Long-acting β2-agonists: reminder for use in children and adults

Benefits of these medicines used in conjunction with inhaled corticosteroids (ICS) in the control of asthma symptoms in children outweigh any apparent risks.

Article date: September 2010

Following a previous review in 2007 of long-acting β2-agonists (LABA) in the treatment of adults, adolescents, and children with asthma, we have further reviewed the use of LABA, specifically in children younger than age 12 years.

All available data on the use of LABA in the treatment of asthma in children were reviewed, and it was concluded that the benefits of these medicines used in conjunction with inhaled corticosteroids (ICS) in the control of asthma symptoms in children outweigh any apparent risks.

Advice for all patients

Prescribers are reminded to follow the advice on the management of asthma from the Commission on Human Medicines, consistent with the guideline from The British Thoracic Society and Scottish Intercollegiate Guidelines Network. In particular:

  • always prescribe LABA with concomitant ICS and only when ICS alone are not sufficient to control asthma symptoms
  • LABA should not be initiated in patients with rapidly deteriorating asthma
  • review LABA therapy regularly, prescribe the lowest effective dose, and stop if there is no benefit
  • stepping-down therapy should be considered when good long-term asthma control has been achieved
  • LABA should not be prescribed for the relief of exercise-induced asthma symptoms in the absence of regular ICS (a short-acting β2-agonist should be used in this situation)
  • combination inhalers should be prescribed when appropriate to aid compliance in line with NICE Guidance

Further advice for use in children

Prescribers are advised that a daily dose of 24 micrograms formoterol should be sufficient for most children, particularly for younger age-groups. Higher doses should be used rarely, and only when control is not maintained on the lower dose.

Further information about LABA in asthma management is available on our website (see Asthma: Long-acting β2 agonists2 agonists)

Article citation: Drug Safety Update Sept 2010, vol 4 issue 2: H2.

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