Click here for long-acting beta 2 agonists (LABA).
Short-acting beta 2 agonists (SABA) [Asthma and COPD]
Prescribe an inhaler with a lower carbon impact where possible – resources can be found here.
Formulary Choices | Drug |
---|---|
Salbutamol DPI | |
Prescribe DPIs by brand name | or |
Terbutaline DPI 500 micrograms/metered inhalation | |
or | |
If a MDI is required | Salamol® (MDI) 100micrograms/ metered inhalation (salbutamol) |
or | |
Salamol®Easi-breathe (breath-actuated MDI) 100micrograms/ metered inhalation (salbutamol) | |
Prescribing Notes
General
- There is virtually no difference in efficacy between salbutamol and terbutaline; currently salbutamol is less expensive and available in a wider range of devices.
- A respiratory disease diagnosis should be made before putting SABA inhaler on repeat prescription.
- Offer Dry Powder Inhalers (DPIs) as first choice when clinically appropriate. If a MDI is required chose a brand with a lower carbon footprint e.g. Salamol® inhaler CFC free (MDI)
- Oral beta 2 agonists have an increased risk of side-effects and should only be prescribed in exceptional cases where inhaled therapies cannot be used. Patients currently prescribed oral beta 2 agonists should be reviewed and a switch to inhaled therapy considered.
Asthma
- SABAs should only be prescribed on a “when required” basis for rescue therapy.
- Inhaled corticosteroids should be considered for patients with any of the following asthma-related features:
- asthma attack in the last two years
- using inhaled SABA three times a week or more
- symptomatic three times a week or more
- waking one night a week with respiratory symptoms
- Asthma patients prescribed more than 12 short-acting reliever inhalers in the previous 12 months should be invited for urgent review (National Review of Asthma Deaths recommendation).
Long-acting beta 2 agonists (LABA) [COPD only]
Prescribe an inhaler with a lower carbon impact where possible – resources can be found here.
Choice | Drug |
---|---|
NB – in asthma, LABAs should only be started in patients who are already on inhaled corticosteroids, and the inhaled corticosteroid should be continued (combination devices are recommended) | |
Formulary choices If a MDI is required | Formoterol DPI NB Formoterol Easyhaler® is a cost-effective choice |
or | |
Salmeterol DPI 50micrograms/dose | |
or | |
Formoterol fumarate MDI 12micrograms/metered inhalation or | |
Salmeterol MDI 25micrograms/metered inhalation | |