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Asthma Inhaled Corticosteroid (ICS) Dose Strength Algorithm

Determine the strength (low, med, high) of an inhaled corticosteroid to correlate with an asthma therapy step.

Jennifer Glen

Provided by EVAL Foundation
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According to the NHLBI 2020 Focused Updates to the Asthma Management Guidelines, "Scheduled, daily inhaled corticosteroid (ICS) treatment is the currently preferred pharmacologic controller therapy for persistent asthma in individuals of all ages. Intermittent ICS dosing includes courses of ICS treatment used for brief periods, usually in response to symptoms or as an add-on with or without a long-acting beta2-agonist (LABA). Recommendations for ICS treatment are organized by age." 

 

The asthma medication recommendations are organized by steps within age groupings (e.g., ages 0-3, 4, 5-11 & 12+). ICS recommendations by step are described by ICS dose strength (e.g., low, medium or high). There are a plethora of ICS medications and dosage combinations by age grouping that comprise each dose strength category. This app serves as an ICS medication look up feature to determine the ICS category (e.g. low, medium or high) based on age, medication and dosage. An ICS can be searched by brand or generic name.

 

All dose recommendations are based on NHLBI guidelines and the GINA guidelines, and focus on ICS medications currently available in the U.S. Below are summaries of medications and dosage recommendations.

 

 

 

 

 

All questions & possible results

Default SectionTitle not visible
Select age group

Select one option:

  • 0-3
  • 4
  • 5-11
  • 12+
Look up medication by

Select one option:

  • Brand Name
  • Generic Name
Select Medication by generic name (12+)

Includes ICS & ICS-LABA combination inhalers

ICS: Inhaled corticosteroid

LABA: Long-Acting Beta-2 Agonist

 

Select one option:

  • beclomethasone (QVAR MDI)
  • budesonide (Pulmicort DPI)
  • budesonide - formoterol combination (Symbicort MDI)
  • ciclesonide (Alvesco MDI)
  • flunisolide (Aerospan MDI)
  • fluticasone (ArmonAir, Arnuity & Flovent)
  • fluticasone - salmeterol combination (Advair & AirDuo)
  • fluticasone - vilanterol combination (Breo Ellipta DPI)
  • mometasone (Asmanex DPI & MDI)
  • mometasone - formoterol combination (Dulera MDI)
  • Unlisted
Select Medication Brand (12+)

Includes ICS & ICS-LABA combination inhalers

ICS: Inhaled corticosteroid

LABA: Long-Acting Beta-2 Agonist

 

Select one option:

  • Advair MDI & Diskus (fluticasone - salmeterol)
  • Aerospan MDI (flunisolide)
  • AirDuo RespiClick DPI (fluticasone - salmeterol)
  • Alvesco MDI (ciclesonide)
  • ArmonAir RespiClick DPI (fluticasone)
  • Arnuity DPI (fluticasone)
  • Asmanex DPI & MDI (mometasone)
  • Breo Ellipta DPI (fluticasone - vilanterol)
  • Dulera MDI (mometasone - formoterol)
  • Flovent MDI & Diskus (fluticasone)
  • Pulmicort DPI (budesonide)
  • Symbicort MDI (budesonide - formoterol)
  • QVAR MDI (beclomethasone)
  • Unlisted
Select Medication by generic name (5-11)

Includes ICS & ICS-LABA combination inhalers

ICS: Inhaled corticosteroid

LABA: Long-Acting Beta-2 Agonist

 

Select one option:

  • beclomethasone (QVAR MDI)
  • budesonide (Pulmicort Nebules)
  • budesonide - formoterol combination (Symbicort MDI)
  • ciclesonide (Alvesco MDI)
  • fluticasone (Flovent MDI & Diskus)
  • fluticasone - salmeterol combination (Advair MDI & Diskus)
  • fluticasone - vilanterol combination (Breo Ellipta DPI)
  • mometasone (Asmanex DPI & MDI)
  • mometasone - formoterol combination (Dulera MDI)
  • Unlisted
Select Medication Brand (5-11)

Includes ICS & ICS-LABA combination inhalers

ICS: Inhaled corticosteroid

LABA: Long-Acting Beta-2 Agonist

 

Select one option:

  • Advair MDI & Diskus (fluticasone - salmeterol)
  • Alvesco MDI (ciclesonide)
  • Asmanex DPI & MDI (mometasone)
  • Breo Ellipta DPI (fluticasone - vilanterol)
  • Dulera MDI (mometasone - formoterol)
  • Flovent MDI & Diskus (fluticasone)
  • Pulmicort Nebules (budesonide)
  • Symbicort MDI (budesonide - formoterol)
  • QVAR MDI (beclomethasone)
  • Unlisted
Select Medication by generic name (0-4)

Includes ICS & ICS-LABA combination inhalers

ICS: Inhaled corticosteroid

LABA: Long-Acting Beta-2 Agonist

 

Select one option:

  • beclomethasone (QVAR MDI)
  • budesonide (Pulmicort Nebules)
  • budesonide - formoterol combination (Symbicort MDI)
  • fluticasone (Flovent MDI)
  • fluticasone - salmeterol combination (Advair MDI)
  • mometasone (Asmanex MDI)
  • mometasone - formoterol combination (Dulera MDI)
  • Unlisted
Select Medication Brand (0-4)

Includes ICS & ICS-LABA combination inhalers

ICS: Inhaled corticosteroid

LABA: Long-Acting Beta-2 Agonist

 

Select one option:

  • Advair MDI (fluticasone - salmeterol)
  • Asmanex MDI (mometasone)
  • Dulera MDI (mometasone - formoterol)
  • Flovent MDI (fluticasone)
  • Pulmicort Nebules (budesonide)
  • Symbicort MDI (budesonide - formoterol)
  • QVAR MDI (beclomethasone)
  • Unlisted
Select delivery inhaler type

DPI: Dry Powder Inhaler (includes Diskus)

MDI: Metered Dose Inhaler

Inhaler Examples

 

Select one option:

  • MDI
  • DPI (includes Diskus)
Select fluticasone DPI strength options by brand

Select one option:

  • 50 / 100 / 250 mcg (Flovent Diskus)
  • 100 / 200 mcg (Arnuity DPI)
  • 55 / 113 / 232 mcg (ArmonAir RespiClick DPI)
  • Unlisted
Select fluticasone - salmeterol combination DPI strength options by brand

Select one option:

  • 100/50 or 250/50 or 500/50 mcg (Advair combo Diskus)
  • 55/14 or 113/14 or 232/14 mcg (AirDuo RespiClick combo DPI)
  • Unlisted
Select QVAR (beclomethasone) strength and dose (12+)

All doses are based on NHLIB/GINA guidelines.

  • Choices are puffs per day.
  • Most clinical dosing is BID. 
  • Therefore, divide total dose by 2 and administer BID.

 

Select one option:

  • QVAR MDI 40 mcg inhale 2-6 puffs/day (total dose range 80-240 mcg per day) - Low Dose
  • QVAR MDI 40 mcg inhale 8-12 puffs/day (total dose range >240-480 mcg per day) - Medium Dose
  • QVAR MDI 80 mcg inhale 1-2 puffs/day (total dose range 80-240 mcg per day) - Low Dose
  • QVAR MDI 80 mcg inhale 4-6 puffs/day (total dose range >240-480 mcg per day) - Medium Dose
  • QVAR MDI 80 mcg inhale 8 puffs/day (total dose range >480 mcg per day) - High Dose
  • Unlisted
Select Alvesco (ciclesonide) strength and dose (12+)

All doses are based on NHLIB/GINA guidelines.

  • Choices are puffs per day.
  • Most clinical dosing is BID. 
  • Therefore, divide total dose by 2 and administer BID.

 

Select one option:

  • Alvesco MDI 80 mcg inhale 2-4 puffs/day (total dose range 160-320 mcg per day) - Low Dose
  • Alvesco MDI 80 mcg inhale 6-8 puffs/day (total dose range >320-640 mcg per day) - Medium Dose
  • Alvesco MDI 160 mcg inhale 1-2 puffs/day (total dose range 160-320 mcg per day) - Low Dose
  • Alvesco MDI 160 mcg inhale 4 puffs/day (total dose range >320-640 mcg per day) - Medium Dose
  • Alvesco MDI 160 mcg inhale 6 puffs/day (total dose range >640 mcg per day) - High Dose
  • Unlisted
Select Pulmicort (budesonide) strength and dose (12+)

All doses are based on NHLIB/GINA guidelines.

  • Choices are puffs per day.
  • Most clinical dosing is BID. 
  • Therefore, divide total dose by 2 and administer BID.

 

Select one option:

  • Pulmicort DPI 90 mcg inhale 2-6 puffs/day (total dose range 180-540 mcg per day) - Low Dose
  • Pulmicort DPI 180 mcg inhale 1-2 puffs/day (total dose range 180-540 mcg per day) - Low Dose
  • Pulmicort DPI 180 mcg inhale 4-6 puffs/day (total dose range >540-1080 mcg per day) - Medium Dose
  • Pulmicort DPI 180 mcg inhale 8 puffs/day (total dose range >1080 mcg per day) - High Dose
  • Unlisted
Select Aerospan (flunisolide) strength and dose (12+)

All doses are based on NHLIB/GINA guidelines.

  • Choices are puffs per day.
  • Most clinical dosing is BID. 
  • Therefore, divide total dose by 2 and administer BID.

 

Select one option:

  • Aerospan MDI 80 mcg inhale 2 puffs/day (total dose range 320 mcg per day) - Low Dose
  • Aerospan MDI 80 mcg inhale 6-8 puffs/day (total dose range >320-640 mcg per day) - Medium Dose
  • Unlisted
Select Flovent (fluticasone) MDI strength and dose (12+)

All doses are based on NHLIB/GINA guidelines.

  • Choices are puffs per day.
  • Most clinical dosing is BID. 
  • Therefore, divide total dose by 2 and administer BID.

 

Select one option:

  • Flovent MDI 44 mcg inhale 2-6 puffs/day (total dose range 88-264 mcg per day) - Low Dose
  • Flovent MDI 110 mcg inhale 1-2 puffs/day (total dose range 88-264 mcg per day) - Low Dose
  • Flovent MDI 110 mcg inhale 4 puffs/day (total dose range >264-440 mcg per day) - Medium Dose
  • Flovent MDI 110 mcg inhale 6 puffs/day (total dose range >440 mcg per day) - High Dose
  • Flovent MDI 220 mcg inhale 1 puffs/day (total dose range 88-264 mcg per day) - Low Dose
  • Flovent MDI 220 mcg inhale 2 puffs/day (total dose range >264-440 mcg per day) - Medium Dose
  • Flovent MDI 220 mcg inhale 4-6 puffs/day (total dose range >440 mcg per day) - High Dose
  • Unlisted
Select Flovent (fluticasone) Diskus strength and dose (12+)

All doses are based on NHLIB/GINA guidelines.

  • Choices are puffs per day.
  • Most clinical dosing is BID. 
  • Therefore, divide total dose by 2 and administer BID.

 

Select one option:

  • Flovent Diskus 50 mcg inhale 2-6 puffs/day (total dose range 100-300 mcg per day) - Low Dose
  • Flovent Diskus 100 mcg inhale 1-3 puffs/day (total dose range 100-300 mcg per day) - Low Dose
  • Flovent Diskus 100 mcg inhale 4 puffs/day (total dose range >300-500 mcg per day) - Medium Dose
  • Flovent Diskus 100 mcg inhale 6 puffs/day (total dose range >500 mcg per day) - High Dose
  • Flovent Diskus 250 mcg inhale 1 puffs/day (total dose range 100-300 mcg per day) - Low Dose
  • Flovent Diskus 250 mcg inhale 2 puffs/day (total dose range >300-500 mcg per day) - Medium Dose
  • Flovent Diskus 250 mcg inhale 4-6 puffs/day (total dose range >500 mcg per day) - High Dose
  • Unlisted
Select Asmanex (mometasone) DPI strength and dose (12+)

All doses are based on NHLIB/GINA guidelines.

  • Choices are puffs per day.
  • Most clinical dosing is BID. 
  • Therefore, divide total dose by 2 and administer BID.

 

Select one option:

  • Asmanex DPI 110 mcg inhale 1-2 puffs/day (total dose range 110-220 mcg per day) - Low Dose
  • Asmanex DPI 110 mcg inhale 4 puffs/day (total dose range >220-440 mcg per day) - Medium Dose
  • Asmanex DPI 110 mcg inhale 6 puffs/day (total dose range >440 mcg per day) - High Dose
  • Asmanex DPI 220 mcg inhale 1 puffs/day (total dose range 110-220 mcg per day) - Low Dose
  • Asmanex DPI 220 mcg inhale 2 puffs/day (total dose range >220-440 mcg per day) - Medium Dose
  • Asmanex DPI 220 mcg inhale 3 puffs/day (total dose range >440 mcg per day) - High Dose
  • Unlisted
Select Asmanex (mometasone) MDI strength and dose (12+)

All doses are based on NHLIB/GINA guidelines.

  • Choices are puffs per day.
  • Most clinical dosing is BID. 
  • Therefore, divide total dose by 2 and administer BID.

 

Select one option:

  • Asmanex MDI 100 mcg inhale 1-2 puffs/day - Low Dose
  • Asmanex MDI 100 mcg inhale 4 puffs/day - Medium Dose
  • Asmanex MDI 100 mcg inhale 6 puffs/day - High Dose
  • Asmanex MDI 200 mcg inhale 1 puffs/day - Low Dose
  • Asmanex MDI 200 mcg inhale 2 puffs/day - Medium Dose
  • Asmanex MDI 200 mcg inhale 3-4 puffs/day - High Dose
  • Unlisted
Select Arnuity (fluticasone) DPI strength and dose (12+)

All doses are based on NHLIB/GINA guidelines.

  • Choices are puffs per day.

 

Select one option:

  • Arnuity DPI 100 mcg inhale 1 puffs/day - Medium Dose
  • Arnuity DPI 200 mcg inhale 1 puffs/day - High Dose
  • Unlisted
Select ArmonAir RespiClick (fluticasone) DPI strength and dose (12+)

All doses are based on NHLIB/GINA guidelines.

  • Choices are puffs per day.
  • Most clinical dosing is BID. 
  • Therefore, divide total dose by 2 and administer BID.

 

Select one option:

  • ArmonAir RespiClick DPI 55 mcg inhale 2 puffs/day (total dose range 100-250 mcg per day) - Low Dose
  • ArmonAir RespiClick DPI 113 mcg inhale 1-2 puffs/day (total dose range 100-250 mcg per day) - Low Dose
  • ArmonAir RespiClick DPI 113 mcg inhale 2 puffs/day (total dose range 250-500 mcg per day) - Medium Dose
  • ArmonAir RespiClick DPI 232 mcg inhale 1 puffs/day (total dose range 100-250 mcg per day) - Low Dose
  • ArmonAir RespiClick DPI 232 mcg inhale 2 puffs/day (total dose range 250-500 mcg per day) - Medium Dose
  • Unlisted
Select Advair (fluticasone - Salmeterol) combo Diskus strength and dose (12+)

All doses are based on NHLIB/GINA guidelines.

  • Choices are puffs per day.
  • Most clinical dosing is BID. 
  • Therefore, divide total dose by 2 and administer BID.

 

Select one option:

  • Advair combo Diskus 100/50 mcg inhale 2 puffs/day (total dose range 100-300 mcg per day) - Low Dose
  • Advair combo Diskus 250/50 mcg inhale 1 puffs/day (total dose range 100-300 mcg per day) - Low Dose
  • Advair combo Diskus 250/50 mcg inhale 2 puffs/day (total dose range >300-500 mcg per day) - Medium Dose
  • Advair combo Diskus 500/50 mcg inhale 1 puffs/day (total dose range >300-500 mcg per day) - Medium Dose
  • Advair combo Diskus 500/50 mcg inhale 2 puffs/day (total dose range >500 mcg per day) - High Dose
  • Unlisted
Select Advair (fluticasone - Salmeterol) combo MDI strength and dose (12+)

All doses are based on NHLIB/GINA guidelines.

  • Choices are puffs per day.
  • Most clinical dosing is BID. 
  • Therefore, divide total dose by 2 and administer BID.

 

Select one option:

  • Advair combo MDI 45/21 mcg inhale 2-4 puffs/day (total dose range 88-264 mcg per day) - Low Dose
  • Advair combo MDI 115/21 mcg inhale 2 puffs/day (total dose range 88-264 mcg per day) - Low Dose
  • Advair combo MDI 115/21 mcg inhale 4 puffs/day (total dose range >264-440 mcg per day) - Medium Dose
  • Advair combo MDI 230/21 mcg inhale 1 puffs/day (total dose range 88-264 mcg per day) - Low Dose
  • Advair combo MDI 230/21 mcg inhale 2 puffs/day (total dose range >264-440 mcg per day) - Medium Dose
  • Advair combo MDI 230/21 mcg inhale 4 puffs/day (total dose range >440 mcg per day) - High Dose
  • Unlisted
Select Symbicort (budesonide - formoterol) combo MDI strength and dose (12+)

All doses are based on NHLIB/GINA guidelines.

  • Choices are puffs per day.
  • Most clinical dosing is BID. 
  • Therefore, divide total dose by 2 and administer BID.

 

Select one option:

  • Symbicort combo MDI 80/4.5 mcg inhale 4 puffs/day (total dose range 180-540 mcg per day) - Low Dose
  • Symbicort combo MDI 160/4.5 mcg inhale 2 puffs/day (total dose range 180-540 mcg per day) - Low Dose
  • Symbicort combo MDI 160/4.5 mcg inhale 4 puffs/day (total dose range >540-1080 mcg per day) - Medium Dose
  • Unlisted
Select Dulera (mometasone - formoterol) combo MDI strength and dose (12+)

All doses are based on NHLIB/GINA guidelines.

  • Choices are puffs per day.
  • Most clinical dosing is BID. 
  • Therefore, divide total dose by 2 and administer BID.

 

Select one option:

  • Dulera combo MDI 100/5 mcg inhale 2 puffs/day (total dose range 110-220 mcg per day) - Low Dose
  • Dulera combo MDI 100/5 mcg inhale 4 puffs/day (total dose range >220-440 mcg per day) - Medium Dose
  • Dulera combo MDI 200/5 mcg inhale 2 puffs/day (total dose range >220-440 mcg per day) - Medium Dose
  • Dulera combo MDI 200/5 mcg inhale 4 puffs/day (total dose range >440 mcg per day) - High Dose
  • Unlisted
Select Breo Ellipta (fluticasone - vilanterol) combo DPI strength and dose (12+)

All doses are based on NHLIB/GINA guidelines.

  • Choices are puffs per day.
  • Most clinical dosing is BID. 
  • Therefore, divide total dose by 2 and administer BID.

 

Select one option:

  • Breo Ellipta combo DPI 100/25 mcg inhale 1 puffs/day (total dose 100 mcg per day) - Medium Dose
  • Breo Ellipta combo DPI 200/25 mcg inhale 1 puffs/day (total dose 200 mcg per day) - High Dose
  • Unlisted
Select AirDuo RespiClick (fluticasone - salmeterol) combo DPI strength and dose (12+)

All doses are based on NHLIB/GINA guidelines.

  • Choices are puffs per day.
  • Most clinical dosing is BID. 
  • Therefore, divide total dose by 2 and administer BID.

 

Select one option:

  • AirDuo RespiClick combo DPI 55/14 mcg inhale 2 puffs/day (total dose range 100-250 mcg per day) - Low Dose
  • AirDuo RespiClick combo DPI 113/14 mcg inhale 1-2 puffs/day (total dose range 100-250 mcg per day) - Low Dose
  • AirDuo RespiClick combo DPI 113/14 mcg inhale 2 puffs/day (total dose range 250-500 mcg per day) - Medium Dose
  • AirDuo RespiClick combo DPI 232/14 mcg inhale 1 puffs/day (total dose range 100-250 mcg per day) - Low Dose
  • AirDuo RespiClick combo DPI 232/14 mcg inhale 2 puffs/day (total dose range 250-500 mcg per day) - Medium Dose
  • Unlisted
Select QVAR (beclomethasone) strength and dose (5-11)

All doses are based on NHLIB/GINA guidelines.

  • Choices are puffs per day.
  • Most clinical dosing is BID. 
  • Therefore, divide total dose by 2 and administer BID.

 

Select one option:

  • QVAR MDI 40 mcg inhale 2-4 puffs/day (total dose range 80-160 mcg per day) - Low Dose
  • QVAR MDI 40 mcg inhale 6 puffs/day (total dose range >160-320 mcg per day) - Medium Dose
  • QVAR MDI 80 mcg inhale 1-2 puffs/day (total dose range 80-160 mcg per day) - Low Dose
  • QVAR MDI 80 mcg inhale 4 puffs/day (total dose range >160-320 mcg per day) - Medium Dose
  • QVAR MDI 80 mcg inhale 6 puffs/day (total dose range >320 mcg per day) - High Dose
  • Unlisted
Select Alvesco (ciclesonide) strength and dose (5-11)

All doses are based on NHLIB/GINA guidelines.

  • Choices are puffs per day.
  • Most clinical dosing is BID. 
  • Therefore, divide total dose by 2 and administer BID.

 

Select one option:

  • Alvesco MDI 80 mcg inhale 1-2 puffs/day (total dose range 80-160 mcg per day) - Low Dose
  • Alvesco MDI 80 mcg inhale 3-4 puffs/day (total dose range >160-320 mcg per day) - Medium Dose
  • Alvesco MDI 80 mcg inhale 6 puffs/day (total dose range >320 mcg per day) - High Dose
  • Alvesco MDI 160 mcg inhale 1 puffs/day (total dose range 80-160 mcg per day) - Low Dose
  • Alvesco MDI 160 mcg inhale 2 puffs/day (total dose range >160-320 mcg per day) - Medium Dose
  • Alvesco MDI 160 mcg inhale 4 puffs/day (total dose range >320 mcg per day) - High Dose
  • Unlisted
Select Pulmicort (budesonide) strength and dose (5-11)

All doses are based on NHLIB/GINA guidelines.

  • Choices are puffs per day.
  • Most clinical dosing is BID. 
  • Therefore, divide total dose by 2 and administer BID.

 

Select one option:

  • Pulmicort Nebules 0.25 mg inhale 2 nebs/day (total dose 0.5 mg per day) - Low Dose
  • Pulmicort Nebules 0.5 mg inhale 1 nebs/day (total dose 0.5 mg per day) - Low Dose
  • Pulmicort Nebules 0.5 mg inhale 2 nebs/day (total dose 1.0 mg per day) - Medium Dose
  • Pulmicort Nebules 1.0 mg inhale 1 nebs/day (total dose 1.0 mg per day) - Medium Dose
  • Pulmicort Nebules 1.0 mg inhale 2 nebs/day (total dose 2.0 mg per day) - High Dose
  • Unlisted
Select Flovent (fluticasone) MDI strength and dose (5-11)

All doses are based on NHLIB/GINA guidelines.

  • Choices are puffs per day.
  • Most clinical dosing is BID. 
  • Therefore, divide total dose by 2 and administer BID.

 

Select one option:

  • Flovent MDI 44 mcg inhale 2-4 puffs/day (total dose range 88-176 mcg per day) - Low Dose
  • Flovent MDI 44 mcg inhale 6 puffs/day (total dose range >176-352 mcg per day) - Medium Dose
  • Flovent MDI 110 mcg inhale 1 puffs/day (total dose range 88-176 mcg per day) - Low Dose
  • Flovent MDI 110 mcg inhale 2 puffs/day (total dose range >176-352 mcg per day) - Medium Dose
  • Flovent MDI 110 mcg inhale 4 puffs/day (total dose range >352 mcg per day) - High Dose
  • Flovent MDI 220 mcg inhale 1 puffs/day (total dose range >176-352 mcg per day) - Medium Dose
  • Flovent MDI 220 mcg inhale 2 puffs/day (total dose range >352 mcg per day) - High Dose
  • Unlisted
Select Flovent (fluticasone) Diskus strength and dose (5-11)

All doses are based on NHLIB/GINA guidelines.

  • Choices are puffs per day.
  • Most clinical dosing is BID. 
  • Therefore, divide total dose by 2 and administer BID.

 

Select one option:

  • Flovent Diskus 50 mcg inhale 2-4 puffs/day (total dose range 100-200 mcg per day) - Low Dose
  • Flovent Diskus 50 mcg inhale 6 puffs/day (total dose range >200-400 mcg per day) - Medium Dose
  • Flovent Diskus 100 mcg inhale 1-2 puffs/day (total dose range 100-200 mcg per day) - Low Dose
  • Flovent Diskus 100 mcg inhale 4 puffs/day (total dose range >200-400 mcg per day) - Medium Dose
  • Flovent Diskus 100 mcg inhale 6 puffs/day (total dose range >400 mcg per day) - High Dose
  • Flovent Diskus 250 mcg inhale 1 puffs/day (total dose range >200-400 mcg per day) - Medium Dose
  • Flovent Diskus 250 mcg inhale 2 puffs/day (total dose range >400 mcg per day) - High Dose
  • Unlisted
Select Asmanex (mometasone) DPI strength and dose (5-11)

All doses are based on NHLIB/GINA guidelines.

  • Choices are puffs per day.
  • Most clinical dosing is BID. 
  • Therefore, divide total dose by 2 and administer BID.

 

Select one option:

  • Asmanex DPI (Twisthaler) 110 mcg inhale 1 puffs/day (total dose range 110 mcg per day) - Low Dose
  • Asmanex DPI (Twisthaler) 110 mcg inhale 2-4 puffs/day (total dose range 220-440 mcg per day) - Medium Dose
  • Asmanex DPI (Twisthaler) 110 mcg inhale 6 puffs/day (total dose range >440 mcg per day) - High Dose
  • Asmanex DPI (Twisthaler) 220 mcg inhale 1-2 puffs/day (total dose range 220-140 mcg per day) - Medium Dose
  • Asmanex DPI (Twisthaler) 220 mcg inhale 3 puffs/day (total dose range >440 mcg per day) - High Dose
  • Unlisted
Select Asmanex (mometasone) MDI strength and dose (5-11)

All doses are based on NHLIB/GINA guidelines.

  • Choices are puffs per day.
  • Most clinical dosing is BID. 
  • Therefore, divide total dose by 2 and administer BID.

 

Select one option:

  • Asmanex MDI 100 mcg inhale 1 puffs/day - Low Dose
  • Asmanex MDI 100 mcg inhale 2 puffs/day - Medium Dose
  • Asmanex MDI 100 mcg inhale 4 puffs/day - High Dose
  • Asmanex MDI 200 mcg inhale 1-2 puffs/day - Medium Dose
  • Asmanex MDI 200 mcg inhale 3-4 puffs/day - High Dose
  • Unlisted
Select Advair (fluticasone - Salmeterol) combo Diskus strength and dose (5-11)

All doses are based on NHLIB/GINA guidelines.

  • Choices are puffs per day.
  • Most clinical dosing is BID. 
  • Therefore, divide total dose by 2 and administer BID.

 

Select one option:

  • Advair combo Diskus 100/50 mcg inhale 1-2 puffs/day (total dose range 100-200 mcg per day) - Low Dose
  • Advair combo Diskus 250/50 mcg inhale 1-2 puffs/day (total dose range >200-400 mcg per day) - Medium Dose
  • Advair combo Diskus 250/50 mcg inhale 2 puffs/day (total dose range >400 mcg per day) - High Dose
  • Advair combo Diskus 500/50 mcg inhale 1-2 puffs/day (total dose range >400 mcg per day) - High Dose
  • Unlisted
Select Advair (fluticasone - Salmeterol) combo MDI strength and dose (5-11)

All doses are based on NHLIB/GINA guidelines.

  • Choices are puffs per day.
  • Most clinical dosing is BID. 
  • Therefore, divide total dose by 2 and administer BID.

 

Select one option:

  • Advair combo MDI 45/21 mcg inhale 2-4 puffs/day (total dose range 88-176 mcg per day) - Low Dose
  • Advair combo MDI 115/21 mcg inhale 1 puffs/day (total dose range 88-176 mcg per day) - Low Dose
  • Advair combo MDI 115/21 mcg inhale 2 puffs/day (total dose range >176-352 mcg per day) - Medium Dose
  • Advair combo MDI 115/21 mcg inhale 4 puffs/day (total dose range >352 mcg per day) - High Dose
  • Advair combo MDI 230/21 mcg inhale 1 puffs/day (total dose range >176-352 mcg per day) - Medium Dose
  • Advair combo MDI 230/21 mcg inhale 2-4 puffs/day (total dose range >352 mcg per day) - High Dose
  • Unlisted
Select Symbicort (budesonide - formoterol) combo MDI strength and dose (5-11)

All doses are based on NHLIB/GINA guidelines.

  • Choices are puffs per day.
  • Most clinical dosing is BID. 
  • Therefore, divide total dose by 2 and administer BID.

 

Select one option:

  • Symbicort combo MDI 80/4.5 mcg inhale 2-4 puffs/day (total dose range 180-360 mcg per day) - Low Dose
  • Symbicort combo MDI 80/4.5 mcg inhale 4 puffs/day (total dose range >360-720 mcg per day) - Medium Dose
  • Symbicort combo MDI 160/4.5 mcg inhale 1 puffs/day (total dose range 180-360 mcg per day) - Low Dose
  • Symbicort combo MDI 160/4.5 mcg inhale 2-4 puffs/day (total dose range >360-720 mcg per day) - Medium Dose
  • Symbicort combo MDI 160/4.5 mcg inhale 4 puffs/day (total dose range >720 mcg per day) - High Dose
  • Unlisted
Select Dulera (mometasone - formoterol) combo MDI strength and dose (5-11)

All doses are based on NHLIB/GINA guidelines.

  • Choices are puffs per day.
  • Most clinical dosing is BID. 
  • Therefore, divide total dose by 2 and administer BID.

 

Select one option:

  • Dulera combo MDI 100/5 mcg inhale 1 puffs/day (total dose 110 mcg per day) - Low Dose
  • Dulera combo MDI 100/5 mcg inhale 2-4 puffs/day (total dose range 220-440 mcg per day) - Medium Dose
  • Dulera combo MDI 100/5 mcg inhale 4 puffs/day (total dose range >440 mcg per day) - High Dose
  • Dulera combo MDI 200/5 mcg inhale 2 puffs/day (total dose range 220-440 mcg per day) - Medium Dose
  • Dulera combo MDI 200/5 mcg inhale 2-4 puffs/day (total dose range >440 mcg per day) - High Dose
  • Unlisted
Select Breo Ellipta (fluticasone - vilanterol) combo DPI strength and dose (5-11)

All doses are based on NHLIB/GINA guidelines.

  • Choices are puffs per day.
  • Most clinical dosing is BID. 
  • Therefore, divide total dose by 2 and administer BID.

 

Select one option:

  • Breo Ellipta combo DPI 200/25 mcg inhale 1 puffs/day (total 200 mcg per day) - High Dose
  • Unlisted
Select QVAR (beclomethasone) strength and dose (0-4)

While dosing is typically based on NHLIB/GINA guidelines, QVAR MDI is not indicated in the guidelines but included because of common local practice.

  • Choices are total puffs per day.
  • Most clinical dosing is BID. 
  • Therefore, divide total dose by 2 and administer BID.

 

Select one option:

  • QVAR MDI 40 mcg inhale 4 puffs/day (total dose 160 mcg per day) - Low Dose
  • QVAR MDI 80 mcg inhale 2 puffs/day (total dose 160 mcg per day) - Low Dose
  • QVAR MDI 80 mcg inhale 4 puffs/day (total dose 320 mcg per day) - Medium Dose
  • QVAR MDI 80 mcg inhale 6 puffs/day (total dose 480 mcg per day) - High Dose
  • Unlisted
Select Pulmicort (budesonide) strength and dose (0-4)

All doses are based on NHLIB/GINA guidelines.

  • Choices are puffs per day.
  • Most clinical dosing is BID. 
  • Therefore, divide total dose by 2 and administer BID. 
  • RTI: Respiratory Tract Infection

 

Select one option:

  • Pulmicort Nebules 0.25 mg inhale 1-2 nebs/day (total dose range 0.25-0.5 mg per day) - Low Dose
  • Pulmicort Nebules 0.5 mg inhale 1 nebs/day (total dose 0.25-0.5 mg per day) - Low Dose
  • Pulmicort Nebules 0.5 mg inhale 2 nebs/day (total dose range >0.5-1.0 mg per day) - Medium Dose
  • Pulmicort Nebules 0.5 mg inhale 3 nebs x 7 days RTI (total dose >1.0 mg per day) - High Dose
  • Pulmicort Nebules 1.0 mg inhale 1 nebs/day (total dose range >0.5-1.0 mg per day) - Medium Dose
  • Pulmicort Nebules 1.0 mg inhale 2 nebs x 7 days RTI (total dose range > 1.0 mg per day) - High Dose
  • Unlisted
Select Flovent (fluticasone) MDI strength and dose (0-4)

All doses are based on NHLIB/GINA guidelines.

  • Choices are puffs per day.
  • Most clinical dosing is BID. 
  • Therefore, divide total dose by 2 and administer BID.
  • All MDI doses administered by facemask with spacer.
  • Therefore, higher doses recommended per guidelines.
  • RTI: Respiratory Tract Infection

 

Select one option:

  • Flovent MDI 44 mcg inhale 4 puffs/day (total dose 176 mcg per day) - Low Dose
  • Flovent MDI 44 mcg inhale 6 puffs/day (total dose range >176-352 mcg per day) - Medium Dose
  • Flovent MDI 110 mcg inhale 2 puffs/day (total dose range >176-352 mcg per day) - Medium Dose
  • Flovent MDI 110 mcg inhale 4 nebs x 7 days RTI (total dose range >352 mcg per day) - High Dose
  • Flovent MDI 220 mcg inhale 1 puffs/day (total dose range >176-352 mcg per day) - Medium Dose
  • Flovent MDI 220 mcg inhale 2 nebs x 7 days RTI (total dose range >352 mcg per day) - High Dose
  • Unlisted
Select Asmanex (mometasone) MDI strength and dose (0-4)

All doses are based on NHLIB/GINA guidelines.

  • Choices are puffs per day.
  • Most clinical dosing is BID. 
  • Therefore, divide total dose by 2 and administer BID.
  • All MDI doses administered by facemask with spacer.
  • Therefore, higher doses recommended per guidelines.

 

Select one option:

  • Asmanex MDI 100 mcg inhale 2 puffs/day - Medium Dose
  • Asmanex MDI 100 mcg inhale 4 puffs/day - High Dose
  • Asmanex MDI 200 mcg inhale 1 puffs/day - Medium Dose
  • Asmanex MDI 200 mcg inhale 2 puffs/day - High Dose
  • Unlisted
Select Advair (fluticasone - Salmeterol) combo MDI strength and dose (0-4)

All doses are based on NHLIB/GINA guidelines.

  • Choices are puffs per day.
  • Most clinical dosing is BID. 
  • Therefore, divide total dose by 2 and administer BID.

 

Select one option:

  • Advair combo MDI 45/21 mcg inhale 2 puffs/day (total dose 176 mcg per day) - Low Dose
  • Advair combo MDI 45/21 mcg inhale 4 puffs/day (total dose range >176-352 mcg per day) - Medium Dose
  • Advair combo MDI 115/21 mcg inhale 2 puffs/day (total dose range >176-352 mcg per day) - Medium Dose
  • Advair combo MDI 115/21 mcg inhale 4 puffs/day (total dose range >352 mcg per day) - High Dose
  • Advair combo MDI 230/21 mcg inhale 2 puffs/day (total dose range >352 mcg per day) - High Dose
  • Unlisted
Select Symbicort (budesonide - formoterol) combo MDI strength and dose (0-4)

All doses are based on NHLIB/GINA guidelines.

  • Choices are puffs per day.
  • Most clinical dosing is BID. 
  • Therefore, divide total dose by 2 and administer BID.
  • Dosing is based on relative ICS potency to fluticasone. Higher dose indicated because it is delivered with  a face mask and spacer.

 

Select one option:

  • Symbicort combo MDI 80/4.5 mcg inhale 2-4 puffs/day (total dose range 180-360 mcg per day) - Low Dose
  • Symbicort combo MDI 80/4.5 mcg inhale 4 puffs/day (total dose range >360-720 mcg per day) - Medium Dose
  • Symbicort combo MDI 160/4.5 mcg inhale 1 puffs/day (total dose range 180-360 mcg per day) - Low Dose
  • Symbicort combo MDI 160/4.5 mcg inhale 2 puffs/day (total dose range >360-720 mcg per day) - Medium Dose
  • Symbicort combo MDI 160/4.5 mcg inhale 4 puffs/day (total dose range >720 mcg per day) - High Dose
  • Unlisted
Select Dulera (mometasone - formoterol) combo MDI strength and dose (0-4)

All doses are based on NHLIB/GINA guidelines.

  • Choices are puffs per day.
  • Most clinical dosing is BID. 
  • Therefore, divide total dose by 2 and administer BID.
  • Dosing is based on relative ICS potency to fluticasone. Higher dose indicated because it is delivered with  a face mask and spacer.

 

Select one option:

  • Dulera combo MDI 100/5 mcg inhale 1 puffs/day (total dose 110 mcg per day) - Low Dose
  • Dulera combo MDI 100/5 mcg inhale 2 puffs/day (total dose range 220-440 mcg per day) - Medium Dose
  • Dulera combo MDI 100/5 mcg inhale 4 puffs/day (total dose range >440 mcg per day) - High Dose
  • Dulera combo MDI 200/5 mcg inhale 1 puffs/day (total dose range 220-440 mcg per day) - Medium Dose
  • Dulera combo MDI 200/5 mcg inhale 2 puffs/day (total dose range >440 mcg per day) - High Dose
  • Unlisted
Possible results
Low-dose ICS: Used in Step 2 (Pref) & Step 3 - Ages 5-11
High-dose ICS: Used in Steps 5 & 6 - Ages 5-11
High-dose ICS: Used in Steps 5 & 6 - Ages 0-4
High-dose ICS: Used in Steps 5 & 6 - Ages 12+
Low-dose ICS: Used in Step 2 (Pref) & Step 3 (Alt) - Ages 12+
Medium-dose ICS: Used in Step 3 (Alt) & Step 4 (Alt) - Ages 12+
ICS medication unlisted: Consider pharmacist consultation
Medium-dose ICS: Used in Step 3 (Alt) & Step 4 - Ages 5-11
Low-dose ICS: Used in Step 2 (Ages 0-4) & Step 3 (Age 4)
Medium-dose ICS: Used in Step 3 & Step 4 - Ages 0-4

Literature

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