From the Guidelines
Budesonide and formoterol can be combined for inhalation, but it is not recommended to mix them in a nebulizer.
Key Points
- The combination of budesonide and formoterol is available as a fixed-dose combination inhaler, which is a common treatment for asthma and COPD 1.
- However, there is no evidence to support the use of a nebulizer to deliver this combination, and it may not be safe or effective 1.
- The FACET study, which evaluated the effects of budesonide and formoterol in asthma patients, used a dry powder inhaler, not a nebulizer 1.
- The Expert Panel Report 3 (EPR-3) guidelines recommend the use of combination inhalers, including budesonide and formoterol, for the treatment of asthma, but do not mention the use of nebulizers for this purpose 1.
- A more recent study suggests that the combination of budesonide and formoterol can be used as a single inhaler for both maintenance and relief therapy, but again, this is not related to the use of a nebulizer 1.
- In general, it is not recommended to mix medications in a nebulizer unless specifically instructed to do so by a healthcare provider, as this can affect the stability and efficacy of the medications.
From the Research
Combination of Budesonide and Formoterol
- The combination of budesonide and formoterol is available as a dry-powder inhaler or a pressurized metered-dose inhaler for the treatment of asthma and chronic obstructive pulmonary disease 2.
- Clinical studies have shown that budesonide/formoterol is effective in improving lung function and reducing the incidence of asthma exacerbations when administered via a single inhaler 3, 4.
- The combination of budesonide and formoterol has been shown to be well tolerated, with no adverse effects on pulse rate, blood pressure, or serum potassium 3.
Nebulizer Compatibility
- A study evaluated the physicochemical compatibility and aerodynamic characteristics of formoterol fumarate mixed with other nebulizing solutions, including budesonide inhalation suspension 5.
- The results showed that the admixture of formoterol and budesonide remained clear and colorless, with no precipitation, and the pH, osmolality, and turbidity were within the initial values 5.
- However, the study noted that the cloudiness observed in the formoterol/budesonide combination was due to budesonide suspension, and the fine particle fraction (FPF) for this combination was affected 5.
Key Findings
- Budesonide and formoterol can be combined in a single inhaler for the treatment of asthma and chronic obstructive pulmonary disease 2, 3, 4, 6.
- The combination is effective in improving lung function and reducing the incidence of asthma exacerbations 3, 4.
- The admixture of formoterol and budesonide is physically and chemically compatible, but the cloudiness observed in the combination may affect the FPF 5.