The dose of the drug is selected individually. In the event that the recommended dose does not exceed 1 mg / day, the entire dose of the drug can be taken at a time (one time). In case of taking a higher dose, it is recommended to divide it into two doses.
Recommended initial dose:
Children 6 months and older: 0.25-0.5 mg per day. If necessary, the dose may be increased to 1 mg / day.
Adults / elderly patients: 1-2 mg per day.
Dose with maintenance treatment:
Children 6 months and older: 0.25-2 mg per day.
Adults: 0.5-4 mg per day. In case of severe exacerbations, the dose may be increased.
Table for determining the dose
| Dose, mg | Amount of preparation Pulmicort suspension for inhalation |
| 0.25 mg / ml | 0.5 mg / ml |
| 0,25 | 1 ml * |
|
| 0,5 | 2 ml |
|
| 0,75 | 3 ml |
|
| 1 | 4 ml | 2 ml |
| 1,5 | - | 3 ml |
| 2 | - | 4 ml |
*) should be diluted with 0.9% solution of sodium chloride to a volume of 2 ml
For all patients, it is desirable to determine the minimum effective maintenance dose.
If it is necessary to achieve an additional therapeutic effect, an increase in the daily dose (up to 1 mg / day) of Pulmicort can be recommended instead of the combination of the drug with oral glucocorticosteroids; due to a lower risk of systemic effects.
Patients receiving oral glucocorticosteroids
Cancellation of oral glucocorticosteroids should be started against a background of stable patient health. Within 10 days, it is necessary to take a high dose of Pulmicort against oral glucocorticosteroids in the usual dose. In the future, during a month, gradually reduce the dose of oral glucocorticosteroids (for example, 2.5 mg of prednisolone or its analog) to the minimum effective dose. In many cases it is possible to completely stop taking oral glucocorticosteroids.Since Pulmicort, used as a suspension with a nebulizer, enters the lungs during inspiration, it is important to instruct the patient to inhale the drug through the nebulizer mouthpiece calmly and smoothly.
There is no data on the use of budesonide in patients with renal insufficiency or liver dysfunction. Taking into account the fact that budesonide is deduced by biotransformation in the liver, we can expect an increase in the duration of the drug in patients with severe hepatic cirrhosis.
Stenosing laryngotracheitis (false croup):
Children 6 months and older: 2 mg per day. The dose of the drug can be taken at a time (once) or divided into two divided doses of 1 mg at intervals of 30 minutes.
The use of pulmicort with a nebulizer
The pulmicort is used for inhalations using an appropriate nebulizer equipped with a mouthpiece and a special mask. The nebulizer is connected to the compressor to create the required air flow (5-8 l / min), the nebulizer filling volume should be 2-4 ml.
It is important to inform the patient:
carefully read the instructions for use;
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for the use of a pulmicorta suspension is not suitable ultrasonic nebulizers;
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The poolmixture slurry is mixed with 0.9 % solution of sodium chloride or with solutions of terbutaline, salbutamol, fenoterol, acetylcysteine, sodium cromoglicate and ipratropium bromide; the diluted suspension should be used within 30 minutes.
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After inhalation, rinse the mouth with water to reduce the development of candidiasis of the oropharynx;
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to prevent skin irritation after using the mask, you should wash your face with water;
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It is recommended that the nebulizer be cleaned regularly according to the manufacturer's instructions;
In cases where a child can not independently inhale through a nebulizer, a special mask is used.
How to use Pulmicort® with a nebulizer
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Before use, shake the container gently with a slight rotational motion.
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Hold the container straight upright (as shown in the picture) and open it, turning and tearing off the "wing".
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Gently place the container open end into the nebulizer and slowly squeeze out the contents of the container.
A container containing a single dose is marked with a line.If the container is turned over, this line will show a volume equal to 1 ml.
If it is necessary to use only 1 ml of the suspension, the contents of the container are squeezed out until the surface of the liquid reaches the level indicated by the line.
The open container is stored in a place protected from light. The open container should be used within 12 hours.
Before using the remainder of the liquid, the contents of the container are gently shaken by rotational movement.
Note
After each inhalation, rinse your mouth with water.
If you are using a mask, make sure that the mask is snug against the face during inhalation. Wash your face after inhalation.
Cleaning
The nebulizer chamber, mouthpiece or mask should be cleaned after each use. The nebulizer chamber, mouthpiece or mask is washed with warm water, using a mild detergent or in accordance with the manufacturer's instructions. Rinse well and dry the nebulizer by connecting the chamber to the compressor or the air inlet valve.