There are no official guidelines to assist in answering this question. I will search for relevant research papers instead.
From the FDA Drug Label
The recommended starting dose and highest recommended dose of budesonide inhalation suspension, based on prior asthma therapy, are listed in the following table. Previous Therapy Recommended Starting Dose Highest Recommended Dose Bronchodilators Alone 0.5 mg total daily dose administered twice daily in divided doses 0.5 mg total daily dose Inhaled Corticosteroids 0. 5 mg total daily dose administered twice daily in divided doses 1 mg total daily dose Oral Corticosteroids 1 mg total daily dose administered as 0.5 mg twice daily 1 mg total daily dose
The starting dose of Budesonide (Inhaled Corticosteroid) is:
- 0.5 mg total daily dose administered twice daily in divided doses for patients previously on Bronchodilators Alone or Inhaled Corticosteroids
- 1 mg total daily dose administered as 0.5 mg twice daily for patients previously on Oral Corticosteroids
- 0.25 mg once daily may be considered for symptomatic children not responding to non-steroidal therapy 1
From the Research
Starting Dose of Budesonide/Formoterol
The starting dose of Budesonide (Inhaled Corticosteroid)/Formoterol (Long-Acting Beta2 Agonist) can vary depending on the patient's condition and the specific formulation used.
- For patients with moderate to severe persistent asthma, the starting dose is typically 160/4.5 microg x 2 inhalations (320/9 microg) twice daily 2, 3.
- For patients with mild to moderate persistent asthma, the starting dose is typically 80/4.5 microg x 2 inhalations (160/9 microg) twice daily 3.
- The dose can be adjusted based on the patient's response to treatment, with a maximum dose of 640/18 microg twice daily 3.
Key Considerations
- Budesonide/formoterol is available in various formulations, including a dry powder inhaler and a pressurized metered-dose inhaler 4, 2.
- The combination of budesonide and formoterol has been shown to be effective in improving lung function, controlling symptoms, and reducing the risk of exacerbations in patients with asthma 4, 5, 6.
- The safety profile of budesonide/formoterol is similar to that of its individual components, with no unexpected pattern of abnormalities reported in clinical trials 3.