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 Formulary Chapter 3: Respiratory system - Full Chapter
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03.02  Expand sub section  Corticosteroids
Beclometasone (Clenil Modulite®)
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First Choice
Green

First choice for CFC-free inhaled corticosteroid. 

Prescribe by brand as Clenil Modulite® and QVAR® brands of beclometasone inhalers are not dose equivalent.

For asthma see Maintenance Management of Asthma – Inhaled and Oral Therapies (adults).

 
Beclometasone and Formoterol (Fostair NEXThaler®)
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Formulary
Green

For asthma see Maintenance Management of Asthma – Inhaled and Oral Therapies (adults).

Available as:

  • Beclometasone 100 microgram / Formoterol 6 microgram
  • Beclometasone 200 microgram / Formoterol 6 microgram

APCO September 2017.

 
   
Beclometasone and Formoterol (Fostair®)
(200mcg/6mcg)
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Formulary
Green

For asthma see Maintenance Management of Asthma – Inhaled and Oral Therapies (adults).

APCO September 2017.

 
   
Budesonide (Pulmicort®)
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Formulary
Green

For asthma see Maintenance Management of Asthma Inhaled and Oral Therapies (adults).

APCO September 2017.

 
   
Fluticasone Furoate & Vilanterol (Relvar Ellipta®)
(184mcg/22mcg)
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Formulary
Green

For asthmatic patients when medium or high dose ICS/LABA required as per Maintenance Management of Asthma – Inhaled and Oral Therapies (adults).

APCO September 2017.

 
   
Fluticasone Propionate and Salmeterol (AirFluSal Forspiro®)
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Formulary
Green

For COPD - For patients on existing seretide accuhaler therapy only. Generic equivalent of seretide® 500 accuhaler.

APCO January 2016.

NB. For Asthma - Not included in Maintenance Management of Asthma – Inhaled and Oral Therapies (adults).

 
   
Fluticasone Propionate and Salmeterol (AirFluSal® MDI)
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Formulary
Green

In asthma patients when medium or high dose ICS/LABA required as per Maintenance Management of Asthma – Inhaled and Oral Therapies (adults).

Available as: 

  • Fluticasone propionate 250 microgram/ Salmeterol 25 microgram
  • Fluticasone propionate 125 microgram/ Salmeterol 25 microgram

APCO September 2017.

 
   
Fluticasone Propionate and Salmeterol (Combisal® 50/25)
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Formulary
Green

Alternative to Seretide 50. 

See Maintenance Management of Asthma – Inhaled and Oral Therapies (adults).

APCO March 2020. 

 
   
Beclometasone and Formoterol (Fostair®)
(100mcg/6mcg)
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Formulary

Green Traffic Light  In line with Maintenance Management of Asthma – Inhaled and Oral Therapies (adults).

APCO September 2017.

Restricted Item Brown Traffic Light  Restricted in line with Guidance on COPD Management in Primary care - Inhaled Therapies.

APCO March 2017.

 
   
Budesonide and Formoterol (Symbicort® Turbohaler)
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Formulary

Green Traffic Light  For management of asthma as per Maintenance Management of Asthma – Inhaled and Oral Therapies (adults).

Restricted Item Brown Traffic Light  Restricted in line with Guidance on COPD Management in Primary care - Inhaled Therapies.

APCO March 2017.

 
   
Fluticasone Furoate & Vilanterol (Relvar Ellipta®)
(92mcg/22mcg)
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Formulary

Green Traffic Light  For asthmatic patients when medium or high dose ICS/LABA required as per Maintenance Management of Asthma – Inhaled and Oral Therapies (adults).

APCO September 2017.

Restricted Item Brown Traffic Light  Restricted in line with Guidance on COPD Management in Primary care - Inhaled Therapies.

APCO March 2017.

 
   
Fluticasone Furoate & Vilanterol & Umeclidinium (Trelegy Ellipta®)
(92mcg/55mcg/22mcg dry powder inhaler)
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Restricted Drug Restricted
Brown

Restricted in line with Guidance on COPD Management in Primary care - Inhaled Therapies.

APCO January 2018.

 
   
Fluticasone Propionate (Flixotide®)
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Restricted Drug Restricted
Brown

Flixotide® should not be initiated for new patients for asthma.

People whose treatment with Flixotide® is not recommended in Maintenance Management of Asthma – Inhaled and Oral Therapies (adults) but was started within the NHS before this guidance was published, should be able to continue treatment until they and their NHS clinician consider it appropriate to stop.

 
   
Fluticasone Propionate and Salmeterol (Seretide®)
(All other strengths and preparations)
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Restricted Drug Restricted
Brown

Restricted for existing patients only.

NB: Seretide® 500 accuhaler is not included in Guidance on COPD Management in Primary care - Inhaled Therapies.

NB: Seretide is not included in  Maintenance Management of Asthma – Inhaled and Oral Therapies (adults) . 

 

 
Link  British guideline on the management of asthma
   
Formoterol fumarate, beclometasone dipropionate and glycopyrronium bromide  (Trimbow® Inhaler)
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Restricted Drug Restricted
Brown

Triple therapy '3 in 1' inhaler for COPD, for use in line with Guidance on COPD Management in Primary care - Inhaled Therapies.

Another option in place of current fostair/ spiriva respimat.

APCO November 2017.

 
   
Beclometasone (Easyhaler®)
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Restricted Drug Restricted
Brown

Beclometasone easyhaler® should not be initiated for new patients for asthma.

People whose treatment with Beclometasone easyhaler® is not recommended in Maintenance Management of Asthma – Inhaled and Oral Therapies (adults) but was started within the NHS before this guidance was published, should be able to continue treatment until they and their NHS clinician consider it appropriate to stop.

Dry-powder inhaler available as 200micrograms per dose DPI.

 
   
Budesonide and Formoterol (Symbicort®)
(Pressurised MDI)
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Restricted Drug Restricted
Brown

Restricted with in line with Guidance on COPD Management in Primary care - Inhaled Therapies.

APCO March 2017.

 
   
Ciclesonide (Alvesco®)
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Restricted Drug Restricted
Brown

For patients who require an inhaled corticosteroid, who have unacceptable side effects caused by standard and high dose corticosteroid despite thorough post-dose mouth rinsing, use of a spacer and treatment of candidiasis.

See Maintenance Management of Asthma – Inhaled and Oral Therapies (adults).

APCO September 2017.

 
   
 ....
 Non Formulary Items
Beclometasone  (Qvar®)

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Non Formulary

NB. Clenil Modulite® is first line.

Prescribe by brand as Clenil Modulite® and QVAR® brands of beclometasone inhalers are not dose equivalent.

 
Budesonide and Formoterol  (DuoResp Spiromax®)

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Non Formulary

NB: Please prescribe by brand. This is a different device to Symbicort® and requires different inhaler technique. 

NB: Not included in Guidance on COPD Management in Primary care - Inhaled Therapies or Maintenance Management of Asthma – Inhaled and Oral Therapies (adults).

 
Budesonide and Formoterol  (Fobumix Easyhaler®)

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Non Formulary
 
Fluticasone Propionate and Formoterol  (Flutiform®)

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Non Formulary
 
Fluticasone Propionate and Salmeterol  (Aloflute®)

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Non Formulary
 
Fluticasone Propionate and Salmeterol  (Sereflo®)

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Non Formulary
 
Fluticasone Propionate and Salmeterol  (Seretide®50)
(Evohaler)

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Non Formulary

Not included in the asthma guidance - Maintenance Management of Asthma – Inhaled and Oral Therapies (adults).

Prescribe Combisal MDI 50/25 instead. 

APCO March 2020.

 
Fluticasone Propionate and Salmeterol  (Sirdupla®)

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Non Formulary
Black

Not recommended for use in asthma.

APCO January 2016.

 
Mometasone Furoate  (Asmanex®)

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Non Formulary
 
Zafirlukast  (Accolate®)

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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

Red

Red: Medicines which should only be prescribed in secondary care by a specialist.  

Amber Continuation

Amber Continuation: Medicines which should be initiated or recommended by a specialist for continuation in primary care. The specialist must notify the GP that the prescribing responsibility has been transferred.   

Amber Shared Care Protocol

Amber Shared Care Protocol: Medicines which are appropriate to be initiated and stabilised by a specialist, once stabilised the medicine may be appropriate for responsibility to be transferred from secondary to primary care with the agreement of a GP and a formal ‘shared care’ agreement. The shared care protocol must be approved by the Area Prescribing Committee Oxfordshire (APCO).   

Green

Green: Medicines which are suitable for initiation and ongoing prescribing within primary care.   

Brown

Brown: Medicines which should only be prescribed in restricted circumstances.  

Black

Black: Medicines which are not recommended for use because of lack of evidence of clinical effectiveness, cost effectiveness or safety.  

OCCG Green

not used  

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