Pulmicort to prevent asthma

In Aotearoa New Zealand, the Pulmicort Turbuhaler comes in different strengths (100 mcg, 200 mcg and 400 mcg).

• The dose of Pulmicort will be different for different people depending on the severity of your symptoms and the strength of your turbuhaler.
• The usual dose is 1 or 2 puffs inhaled twice a day.
• Always take your Pulmicort exactly as your doctor has told you. The pharmacy label on your medicine will tell you how much to take, how often to take it and any special instructions.
• If you miss a dose, you can take it as soon as you remember. But if it is nearly time for your next dose, just take your next dose at the right time.

To get the most benefit, it is important to use the correct technique. Ask your doctor, pharmacist, or nurse to explain how to use your inhaler. Even if you have been shown before, ask your doctor, pharmacist, or nurse to explain how to use your inhaler if you still have any questions. Here is some guidance.

(Healthify He Puna Waiora, NZ & Auckland District Health Board, 2018)

Using your turbuhaler

• Open: unscrew and remove the cap. Hold the turbuhaler upright.
• Load the dose: twist the base anticlockwise and then back in the other direction until you hear a click. Your turbuhaler is now loaded with one dose of medicine
• Breathe out: breathe out, away from the turbuhaler. Do not blow directly into the turbuhaler.
• Inhale your dose: place the mouth piece in your mouth and form a seal with your lips. Breathe in deeply. Remove the turbuhaler and hold your breath for up to 10 seconds.
• Close: replace the cap and twist until it is on properly.

Here are some things to know when you're using a Pulmicort Turbuhaler. Other things may be important as well, so ask your healthcare provider what you should know about.

• Keep using your Pulmicort every day. Do not stop using Pulmicort, even if you feel better. Since asthma is a long-term condition, prevention with Pulmicort is ongoing and it will need to be used every day for months or years.
• Try to use Pulmicort at the same time each day, to help you to remember to use it regularly.
• Pulmicort can cause a sore throat and hoarse voice - rinse your mouth after each use to prevent this.
• Other medicines: Pulmicort interacts with some medications, herbal supplements and rongoā Māori, so check with your doctor or pharmacist before starting Pulmicort and before starting any new products.
• Cleaning: Wipe the mouthpiece with a clean dry tissue regularly, at least once a week. Do not use water or liquids when cleaning the mouthpiece or any part of the turbuhaler.
• Storage: Keep your turbuhaler in a cool, dry place with the cover firmly in place. Don't store it in the bathroom or near a sink. Keep the cap on when you're not using it. The device may clog up if you breathe out through it, dribble into it or keep it an place where there is high humidity (moisture in the air) with the cap off or unsealed.

There is a window under the mouthpiece of the Pulmicort Turbuhaler called a dose indicator window. You will need to check regularly to see if a red mark has appeared in the window. 

• When the red mark appears at the top of the window, there are approximately 20 doses (inhalations) of medicine remaining. Now is the time to get your next Pulmicort Turbuhaler.
• When the red mark reaches the bottom of the window, your Pulmicort Turbuhaler will no longer deliver the correct amount of medicine and should be discarded.

Like all medicines, Pulmicort can cause side effects, although not everyone gets them. Often side effects improve as your body adjusts to the new medicine.

Inhaled steroids usually have fewer and milder side effects than when taken as tablets. However, using high doses of inhaled steroids over long periods can increase your risk of side effects. Learn more about taking steroids long term.