Inhalers should always be prescribed by their BRAND name.
The patient's ability to use a device should be assessed by a competent healthcare professional and re-assessed as part of structured clinical review. If the patient is unable to use a device satisfactorily, an alternative should be found.
RightBreathe is a free app/website designed to help clinicians and patients use inhaled therapy and devices appropriately https://www.rightbreathe.com/. Asthma.org has patient-friendly videos of inhaler technique here.
In children aged 0-5 years, pMDI and spacer are the preferred delivery method for β2 agonists or inhaled steroids. A face mask is required until the child can breathe reproducibly using the spacer mouthpiece.
Formoterol fumarate, beclometasone dipropionate and glycopyrronium bromide
Combination of formoterol fumarate, beclametasone diproprionate and glycopyrronium (5/87/9 micrograms per puff) MDI
120 doses Two puffs twice a day
Maintenance treatment in adult patients with moderat to severe chronic obstructive pulmonary disease who are not adequately treated by a combination of an inhaled corticosteroid and a long-acting β2 agonist.
Vilanterol, fluticasone furoate and umeclidinium
Combination of Vilanterol, fluticasone furoate and umeclidinium (22/92/55 micrograms per inhalation) 30 doses.
Breath actuated dry powder inhaler used as maintenance treatment in adult patients with severe COPD who are not adequately treated by a combination of an inhaled corticosteroid and a long acting B2 agonist.
RED - Hospital only – to be prescribed by a specialist and supplied from secondary care ONLY throughout treatment.
Amber medicines are considered suitable for GP prescribing following specialist initiation or recommendation.
Shared Care - these medicines require specialist initiation and stabilisation. Ongoing division of responsibility for drug and disease monitoring between specialist and GP by a Shared Care Guideline (SCG). If no SCG in place status reverts to red.
These medicines are appropriate for initiation in both primary and secondary care. Prescribing is appropriate within licensed or local recommendations.
Suitable for patient to be directed to buy themselves
Not currently used. We intend to include this TLS in future to highlight where a decision to use this medicine is under review.
(In use from Oct 2020) Used where a decision has been made by the BSW APC not to routinely commission this preparation for its licensed indications. Do not prescribe.
Not currently used. We intend to include this TLS in future to highlight where this medicine and indication is ONLY available through a Specialist Centre according to a NICE Highly Specialised Technology or NHSE Specialised Commission Circular / Policy.