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St Paul's CofE Primary School

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Clarification on what constitutes a High Risk Asthmatic.

We have been asked to provide any clarification on what is classed as an Asthmatic, which you appreciate is a very widespread term. 

 

The Asthma UK organisation has clarified with the Department of Health on who is in the high risk category of Asthmatic Vulnerable persons.

The Department of Health will be contacting individuals who they have assessed (from GP or Specialist notes) as being within the Vulnerable person groups, therefore your affected staff may provide that contact information with you for clarity. If a person is in these groups, they will get a text message or a letter this week. If an individual haven't heard anything by the 29th March, and they think they are in a high risk group, they should contact their GP.

 

The classification of a high risk Asthmatic is:

If you are, or your child is, taking:

  • Any biologic therapy, also called a mAb (Xolair/omalizumab, Nucala/mepolizumab, Cinqaero/reslizumab, Fasenra/benralizumab)
  • Steroid tablets or liquid every day
  • Antibiotic tablets or liquid for asthma every week (e.g. azithromycin)
  • Tiotropium
  • A combination inhaler that also contains a long-acting bronchodilator (e.g. Seretide, Fostair, Symbicort) at a high daily steroid dose (see the list below)
  • An inhaler with a high daily steroid dose (see the list below) AND you are taking Montelukast

Then you should follow the shielding advice, which means:

  • Stay at home at all times and avoid any face-to-face contact with others for at least 12 weeks.

Classification of slightly lower risk Asthmatics:

If you are not on the medicines listed above, but any of these apply to you:

  • You have had an admission to hospital in the last year,
  • You have needed 2 or more courses of oral steroids in the last year, OR
  • You are using your blue reliever inhaler 3 or more times per week

Then you may benefit from stricter social distancing. If you are using your reliever inhaler more than 3 times a week, current advice is that you speak to your GP or asthma nurse about improving your asthma control as soon as possible.

 

There is a comprehensive list of steroids below.

Relevant link:  https://www.asthma.org.uk/coronavirus

 

Any questions or queries please get in touch.

Kind regards

Nick

 

 

What is a high daily steroid dose for different inhalers?

If you are on the dose listed or more, then it is considered a high daily dose of steroids. This will help you work out if you need to follow the shielding advice above.

 

We have taken this list from the British Thoracic Society’s guideline on asthma management and information from our clinical advisers. If your inhaler is not listed, it may not be able to be prescribed at a high dose. If you think you might be on a high dose and your inhaler is not listed here, you can contact your asthma nurse or pharmacist for advice.

 

 

Inhaler

Adult

Child

Clenil Modulite pMDI

250 micrograms 2 puffs twice a day

200 micrograms 2 puffs twice a day

Kelhale pMDI

100 micrograms 4 puffs twice a day

 

Qvar pMDI, Autohaler or Easi-Breathe

100 micrograms 4 puffs twice a day

100 micrograms 2 puffs twice a day

Soprobec pMDI

250 micrograms 2 puffs twice a day

200 micrograms 2 puffs twice a day

Alvesco pMDI

160 micrograms 2 puffs twice a day

160 micrograms 2 puffs once a day

Flixotide Evohaler

250 micrograms 2 puffs twice a day

125 micrograms 2 puffs twice a day

Budesonide Easyhaler

400 micrograms 2 puffs twice a day

200 micrograms 2 puffs twice a day

Budelin Novolizer

200 micrograms 4 puffs twice a day

200 micrograms 2 puffs twice a day

Pulmicort Turbohaler

400 micrograms 2 puffs twice a day

200 micrograms 2 puffs twice a day OR 400 micrograms 1 puff twice a day

Flixotide Accuhaler

500 micrograms 1 puff twice a day

250 micrograms 1 puff twice a day

Fostair pMDI or NEXThaler

200/6 two puffs twice a day

 

DuoResp Spiromax

320/9 two puffs twice a day

320/9 one puff twice a day OR 160/4.5 two puffs twice a day

Symbicort Turbohaler

400/12 two puffs twice a day

200/6 two puffs twice a day

Fobumix Easyhaler

320/9 two puffs twice a day

 

Flutiform MDI

250/10 two puffs twice a day

125/5 two puffs twice a day

Flutiform K-Haler

Not licensed at high doses

125/5 two puffs twice a day

Aerivio Spiromax

500/50 one puff twice a day

 

AirFluSal Forspiro

500/50 one puff twice a day

 

AirFluSal pMDI

250/25 two puffs twice a day

 

Aloflute pMDI

250/25 two puffs twice a day

 

Combisal pMDI

250/25 two puffs twice a day

125/25 two puffs twice a day

Fusacomb Easyhaler

500/50 one puff twice a day

 

Sereflo pMDI

250/25 two puffs twice a day

 

Seretide Accuhaler

500/50 one puff twice a day

250/50 one puff twice a day

Seretide Evohaler

250/25 two puffs twice a day

125/25 two puffs twice a day

Sirdupla pMDI

250/25 two puffs twice a day

 

Stalpex Orbicel

500/50 one puff twice a day

 

Relvar Ellipta

184/22 one puff once a day

92/22 one puff once a day

Asmanex Twisthaler

400 micrograms 1 puff twice a day

200 micrograms 1 puff twice a day

 

 

If being used as part of a MART regime

Fostair pMDI or NEXThaler

100/6 one puff twice a day + 1 additional puff when necessary (if using at least 5 puffs each day on average)

Symbicort Turbohaler

100/6 two puffs each day + 1 additional puff when necessary (if using at least 10 puffs each day on average)

Symbicort Turbohaler

200/6 two puffs each day + 1 additional puff when necessary (if using at least 5 puffs each day on average)

DuoResp Spiromax

160/4.5 two puffs each day + 1 additional puff when necessary (if using at least 5 puffs each day on average)

Fobumix Easyhaler

80/4.5 two puffs each day + 1 additional puff when necessary (if using at least 10 puffs each day on average)

Fobumix Easyhaler

160/4.5 two puffs each day + 1 additional puff when necessary (if using at least 5 puffs each day on average)

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