Airsupra Will Be a New Combo Inhaler for Asthma

You’ll hear about albuterol/budesonide (Airsupra), the first combo RESCUE inhaler to treat and help prevent asthma attacks.

We’re used to seeing albuterol prn for quick relief.

But now more patients will use a fast-acting beta-agonist (albuterol, formoterol) PLUS an inhaled corticosteroid (ICS), such as budesonide, during an attack.

That’s because taking this combo prn for rescue ALSO reduces inflammation...and lowers the risk of future exacerbations.

But be aware that the albuterol/budesonide product is only a reliever inhaler...it should NOT be used as a maintenance treatment.

On the other hand, some formoterol/ICS inhalers (Symbicort, Dulera) can be used regularly for maintenance AND as needed for relief.

When you get an Rx for an albuterol/budesonide product, enter the prescriber’s directions completely. Patients will inhale 2 puffs as needed for asthma symptoms...with a max of 6 doses (12 puffs) per day.

Calculate days’ supply correctly. Each inhaler contains 120 puffs...and will last 10 days if patients use the max 12 puffs/day.

Watch for early refills. Using more than prescribed could mean asthma is not properly controlled...and increase the risk of side effects (heart palpitations, oral fungal infections, etc).

Anticipate payer rejects. Insurers may want patients to try albuterol plus an ICS separately before authorizing the combo albuterol/budesonide inhaler...due to cost.

For example, Airsupra costs about $475/inhaler. But generic albuterol is about $30/inhaler...and mometasone (Asmanex) is around $100.

Or payers may prefer a formoterol/ICS combo so patients can use one inhaler for rescue and maintenance. Formoterol/budesonide (Symbicort) costs about $200/inhaler...and formoterol/mometasone (Dulera) about $300.

Attach “Shake well” auxiliary labels to Airsupra Rxs...it must be shaken before each use to ensure the proper amount of med is administered.

Pull in the pharmacist to go over inhalation technique, etc.

For instance, patients will need to prime albuterol/budesonide before first use...and if not used in more than 7 days. And once the package is opened, it has a beyond-use date of 12 months.

See how inhalers stack up with our resources, Comparison of Asthma Medications and Improving Asthma Care. And get more practice pearls in our technician tutorial, Dispensing Inhaled Medications.

Key References

  • Papi A, Chipps BE, Beasley R, et al. Albuterol-Budesonide Fixed-Dose Combination Rescue Inhaler for Asthma. N Engl J Med. 2022 Jun 2;386(22):2071-2083.
  • Chipps BE, Israel E, Beasley R, et al. Albuterol-Budesonide Pressurized Metered Dose Inhaler in Patients With Mild-to-Moderate Asthma: Results of the DENALI Double-Blind Randomized Controlled Trial. Chest. 2023 Sep;164(3):585-595.
  • Global Initiative for Asthma. Global Strategy for Asthma Management and Prevention. Updated 2023. https://ginasthma.org/wp-content/uploads/2023/07/GINA-2023-Full-report-23_07_06-WMS.pdf. (Accessed February 29, 2024).
  • Crossingham I, Turner S, Ramakrishnan S, et al. Combination fixed-dose beta agonist and steroid inhaler as required for adults or children with mild asthma. Cochrane Database Syst Rev. 2021 May 4;5(5):CD013518.
Pharmacy Technician's Letter. April 2024, No. 400411



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