What quantity of AIRSUPRA (albuterol and budesonide) inhaler should be prescribed for an adult (≥ 18 years) for rescue use?

AIRSUPRA Prescribing Quantity for Adults

For adults ≥18 years with moderate-to-severe asthma, prescribe one 8.7-gram AIRSUPRA inhaler containing 120 actuations, which provides 60 doses (each dose = 2 actuations of albuterol 90 µg + budesonide 80 µg) for as-needed rescue use. 1

Dosing Specifications

• Each dose consists of 2 actuations delivering albuterol 180 µg (90 µg per actuation) plus budesonide 160 µg (80 µg per actuation) 1
• AIRSUPRA is used as-needed only for rescue therapy, not as scheduled maintenance treatment 1, 2
• The standard inhaler canister contains 120 actuations = 60 complete doses 1

Expected Usage and Refill Timing

• In clinical trials of moderate-to-severe asthma, patients used AIRSUPRA as-needed for symptom relief while continuing their maintenance inhaled corticosteroid therapy 1
• For mild asthma trials, 74.4% of patients were using only a SABA at baseline, and the mean annualized rate of severe exacerbations with albuterol-budesonide was 0.15 events per year 2
• Prescribe a 30–60 day supply initially, with refills authorized based on individual rescue medication use patterns 1, 2
• Increasing rescue inhaler use (>2 doses per week for symptom control) signals worsening asthma control and necessitates reassessment of maintenance therapy 3

Clinical Context and Monitoring

• AIRSUPRA demonstrated a 26% reduction in severe asthma exacerbations compared to albuterol alone (hazard ratio 0.74; 95% CI 0.62–0.89; P=0.001) in patients with moderate-to-severe asthma 1
• In mild asthma, AIRSUPRA reduced severe exacerbations by 47% compared to albuterol alone (hazard ratio 0.53; 95% CI 0.39–0.73) 2
• The mean annualized systemic glucocorticoid exposure was lower with AIRSUPRA (23.2 mg/year) versus albuterol alone (61.9 mg/year) in mild asthma 2

Important Prescribing Caveats

• AIRSUPRA is FDA-approved only for adults ≥18 years; it is not approved for pediatric patients 1, 4
• Patients must continue their prescribed maintenance inhaled corticosteroid therapy; AIRSUPRA does not replace controller medications 1
• The combination addresses both bronchoconstriction (albuterol) and airway inflammation (budesonide) during acute symptom episodes 5, 1
• Adverse event profiles were similar between AIRSUPRA and albuterol alone in clinical trials 1, 2

Practical Prescription Writing

Write the prescription as:

• Medication: AIRSUPRA (albuterol 90 µg + budesonide 80 µg per actuation) inhalation aerosol
• Quantity: 1 inhaler (8.7 grams, 120 actuations)
• Directions: Inhale 2 actuations as needed for asthma symptoms or before exercise
• Refills: 3–6 refills (adjust based on usage patterns)
• Counseling: Instruct patient to shake inhaler before each use and prime if not used for >7 days 1