flutiform for children
(5-12 years)


Overview

flutiform is a maintenance treatment for asthma. It contains two ingredients:

  1. Inhaled corticosteroid called fluticasone propionate
    This reduces swelling and inflammation in the airways of your lungs.
  1. Long-acting bronchodilator called formoterol
    This relaxes narrowed airways, so they stay open making it easier for you to breathe.

For these ingredients to be effective, they need to be delivered straight to the lungs. flutiform is administered through an aerosol inhaler, also known as a pressurised metered dose inhaler.


What is flutiform?

flutiform is an inhaled asthma treatment, which combines two active medications that help to improve your child’s breathing:

  • Fluticasone propionate is an inhaled corticosteroid. It helps reduce swelling and inflammation in the lungs.
  • Formoterol is a long-acting bronchodilator. It helps your child’s lungs to stay open, making it easier for them to breathe.

How does flutiform treat my child's asthma?

flutiform helps prevent your child becoming breathless and wheezy. However, it does not work if your child is already having an asthma attack i.e. they are already breathless and wheezing. A fast-acting ‘reliever’ inhaler will need to be used if this happens.


How old should my child be before they use flutiform?

flutiform 50 µg /5 µg is the lowest strength inhaler and is approved for use in children who are aged 5 years and over. It can also be used in adults and adolescents over 12 years of age.


How many puffs and how often should I give flutiform to my child?

The usual dose of flutiform is two puffs twice a day, which is two puffs in the morning and two in the evening.


How many puffs are there in the flutiform inhaler?

A new flutiform inhaler contains 124 puffs.  Four are used to prime the inhaler, leaving 120 puffs. This is enough for 30 days of treatment at the usual dose of 2 puffs twice a day, which is two puffs in the morning and two in the evening. There is an integrated counter on the front of the inhaler that will let you know the number of puffs remaining.


How does the flutiform dose counter work?

The dose counter is on the front of the inhaler and is designed to show how many doses are left. It counts down in units of 10 from 120 to 60. From 60 to 0 it counts down in units of 5. The colour of the counter will change depending on the number of puffs remaining:

  • Green – 120 to 50 puffs
  • Yellow – 49 to 30 puffs
  • Red – 29 to 0 puffs

When the counter turns red, there is about 1 week of medicine left and your child’s doctor or asthma nurse should be contacted for a replacement inhaler. Your child should not use the inhaler when the counter reads zero.


When and how is flutiform ‘primed’/prepared for everyday use?

Your child’s flutiform inhaler needs to be set up, or primed, before your child uses it for the first time. This makes sure it works properly and provides the correct dose, setting it up for everyday use.

To prime/set-up the inhaler

  1. Remove the mouthpiece cover of the inhaler and then shake it well.
  2. Pointing the mouthpiece of the inhaler away from you, press down on the aerosol can and release one puff.
  3. Step 2 should be performed a total of four times, releasing four puffs of medicine, to set up the inhaler for daily use. The inhaler should always be shaken immediately before use.

If your child’s flutiform inhaler hasn’t been used for more than 3 days, then it needs to be ‘primed’ before use as in steps 1–3 above.

If your child’s flutiform inhaler has been exposed to freezing conditions, it should be allowed to warm at room temperature for 30 minutes, and then ‘primed’ before use as in steps 1–3 above.


How does my child use flutiform inhaler?

  1. The mouthpiece cover of the inhaler should be removed. The mouthpiece should be clean and free from any dust.
  2. The inhaler should be shaken immediately before each use to make sure the contents are evenly mixed.
  3. Your child should be sat upright or standing. They should then breathe out as deeply as possible.
  4. The inhaler should be held upright and the mouthpiece placed in their mouth with their lips around it. They should not bite the mouthpiece.
  5. Your child should then breathe in slowly and deeply and, at the same time, the aerosol canister should be pressed down to release one puff. Your child should then continue to breathe in steadily and deeply (for about 2–3 seconds).
  6. While your child is holding their breath, the inhaler should be removed from their mouth. They should continue holding their breath for as long as is comfortable. They should not breathe out into their inhaler.
  7. For their second puff, the inhaler should be held upright and steps 2 to 6 should be repeated.
  8. The mouthpiece cover should then be replaced. If a 'mist' is seen around the top of the inhaler or around your child’s mouth, then the dose may not have been taken properly and step 2 onwards will need to be repeated.

If your child is using the inhaler on their own but has weak hands, it may be easier for them to hold the inhaler in both hands placing their index fingers on the aerosol can and both thumbs on the base of the inhaler. 

If your child has difficulty with the inhaler, their doctor or asthma nurse may provide a device called an AeroChamber Plus® Flow-Vu® spacer, to help them to breathe their medicine into their lungs properly.

Helpful tip: After using their inhaler, your child should always rinse their mouth out, gargle with water or brush their teeth and spit out the residue. This may help prevent them developing sore mouth and throat or a hoarse voice.

Your child should always use their inhaler exactly as their doctor, pharmacist or asthma nurse has told them. Check with your child’s doctor, pharmacist or asthma nurse if you or they are unsure.


How should my child use flutiform with a spacer?

The AeroChamber Plus® Flow-Vu® spacer is recommended for use with flutiform inhaler

  1. The mouthpiece cover of the inhaler should be removed. The mouthpiece should be clean and free from any dust.
  2. The inhaler should be shaken immediately before each use to make sure the contents are evenly mixed.
  3. Insert the inhaler into the back-piece of the chamber.
  4. The inhaler should be held upright and the mouthpiece of the spacer placed in the child’s mouth with their lips around it. They should not bite the mouthpiece.
  5. Your child should be sat upright or standing. They should exhale and press down on the aerosol can to release one puff. Your child should breathe in and out through the chamber for 2-3 breaths, keeping their lips sealed around the chamber mouthpiece.
  6. For their second puff, the inhaler should be held upright and steps 2 to 5 should be repeated.
  7. The inhaler should then be removed from the chamber and the inhaler mouthpiece cover replaced.

Your child’s doctor, asthma nurse or pharmacist will also advise you how to use the AeroChamber Plus® Flow-Vu® spacer device with your inhaler. The AeroChamber Plus® Flow-Vu® spacer device will come with instructions for use as well as care and cleaning instructions, which must be read carefully. If you have any further questions, ask your child’s doctor, asthma nurse or pharmacist


How old should my child be before they use flutiform on their own?

A child’s ability to use flutiform on their own is based on their age and capability. If you take your child for their regular asthma review, your child’s doctor or asthma nurse will be able to advise if they still need help with their inhaler.

If you have any further questions, ask your child’s doctor, pharmacist or asthma nurse. 


What do I do if they forget to take flutiform?

If you or your child forgets a dose, ensure they take it as soon as you remember. However, if it is nearly time for their next dose, skip the missed dose. Your child should not take a double dose to make up for a forgotten dose.


What are the side-effects of flutiform?

As with many medicines, flutiform can cause side-effects, however not everybody will get them. Your child’s doctor or asthma nurse will prescribe the dose necessary to control your child’s asthma.

All medicines can cause allergic reactions, although serious allergic reactions are reported rarely. Tell your doctor immediately if your child experiences:

  • Sudden swelling of the eyelids, face, throat, tongue or lips
  • Rash or itching especially those covering the whole body
  • Symptoms such as dizziness, light-headedness or fainting
  • Sudden changes in their breathing pattern such as increased wheezing or shortness of breath

As with other inhalers, your child’s breathing may worsen immediately after using their inhaler. If you notice an increase in wheezing and shortness of breath in your child, they should stop using flutiform and use their quick acting ‘reliever’ inhaler. Contact your child’s doctor or asthma nurse straight away and they will assess your child and may start them on a different treatment. Your child should have their ‘reliever’ inhaler with them at all times.

If you think your child is experiencing any side effects, talk to your doctor or asthma nurse. This includes any possible side effects not listed here. You can also report side effects directly via the Yellow Card Scheme at: www.mhra.gov.uk/yellowcard.


Will flutiform affect my child’s growth?

Long term use of inhaled corticosteroids, especially at high doses, can potentially impact growth. It is recommended that the height of children receiving prolonged treatment with inhaled corticosteroid is regularly monitored.

flutiform is licenced for use in children aged 5 years and over at a low dose of 50µg/5µg 2 puffs in the morning and evening each day. 

Your child’s doctor or asthma nurse will prescribe the dose necessary to control your child’s asthma. If you have any questions about your child’s asthma medication, please speak to your doctor, asthma nurse or pharmacist. 


When and how should the flutiform inhaler be cleaned?

It is important that the flutiform inhaler is cleaned weekly. The instructions below should be followed carefully:

  1. Remove the mouthpiece cover.
  2. Do not remove the aerosol can from the plastic dispenser (actuator).
  3. Wipe the inside and outside of the mouthpiece and the actuator with a clean, dry cloth or tissue.
  4. Replace the mouthpiece cover.
  5. Do not put the metal canister into water.

To clean the AeroChamber Plus® Flow-Vu® spacer device, read the care and cleaning instructions that came with it.


How should I store my child’s flutiform inhaler?

The inhaler should not be stored above 25°C or refrigerated/ frozen. If your child’s inhaler is exposed to freezing conditions, then it is advised to allow the inhaler to warm at room temperature for 30 minutes and to then ‘re-prime’ it before use (see How is flutiform primed/prepared for everyday use?).

The inhaler should not be exposed to temperatures higher than 50°C. As the canister contains a pressurised liquid, it should not be punctured, broken or burned, even when apparently empty.

The inhaler should not be used:

  • After the expiry date (printed on the canister label, foil pouch and carton)
  • If the inhaler has been removed from the foil pouch for more than 3 months

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