NHS Dumfries and Galloway Guide to inhalers: Comparison of current inhaled therapies for Asthma and COPD. LABAs (Long acting Beta2agonist) Formoterol 12 micrograms (Easyhaler ® formoterol)
Licensed in asthma (with regular corticosteroid) and COPD Formulary
120 dose unit, (1 or 2 puffs twice daily)
£23.75
Licensed in asthma (with regular corticosteroid) and COPD Non- formulary
120 dose Evohaler, (2 puffs twice daily)
£29.26
60 dose Accuhaler (1 inhalation twice daily)
£29.26
Other non-formulary brands include (Atimos® MDI, Foradil® DPI, Oxis ® Turbohaler®) Salmeterol (Serevent® Evohaler® 25 micrograms and Serevent Accuhaler 50 micrograms)
Indacaterol 150 micrograms and 300 micrograms (Onbrez® Breezhaler®)
Licensed in COPD Non-formulary
30 dose pack, same price for both strengths (one inhalation daily)
£29.26
▼Olodaterol 2.5 micrograms (Striverdi® Respimat®)
Licensed in COPD 3 months in-use shelf life Non-formulary
60 doses (2 puffs daily)
£26.35
Dr Emily Kennedy, Prescribing Support Pharmacist April 2015
LABA/Steroid combinations Beclometasone/ formoterol 100/6 (Fostair® NEXThaler® and MDI)
▼Fluticasone / Formoterol (Flutiform® MDI)
Fluticasone / Salmeterol (Seretide Evohaler and Seretide® Accuhaler®)
Licensed for 18 years plus MDI licensed for Asthma (and fMART) and COPD Nexthaler (dry powder inhaler) licensed for Asthma 6 months in-use shelf life Formulary Licensed for asthma for 12 years plus (50/5, 125/5) and 18 years plus (250/5) Formulary
120 doses (1 -2 puffs twice daily)
MDI in Asthma only (Seretide 50 for 5 years plus) Accuhaler in Asthma and COPD Limited formulary
120 dose Evohaler (2 puffs twice daily) 50/25 125/25 250/25 60 dose Accuhaler (One puff twice daily) 100/50 250/50 500/50 160/4.5, 120 doses
NB: Seretide 500 Accuhaler, 1 puff twice daily is less expensive than Seretide 250 Evohaler 2 puffs twice daily.
▼Budesonide and formoterol fumarate Dry powder inhaler (Duoresp® Spiromax®)
Licensed in 18 years plus Asthma and COPD 6 months in-use shelf life Formulary 160/4.5 equiv to formoterol 6 micrograms / budesonide 200 micrograms 320/9(equiv to formoterol 12 micrograms / budesonide 400 micrograms
Dr Emily Kennedy, Prescribing Support Pharmacist April 2015
120 doses (2 puffs twice daily) 50/5 125/5 250/5
320/9, 60 doses
£29.32
£18.00 £29.26 £45.56
£18.00 £35.00 £59.48
£18.00 £35.00 £40.92
£29.97
£29.97
Budesonide/ Formoterol (Symbicort ® Turbohaler®)
▼Fluticasone furoate/vilanterol (Relvar ® Ellipta®)
Licensed for asthma (and SMART) and COPD Non-formulary
Asthma (both strengths) COPD (92/22 only) Non-formulary N.B. 184 micrograms inhaled fluticasone furoate equivalent to 500 micrograms fluticasone propionate
Dr Emily Kennedy, Prescribing Support Pharmacist April 2015
100/6, 120 doses (1-2- puffs twice daily)
£33.00
200/6, 120 doses (1-2 puffs twice daily)
£38.00
400/12, 60 doses (1 puff twice a day)
£38.00
92/22, 30 doses (1 puff daily)
£27.80
184/22, 30 doses
£38.87
(1 puff daily)
LAMAs (Long acting anti-muscarinics) ▼Aclidinium (Eklira ® Genuair® 375 micrograms)
Tiotropium (Spiriva® Handihaler® 18 micrograms and Respimat ® 2.5micrograms)
COPD Formulary
60 dose unit, ( One inhalation twice daily)
£28.60
COPD - Formulary
30 dose pack with Handihaler, (once daily inhalation ) 30 dose capsule refill pack
£34.87
Respimat awaiting licence for asthma and SMC advice (LAMA therapy included in the update SIGN/BTS Asthma guidance @ STEP 4) Licensed in 18 years plus 3 months in-use shelf life
60 dose Respimat (Two puffs daily)
£33.50 £33.50
▼Glyccopyrronium 50 micrograms (Seebri® Breezhaler®)
COPD Non-formulary
30 dose pack, (1 puff daily) £27.50
▼Umeclidinium bromide 55 micrograms (Incruse® Ellipta®)
COPD Non-formulary
60 doses (2 puffs daily)
6 weeks In-use shelf life Should be used with caution in patients with severe cardiovascular disorders, particularly
cardiac arrhythmias Accepted for use in Scotland by SMC (Dec 14)
Dr Emily Kennedy, Prescribing Support Pharmacist April 2015
£27.50
LAMA/LABA combinations ▼Indacaterol/Glyccopyrronium (Ultibro® Breezhaler®)
COPD Accepted for use in Scotland by SMC (Dec 14)
30 doses (One puff daily)
£36.88
▼Formoterol/ Aclidinium (Duaklir® Genuair®)
COPD Accepted for use in Scotland by SMC (April 15)
60 doses (1 puff twice daily)
£32.50
▼Umeclidinium bromide and vilanterol (Anoro® Ellipta®)
COPD 6 weeks in-use shelf life after opening Should be used with caution in patients with severe cardiovascular disease. Accepted for use in Scotland by SMC (Feb 15)
30 doses (1 inhalation daily)
£32.50
Olodaterol/tiotropium (Spiolto Respimat) planned for UK launch in Q3 2015 by Boehringer Ingelheim, no further information available
COPD
Dr Emily Kennedy, Prescribing Support Pharmacist April 2015
