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Chronic obstructive pulmonary disease - Management
Inhaled corticosteroids +/- spacer device

Age from 16 years onwards
Beclometasone CFC-free MDI (Clenil): 400mcg twice a day
Clenil Modulite 200micrograms/dose inhaler
Inhale two puffs twice a day using the spacer.
Supply 1 200 dose inhaler.
Age: from 16 years onwards
NHS cost: £16.17
Licensed use: no - off-label indication
Patient information: Rinse out mouth after use
Beclometasone CFC-free MDI (Clenil): 500-1000mcg twice a day
Clenil Modulite 250micrograms/dose inhaler
Inhale two to four puffs twice a day, using the spacer
Supply 2 200 dose inhaler.
Age: from 16 years onwards
NHS cost: £32.58
Licensed use: no - off-label indication
Patient information: Rinse out mouth after use.
Beclometasone CFC-free MDI (Qvar): 200mcg twice a day
Qvar 100 inhaler
Inhale two puffs twice a day.
Supply 1 200 dose inhaler.
Age: from 16 years onwards
NHS cost: £17.21
Licensed use: no - off-label indication
Patient information: Rinse out mouth after use.
Beclometasone CFC-free MDI (Qvar): 200-400mcg twice a day
Qvar 100 inhaler
Inhale two to four puffs twice a day.
Supply 2 200 dose inhaler.
Age: from 16 years onwards
NHS cost: £34.42
Licensed use: no - off-label indication
Patient information: Rinse out mouth after use.
Fluticasone CFC-free MDI: 250-500mcg twice a day
Fluticasone 250micrograms/actuation inhaler CFC free
Inhale one to two puffs twice a day.
Supply 1 120 dose inhaler.
Age: from 16 years onwards
NHS cost: £36.14
Licensed use: no - off-label indication
Patient information: Rinse out mouth after use.
Volumatic spacer: for use with Clenil or Flixotide
Volumatic
Use to aid inhalation.
Supply 1 spacer.
Age: from 16 years onwards
NHS cost: £2.81
OTC cost: £4.96
Licensed use: no - misc item available on the NHS
Patient information: Wash your spacer device regularly according to the instructions in the patient information leaflet. Replace spacer device every 6 to 12 months.
Budesonide CFC-free MDI: 400mcg twice a day
Budesonide 200micrograms/dose inhaler CFC free
Inhale two puffs twice a day.
Supply 1 120 dose inhaler.
Age: from 16 years onwards
NHS cost: £13.20
Licensed use: no - off-label indication
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Patient information: Rinse your mouth out with water after using this inhaler. Please follow the care instructions provided with this inhaler. This will ensure it works correctly.
NebuChamber spacer device: for use with Pulmicort
NebuChamber with child mask
Use to aid inhalation.
Supply 1 spacer.
Age: from 16 years onwards
NHS cost: £8.56
Licensed use: no - misc item available on the NHS
Patient information: Seal your lips around the spacer mouthpiece and spray one puff only from the inhaler into the other end of the spacer. (You do not need to use the mask that comes with this spacer.) Breathe in slowly and deeply to inhale the dose and breathe out. The drug aerosol is very short lived so do not wait more than a few seconds to inhale the dose. If a second dose is required, repeat the process about 30 seconds later. Follow the instructions in all patient information leaflet carefully. Wash the spacer device thoroughly once a month with dilute washing up liquid, do not rinse and leave to air dry. Replace the device every 6 to 12 months.

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