Posology : מינונים

4.2 Posology and Method of Administration

Flixotide Diskus is for inhalation by oral inhalation only.
Patients should be made aware of the prophylactic nature of therapy with inhaled fluticasone propionate and that it should be taken regularly even when they are asymptomatic.

The dosage of fluticasone propionate should be adjusted according to the individual response.
Asthma

The onset of therapeutic effect is 4 to 7 days, although some benefit may be apparent as soon as 24 hours for patients who have not previously received inhaled steroids.

If patients find that relief with short-acting bronchodilator treatment becomes less effective or they need more inhalations than usual, medical attention must be sought.

Adults and children over 16 years of age:-

100 to 1000 micrograms twice daily.
Patients should be given a starting dose of inhaled fluticasone propionate which is appropriate for the severity of their disease:-

Mild asthma:                     - 100 to 250 micrograms twice daily.
Moderate asthma:                 - 250 to 500 micrograms twice daily.
Severe asthma:                   - 500 to 1000 micrograms twice daily.

The dose may then be adjusted until control is achieved or reduced to the minimum effective dose, according to the individual response.

Alternatively, the starting dose of fluticasone propionate may be gauged at half the total daily dose of beclomethasone dipropionate or equivalent as administered by metered-dose inhaler.

Children over 4 years of age:-

50 to 100 micrograms twice daily.
Children should be given a starting dose of inhaled fluticasone propionate which is appropriate for the severity of their disease, this may be 50 to 100 micrograms twice daily.

Many children’s asthma will be well controlled using the 50 to 100 mcg twice daily dosing regimen. For those patients whose asthma is not sufficiently controlled, additional benefit may be obtained by increasing the dose up to 200 mcg twice daily.

The dose may then be adjusted until control is achieved or reduced to the minimum effective dose according to the individual response.

Chronic Obstructive Pulmonary Disease (COPD)

Adult dose:-
500 micrograms twice daily, used as an adjunct to long-acting bronchodilators (e.g. LABAs) .


Medication must be used daily for optimum benefit which may take three to six months. If there is no improvement after three to six months then the patient should undergo medical assessment.

Only the 250 or 500 microgram devices are suitable for the administration of this dose.

Special patient groups
There is no need to adjust the dose in elderly patients or in those with hepatic or renal impairment.