The breath-actuated dry powder inhaler is available in two strengths:
- 160/4.5 (formoterol fumarate dihydrate 6 microgram, budesonide 200 microgram per dose) - equivalent to Symbicort 200/6 Turbohaler
- 320/9 (formoterol fumarate dihydrate 12 microgram, budesonide 400 microgram per dose) - equivalent to Symbicort 400/12 Turbohaler.
In asthma, the 160/4.5 inhaler may be used both as regular maintenance treatment and as needed in response to symptoms. The 320/9 inhaler must be used with a separate reliever.
In COPD, both inhalers are indicated for symptomatic treatment in patients with a forced expiratory volume in one second (FEV1) <50% predicted normal and a history of repeated exacerbations, who have significant symptoms despite regular therapy with long-acting bronchodilators.
The Spiromax device has a design similar to that of pressurised metered-dose inhalers. There are three steps to using the inhaler: open, breathe and close. No priming is required. Dose confirmation is provided by a 'click' sound, lactose taste and a dose indicator.
Further information: Teva UK