The dosage of Pulmicort Turbuhaler is individual. When treatment with inhaled glucocorticosteroids is started during periods of severe asthma and while reducing or discontinuing oral glucocorticosteroids, the dosage should be:
Adults: 200-1600 mcg daily, divided into 2-4 administrations (less severe cases 200-800 mcg daily, more severe cases 800-1600 mcg daily).
Children ≥6 years: 200-800 mcg daily, divided into 2-4 administrations; 400 mcg/day can be used once daily.
The maintenance dose is individual and should be the lowest possible. Twice-daily administration (morning and evening) is usually sufficient.
In patients where an increased therapeutic effect is desired, an increased dose of Pulmicort Turbuhaler is recommended because of the lower risk of systemic effects as compared with a combined treatment with oral glucocorticosteroids.
Patients Not Dependent on Oral Steroids: A therapeutic effect is usually reached within 10 days. In patients with excessive mucus secretion in the bronchi, a short (about 2 weeks) additional oral corticosteroid regimen can be given initially.
Patients Dependent on Oral Steroids: When transfer from oral steroids to Pulmicort Turbuhaler is started, the patient should be in a relatively stable phase. A high dose of Pulmicort Turbuhaler is given in combination with the previously used oral steroid for about 10 days. After that, the oral dose is gradually reduced (with eg, 2.5 mg prednisolone or the equivalent each month) to the lowest possible level. In many cases, it is possible to completely substitute the oral steroid with Pulmicort Turbuhaler.
Note: The medication from Pulmicort Turbuhaler is delivered to the lungs as the patient inhales and therefore, it is important to instruct the patient to breathe-in forcefully and deeply through the mouthpiece. When prescribing Pulmicort Turbuhaler to young children, it is necessary to ascertain that they can follow the instruction for use.
The patient may not taste or feel any medication when using Pulmicort Turbuhaler due to the small amount of drug dispensed.
The patient should be instructed to rinse the mouth with water after each dosing occasion.