Inhaler DosingAgent Strength/puff Onset Duration Usual dose Maximum Dose

AnticholinergicsIpratropium MDI (Atrovent)

20mcg 1-3min ≤4H 2 puffs TDS-QID1,2 12puffs/day1

Tiotropium Handihaler(Spiriva)

18mcg (capsule) 1 cap OD 1 cap/day

Short-acting Beta2-Agonist (SABA)Salbutamol (Ventolin/Buventol)

100mcg 5min 6-8H 2 puff q4-6H Acute: 4-8puffs q20min upto 4H, then q1-4H PRN

Terbutaline Turbuhaler (Bricanyl)

500mcg 5min 4-7H 1puff PRN 6puffs/day

Long-acting Beta2-Agonist (LABA)Formoterol Tubuhaler (Oxis)

4.5mcg ≤3 min 12H 1-2puffs OD-BD 4puffs BD (8puffs/day)3

9mcg 1puff OD-BD 2puffs BD (4puffs/day)3

Indacaterol Breezhaler(Onbrez)

150mcg (capsule) 5min 24H 1 cap OD 300mcg/day300mcg(capsule) 1 cap OD 300mcg/day

Inhalation Corticosteroids (ICS)Beclomethasone dipropionate (Becotide)

100mcg 6-8H 2puffs BD 4puffs BD

Budesonide (Pulmicort ) 200mcg 12H 1-2puffs BD 2-12 puffs/day in 2-4 divided doses (Severe asthma)

Ciclesonide (Alvesco) 160mcg 1-2puffs BD 2puffs BDFluticasone (Flixotide) 125mcg 1-2puffs BD 8puffs BD

ICS + LABABudesonide / Formoterol Tubuhaler (Symbicort)

160mcg/4.5mcg 1-2puffs BD 4puffs BD320mcg/9mcg 1puff BD 2puffs BD

Beclomethasone / Formoterol (Fostair)

100mcg/6mcg 1-2puffs BD 2puffs BD

Fluticasone/Salmeterol MDI (Seretide)

125mcg/25mcg 1-2puffs BD

Fluticasone/Salmeterol Accuhaler (Seretide)

250mcg/50mcg 1-2puffs BD500mcg/50mcg 1puff BD 1puff BD

Anticholinergic + LABAIpratropium / Salbutamol (Combivent )

20mcg/100mcg 2puffs QID 12 puffs daily

Ipratropium / Fenoterol(Berodual N)

20mcg/50mcg 1-2puffs TDS 8puffs daily

Reference: 1. Lexi comp 2. Blue Book3. MIMS Online-Product prescribing information4. BNF5. Micromedex- Drug Consult