Australian guidelines recommend that most adults and adolescents with asthma should be taking a preventer inhaler. This is to minimise symptoms, prevent a decline in lung function, and to reduce the risk of exacerbations and asthma-related death.1 For the majority of patients, most of these benefits can be achieved with low-dose inhaled corticosteroids (e.g. beclometasone 200 micrograms/day, budesonide 400 micrograms/day, ciclesonide 160 micrograms/day or fluticasone propionate 200 micrograms/day). However, in Australia, most patients are prescribed inhaled corticosteroids in combination with long-acting beta2 agonists,2,3 often at moderate or high doses.2 This is common practice, despite these combination products not being subsidised by the Pharmaceutical Benefits Scheme (PBS) for the initial treatment of asthma.
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