- ACRONYMS AND DEFINITIONS
- ICS - Inhaled corticosteroid
- NHLBI - National Heart, Lung, and Blood Institute
| ICS DOSING FOR 0 - 4 YEARS OF AGE | |||
|---|---|---|---|
| Medication | Low | Medium | High |
| Budesonide (Pulmicort Respules®) given once daily or in 2 divided doses 0.25, 0.5, 1 mg nebs |
0.25 - 0.5 mg/day (see notes below) |
> 0.5 - 1.0 mg/day (see notes below) |
> 1.0 mg/day (see notes below) |
| Fluticasone (Flovent HFA®) given in 2 divided doses 44, 110, or 220 mcg/actuation |
176 mcg/day (see notes below) |
> 176 - 352 mcg/day (see notes below) |
> 352 mcg/day (see notes below) |
- NOTES:
- For children < 4 years of age:
- The safety and efficacy of ICS in children less than 1 year of age has not been established
- Children less than 4 years of age generally require delivery of ICS (budesonide and fluticasone MDI) through a face mask that fits snugly over nose and mouth to avoid nebulizing in the eyes. Face should be washed after treatment to prevent local corticosteroid side effects.
- For budesonide, the dose may be given 1 - 3 times daily
- Budesonide suspension is compatible with albuterol, ipratropium, and levalbuterol nebulizer solutions in the same nebulizer. Only use jet nebulizers as ultrasonic nebulizers are ineffective for suspensions.
- For fluticasone MDI, the dose should be divided 2 times daily; the low dose for children < 4 years of age is higher than for children 5 - 11 years of age because of lower dose delivered with face mask and data on efficacy in young children.
| ICS DOSING FOR 5 - 11 YEARS OF AGE | |||
|---|---|---|---|
| Medication | Low | Medium | High |
| Beclomethasone (Qvar®) given in 2 divided doses 40 or 80 mcg/actuation |
80 - 160 mcg/day | > 160 - 320 mcg/day | > 320 mcg/day |
| Budesonide (Pulmicort Flexhaler®) given in 2 divided doses 90 or 180 mcg/actuation |
180 - 360 mcg/day | > 360 - 720 mcg/day | > 720 mcg/day |
| Budesonide (Pulmicort Respules®) given once daily or in 2 divided doses 0.25, 0.5, 1 mg nebs |
0.5 mg/day | 1.0 mg/day | 2.0 mg/day |
| Ciclesonide (Alvesco®) given in 2 divided doses 80 or 160 mcg/actuation |
80 - 160 mcg/day | > 160 - 320 mcg/day | > 320 mcg/day |
| Flunisolide (Aerospan®) given in 2 divided doses 80 mcg/actuation |
160 mcg/day | 320 - 480 mcg/day | ≥ 480 mcg/day |
| Fluticasone (Flovent HFA®) given in 2 divided doses 44, 110, or 220 mcg/actuation |
88 - 176 mcg/day | > 176 - 352 mcg/day | ≥ 352 mcg/day |
| Fluticasone (Flovent Diskus®) given in 2 divided doses 50, 100, or 250 mcg/actuation |
100 - 200 mcg/day | > 200 - 400 mcg/day | > 400 mcg/day |
| Mometasone (Asmanex®) given once daily or in 2 divided doses 110 or 220 mcg/actuation |
110 mcg/day | 220 - 440 mcg/day | > 440 mcg/day |
| ICS DOSING FOR ≥ 12 YEARS OF AGE | |||
|---|---|---|---|
| Medication | Low | Medium | High |
| Beclomethasone (Qvar®) given in 2 divided doses 40 or 80 mcg/actuation |
80 - 240 mcg/day | > 240 - 480 mcg/day | > 480 mcg/day |
| Budesonide (Pulmicort Flexhaler®) given in 2 divided doses 90 or 180 mcg/actuation |
180 - 540 mcg/day | > 540 - 1080 mcg/day | > 1080 mcg/day |
| Budesonide (Pulmicort Respules®) given once daily or in 2 divided doses 0.25, 0.5, 1 mg nebs |
N/A | ||
| Ciclesonide (Alvesco®) given in 2 divided doses 80 or 160 mcg/actuation |
160 - 320 mcg/day | > 320 - 640 mcg/day | > 640 mcg/day |
| Flunisolide (Aerospan®) given in 2 divided doses 80 mcg/actuation |
320 mcg/day | > 320 - 640 mcg/day | > 640 mcg/day |
| Fluticasone (Flovent HFA®) given in 2 divided doses 44, 110, or 220 mcg/actuation |
88 - 264 mcg/day | > 264 - 440 mcg/day | > 440 mcg/day |
| Fluticasone (Flovent Diskus®) given in 2 divided doses 50, 100, or 250 mcg/actuation |
100 - 300 mcg/day | > 300 - 500 mcg/day | > 500 mcg/day |
| Mometasone (Asmanex®) given once daily or in 2 divided doses 110 or 220 mcg/actuation |
110 - 220 mcg/day | > 220 - 440 mcg/day | > 440 mcg/day |