suitable for on-going prescribing within primary care after specialist initiation and an initial review (unless specified) in secondary care. Little or no monitoring is required.  

Grey

Not suitable for routine prescribing but may be suitable for a defined patient population. Whilst prescribers should think very carefully before prescribing or recommending any of the products on the grey list, there may be exceptional instances when the use of one of these products is necessary for a particular patient.   

Red

Drugs designated red are considered to be specialist medicines and prescribing responsibility for these medicines should normally remain with the consultant or specialist clinician. These drugs should not be initiated or prescribed in primary care. It is recommended that the supply of these specialist medicines should be organised via the hospital pharmacy, this may include arranging for supply via a home care company.   

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