The usual recommended starting dosage for adults is often 200/6 micrograms (mcg) taken twice daily, with adjustments made based on the severity of the patient's condition and their response to treatment.

For patients managing asthma, the maximum dosage may be up to 800/24 mcg per day, but this should be determined by a healthcare professional. In children aged 12 years and younger, Luforbec is generally not recommended unless otherwise advised by a healthcare provider.

Patients should use Luforbec regularly, even when symptoms are not present, to maintain effective control of their respiratory condition. It is important to shake the inhaler well before each use, exhale fully, and then inhale deeply and slowly while pressing down on the inhaler to ensure proper medication delivery. If multiple doses are prescribed, patients should wait about 30 seconds between inhalations.

To reduce the risk of side effects such as oral thrush, patients are advised to rinse their mouths
with water after each use. As with all medications, it is crucial for individuals to follow the specific dosage and administration instructions provided by their healthcare provider. Always use this medication exactly as your clinician has told you. Check with our clinical team or your GP or pharmacist if you are not sure.

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Just because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.

Common Side Effects

• Oral Thrush (Candidiasis): This is a common side effect due to the immunosuppressive effects of budesonide on the oral mucosa. Symptoms include white patches, soreness, or a burning sensation in the mouth and throat.
• Hoarseness and Dysphonia: Many users report changes in their voice, including hoarseness and difficulty speaking clearly, often due to irritation of the vocal cords.
• Cough: Patients may experience a persistent cough after inhalation, which could be due to throat irritation or an adverse reaction to the medication.
• Headache: Mild to moderate headaches are frequently reported by patients using Luforbec.

Less Common Side Effects

• Nausea: Some patients may experience gastrointestinal upset or nausea.
• Dizziness: Lightheadedness or dizziness may occur, occasionally interfering with daily activities.
• Tremors: Due to the formoterol component, patients may experience muscle tremors, particularly in the hands.

Rare Side Effects

• Paradoxical Bronchospasm: Rarely, patients may experience worsening of wheezing and breathlessness immediately after using the inhaler. If this occurs, it requires immediate medical attention and discontinuation of the medication.
• Adrenal Suppression: Long-term use, particularly at high doses, can lead to suppression of the adrenal glands, leading to insufficient steroid production.
• Growth Suppression in Children: Prolonged use of inhaled corticosteroids in children may potentially affect growth velocity.
• Cardiac Effects: Some patients may experience increased heart rate (tachycardia), palpitations, or in rare cases, arrhythmias due to the beta-agonist component.
• Hypokalemia: Lowered potassium levels can occur, potentially leading to muscle weakness or cramps.

For full information on side effects and correct use, see the patient information leaflet. If any side effects concern you, or you are experiencing any of the side effects mentioned in the patient information leaflet whilst taking this medication, please contact our clinical team or speak to your GP.

While it is beneficial for reducing airway inflammation and controlling symptoms, there are important cautions and warnings to consider:

Cautions:

• Systemic Effects: Long-term use of inhaled corticosteroids can lead to systemic corticosteroid effects, particularly at high doses. Patients should be monitored for signs of adrenal suppression, Cushing's syndrome, and other corticosteroid-related side effects.
• Oral Candidiasis: Patients should be cautioned about the risk of developing oral thrush (candidiasis) due to local immunosuppression in the mouth and throat. To reduce this risk, rinsing the mouth after each use is essential.
• Growth in Children: Prolonged use of inhaled corticosteroids in children may affect growth velocity. Regular monitoring of growth should be conducted for children using Luforbec.
• Pre-existing Conditions: Caution is advised in patients with a history of tuberculosis, fungal infections, or other viral infections, as corticosteroids may exacerbate these conditions.
• Concurrent Medications:Patients should inform their healthcare provider about any other medications they are taking, particularly other corticosteroids or drugs that may affect liver enzymes, as these may alter the effectiveness of Luforbec.

Warnings

• Not for Acute Relief: Luforbec is not a rescue medication and should not be used for the immediate relief of acute asthma attacks or bronchospasms. Patients should have a short-acting beta-agonist inhaler available for such situations.
• Paradoxical Bronchospasm: In rare cases, Luforbec can cause paradoxical bronchospasm, characterized by worsening wheezing and difficulty breathing immediately following inhalation. If this occurs, the medication should be discontinued, and medical attention should be sought.
• Underlying Systemic Steroid Use: If patients are transitioning from systemic corticosteroids to Luforbec, careful monitoring is necessary, as there may be a risk of adrenal insufficiency. Doses may need adjustment as the body acclimates to lower steroid levels.
• Monitoring: Regular follow-ups are essential for patients on Luforbec, especially for long-term use. Healthcare providers should monitor lung function, symptom control, and any potential side effects.

Get emergency medical help if you have signs of an allergic reaction to this medication. These include:

• Hives
• Dizziness
• Fast or pounding heartbeats
• Wheezing
• Difficult breathing
• Swelling of your face, lips, tongue, or throat.

It is important that you let us know which prescription, over-the-counter medicines and recreational drugs you are currently taking. You must also tell us about any other medical conditions that you currently have (or had in the past). This will help us ensure the prescribed medication is safe and appropriate for you to take.

For full information on warnings, medication interactions and contraindications, refer to the Patient Information Leaflet. Please read all packaging and the Patient Information Leaflet before taking any new medicine and inform our clinical team or your GP of medicines you are taking or intend to take.