SUGGESTED SEQUENCE FOR USE
OF MULTIPLE INHALED MEDICATIONS
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If Using
ONLY Long-acting Medications
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If using BOTH Short & Long-acting Medications
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▼
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▼
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FIRST
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FIRST
(see Note 3)
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Long-acting β-agonist (alone or combined)
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Long-acting β-agonist (alone or combined)
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| Brovana (arformorterol) |
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Brovana (arformorterol) |
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Foradil (formoterol),
Performist (formoterol)
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Foradil (formoterol),
Perforomist (formoterol)
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Oxis,
Oxese (formoterol)
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Oxis,
Oxese (formoterol)
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Serevent (salmeterol)
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Serevent (salmeterol)
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Advair (Serevent
& Flovent)
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Advair (Serevent
& Flovent)
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Duova (formoterol
& tiotropium bromide)
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Duova (formoterol
& tiotropium bromide)
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Seretide (salmetrol
& fluticasone)
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Seretide (salmetrol
& fluticasone)
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Symbicort
(formoterol & budesonide)
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Symbicort
(formoterol & budesonide)
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▼
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▼
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SECOND
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SECOND
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Long-acting Anticholinergic
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Long-acting Anticholinergic
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Spiriva (tiotropium
bromide)
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Spiriva (tiotropium
bromide)
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Tiova (tiotropium
bromide)
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Tiova (tiotropium
bromide)
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(Also,
see note 4)
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(Also,
see note 4)
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▼
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▼
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LAST
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THIRD
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Steroid
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Steroid
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Aerobid,
Aerospan HFA (flunisolide)
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Aerobid,
Aerospan HFA (flunisolide)
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Asmanex (mometasone)
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Asmanex (mometasone)
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Azmacort (triamcinolone)
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Azmacort (triamcinolone)
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dexamethasone
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dexamethasone
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Flovent, -HFA,
-Diskus (fluticasone)
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Flovent, -HFA,
-Diskus (fluticasone)
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Pulmicort
(budesonide)
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Pulmicort
(budesonide)
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QVAR,
Vanceril (beclomethasone)
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QVAR,
Vanceril (beclomethasone)
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▼
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NOTES:
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LAST
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(1.)
Take short-acting drugs at least 2 hours
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Short-acting β-agonist (alone or combined)
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before
long-acting drugs in the same class to
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albuterol
(salbutamol in UK)
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avoid
interfering with the long-acting drug's action.
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Alupent (metaproterenol)
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Berotec
(Canada) (feneterol)
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(2.)
If albuterol is used on a regular scheduled
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Bricanyl (terbutaline)
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Basis, always
take it after the long-acting
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Bronkosol
(isoetharine)
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β-agonist,
and never less than 2 hours before it.
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Maxair (pirbuterol)
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Medihaler-Iso, Isuprel (isoproterenol)
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(3.)
If you must use albuterol on a "rescue"
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ProAir, -HFA (albuterol) |
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basis, then
wait two hours before taking a
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Proventil,
-HFA
(albuterol)
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long-acting
β-agonist.
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Ventolin,
Airomir (Canada) (albuterol)
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Xopenex, -HFA
(levalbuterol)
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(4.)
If Atrovent is used in addition to Spiriva/
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Combivent
(Atrovent & albuterol) (see note 4)
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Tiova,
always take it after the Spiriva/
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Mark
Mangus, BSRC, RPFT, RRT
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Tiova, and
never less than 2 hours before it.
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3/27/2006
(Rev2: 7/17/2007)
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