Despite being different doses; Braltus® and Spiriva® Handihaler and Respimat are clinically equivalent and produce the same amount of active ingredient in the body. 10 micrograms of Braltus® is equivalent to 18 micrograms of Spiriva® Handihaler and 5 micrograms of Respimat.
Capsules for Spiriva® Handihaler and Braltus® should be used for their intended device only.
Spiriva® should be prescribed/endorsed with the type of device intended on the prescription (either HandiHaler or Respimat).
The Braltus Zonda is significantly cheaper than Spiriva HandiHaler and product switching from the Spiriva product to Braltus Zonda is encouraged.
Short-acting antimuscarinic Inhaler, Nebules Should only be prescribed for those patients with COPD in whom salbutamol is not tolerated or ineffective. It should not be used in combination with salbutamol. For those patients requiring regular antimuscarinuc therapy tiotropium is the prefered choice
Umeclidinium (Incruse Ellipta®)
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Non Formulary section
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Green -Medicines suitable for routine use within primary care and Secondary care
Can be initiated within primary care within their licensed indication, in accordance with nationally recognised formularies
Amber- Medicines suitable to be prescribed in primary care after specialist /Consultant recommendation or initiation.
A supporting prescribing guideline may be requested which must have been agreed by the relevant secondary care trust Medicines and Therapeutic Committee and approved by the Area Prescribing Committee.
Red-Hospital initiation and continuation only
AMBER SHARE CARE PROTOCOL- Medicines that should be initiated by a specialist and prescribed by primary care prescribers only under a shared care protocol, once the patient has been stabilised
To be supplied from the appropriate commissioned provider.
GREEN 2- to be prescribed by primary care only
GREY- NON FORMULARY (As agreed by Area Prescribing Committee)