Bronchial asthma: Children 6 to 11 years: 100 to >400 micrograms daily in 2 to 4 divided doses.
The full daily dose may be given in one administration.
Adult: 200 to >800 micrograms daily in 2 to 4 divided doses.
The daily doses may be increased up to 1600 micrograms in more severe cases.
Patients taking up to 400 micrograms/day may take the full dose in one administration.
After asthma stability has been achieved, titrate to the lowest effective dose to reduce the possibility of adverse effects.
Conversion from oral systemic corticosteroid to orally inhaled corticosteroid: The patients' asthma condition should be in reasonably stable on oral corticosteroids before initiating oral inhalation therapy. A gradual dose reduction of oral corticosteroids should begin 7-10 days after starting high dose of inhaled therapy concurrently with the previously used dose of oral corticosteroid such as reducing prednisolone dose by 2.5 mg per month (or equivalent of other corticosteroids).
Mode of Administration: PULVISONIDE 200 capsules should only be used with the inhaler and inhaled through your mouth (oral inhalation).
Do not intake or swallow PULVISONIDE 200 capsules.
PULVISONIDE 200 capsules should always be stored in blister and only removed immediately before use. The capsules should not be stored in the inhaler.
After receiving orally inhaled budesonide, patients should rinse their mouth with water to remove residual drug in the oropharyngeal area and to reduce the development of fungal overgrowth and infection.
Instruction for using PULVISONIDE 200: Remove the protection cap from the inhaler.
Hold the base of the inhaler firmly.
Open the inhaler by turning the mouthpiece in the direction of the arrows.
Take a capsule and place it in the capsule chamber of the inhaler.
Check whether the capsule is completely inside the capsule chamber. If not, put the capsule in correctly.
Close the inhaler by turning the mouthpiece back to the closed position.
Hold the inhaler upright (with the mouthpiece upwards). Hold the push buttons between thumb and index finger. Use both fingers at the same time to press these buttons once. (Figure 6) The capsule is now evenly punctured.
Deeply breathe out (not through the inhaler). After that, hold the inhaler horizontally.
Tilt the head back slightly. Insert the mouthpiece of the inhaler completely into the mouth, behind the teeth and on the tongue. Close the lips tight round the mouthpiece.
Breathe in rapidly but steadily, as deeply and forcefully as the patient can. The inhaler makes a rattling noise if it is operating properly. This is because the capsule spins in the chamber as the powder disperses.
Remove the inhaler from the mouth. Hold the breath for about 5-10 seconds so that the lungs can take up the medication. Breathe out gently.
Open the inhaler and check whether the capsule is empty, if not repeat the previous four steps.
Open the inhaler and remove the empty capsule. Put the protection cap back on the inhaler.
Instruction for cleaning PULVISONIDE 200: Clean the inhaler of PULVISONIDE 200 once a week.
Open the inhaler by turning the mouthpiece as far as possible in the direction of the arrows.
Rinse the mouthpiece with running water.
Before using the inhaler again, it should be completely dry.