Moderate asthma : symptoms daily exacerbations affect activity and sleep night-time asthma symptoms > 1 time a week daily use of short-acting beta 2 -agonist PEF or FEV 1 > 60- 30 % Mild asthma : symptoms > 1 time a week but 2 times a month PEF or FEV 1 > 80 % predicted, variability 20 - 30 % The patient should be instructed that Metaz 200 micrograms Inhalation Powder is not intended to be used "on demand" as a reliever medication to treat acute symptoms and that this product must be taken regularly to maintain therapeutic benefit even when he or she is asymptomatic. During withdrawal of oral corticosteroids, patients must be carefully monitored for signs of unstable asthma, including objective measures of airway function, and for adrenal insufficiency (see 4.4). Generally, these decrements are not to exceed 2.5 mg of prednisone daily, or its equivalent.Ī slow rate of withdrawal is strongly recommended. The next reduction is made after an interval of one to two weeks, depending on the response of the patient. After approximately one week, gradual withdrawal of the systemic corticosteroid can be initiated by reducing the daily or alternate daily dose. In patients with severe asthma and previously receiving oral corticosteroids, Metaz 200 micrograms Inhalation Powder will be initiated concurrently with the patient's usual maintenance dose of systemic corticosteroid. When symptoms are controlled, titrate Metaz 200 micrograms Inhalation Powder to the lowest effective dose.
Patients with severe asthma: The recommended starting dose is 400 micrograms twice daily, which is the maximum recommended dose. Dose reduction to 200 micrograms once daily given in the evening may be an effective maintenance dose for some patients. The dose of Metaz 200 micrograms Inhalation Powder should be individualised and titrated to the lowest dose at which effective control of asthma is maintained. Some patients may be more adequately controlled on 400 micrograms daily, given in two divided doses (200 micrograms twice daily). Data suggest that better asthma control is achieved if once daily dosing is administered in the evening. Patients with persistent mild to moderate asthma: The recommended starting dose for most of these patients is 400 micrograms once daily.
Dosage recommendations are based on severity of asthma (see criteria below).
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