From the Guidelines
The recommended medications and dosages for the listed conditions are as follows:
Medications for Respiratory Conditions
- Asthma:
- Salbutamol (Albuterol) inhaler: 5 mg or 0.15 mg/kg nebulised, or 100 mg MDI + Spacer, one actuation then inhale, repeat up to 20 times 1
- Fluticasone (Flovent) inhaler: 110mcg, 2 puffs twice daily for long-term control
- Montelukast (Singulair): 10mg, 1 tablet daily for long-term control
- Pneumonia:
- Azithromycin (Zithromax): 500mg, 1 tablet on the first day, then 250mg daily for 4 days
- Amoxicillin-clavulanate (Augmentin): 875mg/125mg, 1 tablet twice daily for 7-10 days
- Sinus infection:
- Amoxicillin-clavulanate (Augmentin): 875mg/125mg, 1 tablet twice daily for 7-10 days
- Azithromycin (Zithromax): 500mg, 1 tablet on the first day, then 250mg daily for 4 days
- Nasal decongestant: Oxymetazoline (Afrin) spray: 2-3 sprays in each nostril twice daily for 3-5 days
- Bronchitis:
- Azithromycin (Zithromax): 500mg, 1 tablet on the first day, then 250mg daily for 4 days
- Amoxicillin-clavulanate (Augmentin): 875mg/125mg, 1 tablet twice daily for 7-10 days
- Cough suppressant: Dextromethorphan (Robitussin): 15-30mg, 1-2 teaspoons every 4-6 hours as needed
- COPD:
- Albuterol (Ventolin) inhaler: 2.5mg/3mL, 2-4 puffs every 4-6 hours as needed
- Tiotropium (Spiriva) inhaler: 18mcg, 1 capsule daily
- Fluticasone-salmeterol (Advair) inhaler: 250mcg/50mcg, 1 inhalation twice daily
- Phosphodiesterase-4 inhibitors, such as Roflumilast, may be used in patients with severe to very severe COPD and a history of exacerbations 1
- Long-term azithromycin therapy may be used to reduce exacerbations in patients with COPD 1
Medications for Non-Respiratory Conditions
- Diabetes (Type 2):
- Metformin (Glucophage): 500-1000mg, 1-2 tablets twice daily
- Glipizide (Glucotrol): 5-10mg, 1-2 tablets daily
- Insulin glargine (Lantus): 10-50 units, 1 injection daily
- Ear infection (Otitis Media):
- Amoxicillin (Amoxil): 500mg, 1 capsule three times daily for 7-10 days
- Azithromycin (Zithromax): 500mg, 1 tablet on the first day, then 250mg daily for 4 days
- Pain reliever: Acetaminophen (Tylenol): 325-650mg, 1-2 tablets every 4-6 hours as needed
It is essential to consult a healthcare professional for personalized treatment and to discuss potential side effects, interactions, and contraindications. The treatment recommendations may vary depending on individual patient needs and medical history. In patients with COPD, the use of inhaled corticosteroids (ICS) may increase the risk of pneumonia, especially in those with severe disease 1. The use of phosphodiesterase-4 inhibitors, such as Roflumilast, may improve lung function and reduce exacerbations in patients with severe to very severe COPD and a history of exacerbations 1. Long-term azithromycin therapy may reduce exacerbations in patients with COPD, but it is associated with an increased incidence of bacterial resistance and impaired hearing tests 1. In patients with diabetes, the treatment should be individualized based on the patient's specific needs and medical history. In patients with ear infections, the treatment should be based on the severity of the infection and the patient's medical history. Please consult a healthcare professional for personalized treatment and to discuss potential side effects, interactions, and contraindications.
From the FDA Drug Label
2 DOSAGE AND ADMINISTRATION Wixela Inhub® should be administered as 1 inhalation twice daily by the orally inhaled route only.
Adult and Adolescent Patients Aged 12 Years and Older For patients aged 12 years and older, the dosage is 1 inhalation twice daily, approximately 12 hours apart. The maximum recommended dosage is Wixela Inhub® 500/50 twice daily. 2. 2 Chronic Obstructive Pulmonary Disease The recommended dosage for patients with COPD is 1 inhalation of Wixela Inhub® 250/50 twice daily, approximately 12 hours apart.
The recommended medications and dosages are:
- Asthma: Fluticasone-salmeterol (INH) 1 inhalation twice daily, with a maximum dosage of Wixela Inhub 500/50 twice daily for adult and adolescent patients aged 12 years and older, and Wixela Inhub 100/50 twice daily for pediatric patients aged 4 to 11 years.
- Chronic Obstructive Pulmonary Disease (COPD): Fluticasone-salmeterol (INH) 1 inhalation of Wixela Inhub 250/50 twice daily. The FDA drug label does not answer the question for Pneumonia, Sinusitis, Bronchitis, Diabetes Mellitus, and Otitis Media. 2
From the Research
Medications and Dosages for Respiratory Conditions
- Asthma:
- Inhaled corticosteroid (ICS)-containing therapy is recommended to reduce the risk of severe exacerbations 3
- For adults and adolescents with "mild" asthma, combination ICS-formoterol can be taken as needed for symptom relief 3
- For patients with moderate-severe asthma, maintenance-and-reliever therapy (MART) with ICS-formoterol is the preferred regimen 3
- Pneumonia:
- No specific medication recommendations are provided in the available studies
- Sinusitis:
- No specific medication recommendations are provided in the available studies
- Bronchitis:
- No specific medication recommendations are provided in the available studies
- Chronic Obstructive Pulmonary Disease (COPD):
- No specific medication recommendations are provided in the available studies
Medications and Dosages for Non-Respiratory Conditions
- Diabetes Mellitus:
- No specific medication recommendations are provided in the available studies
- Otitis Media:
- No specific medication recommendations are provided in the available studies
General Guidance on Treatment Recommendations
- Clinicians should consider the rigor of treatment recommendations, with high rigor recommendations coming from systematically developed, evidence-based practice guidelines or rigorously conducted decision analyses 4
- Recommendations should be clear and actionable, and explicitly specify whether they are strong or weak, and are appropriate for all patients or depend on individual patients' circumstances and values 5