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