Formisonide-native
Formisonide-native: instructions for use and reviews
- 1.production and composition
- 2. Pharmacological properties
- 3. Indications for use
- 4. Contraindications
- 5. Method of application and dosage
- 6. Side effects
- 7. Overdose
- 8. Special instructions
- 9. Application during pregnancy and lactation
- 10. Use in childhood
- 11. Drug interactions
- 12. Analogs
- 13. Terms and conditions of storage
- 14. Terms of dispensing from pharmacies
- 15. Reviews
- 16. Price in pharmacies
Latin name: Formisonid-nativ
ATX code: R03AK07
Active ingredient: budesonide (Budesonide) + formoterol (Formoterol)
Manufacturer: JSC Pharmstandard-Leksredstva (Russia); Nativa LLC (Russia)
Description and photo update: 2019-08-07
Prices in pharmacies: from 740 rubles.
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Formisonide-native is a combined drug with anti-inflammatory and bronchodilator effects for inhalation use.
Release form and composition
Dosage form - powder for inhalation dosed in capsules: almost white or white; capsules - hard, transparent, size 3; 80 mcg + 4.5 mcg - light brown; 160 mcg + 4.5 mcg - colorless, with a slightly yellowish tinge; 320 mcg + 9 mcg - green (in a cardboard box 3, 6 or 12 blister packs of 10 capsules with / without an inhalation device and instructions for use Formisonide-native).
Composition for 1 capsule:
- active substances: budesonide - 80, 160 or 320 mcg; formoterol fumarate dihydrate - 4.5; 4.5 or 9 mcg;
- auxiliary components, powder: sodium benzoate - 20 μg; lactose monohydrate - up to 12,000 mcg;
- capsule: caramel dye (dosage 80 mcg + 4.5 mcg) - 1.4388%; dye chlorophyllin-copper sodium and potassium (dosage 320 μg + 9 μg) - 0.2%; hypromellose - up to 100%.
Pharmacological properties
Pharmacodynamics
Formisonide-native is a combined preparation containing formoterol and budesonide. The active components have a different mechanism of action and exhibit an additive effect in relation to the severity of symptoms of asthma (bronchial asthma), improving lung function and reducing the frequency of exacerbations of asthma and COPD (chronic obstructive pulmonary disease).
The special properties of the active components of Formisonide-native allow them to be used in the treatment of asthma simultaneously as a supportive therapy and to relieve seizures, or only as a supportive therapy.
Budesonide belongs to the GCS (glucocorticosteroids), after inhalation in recommended doses, the substance has a rapid (over several hours) and dose-dependent anti-inflammatory effect on the respiratory tract, while the severity of symptoms and the frequency of BA exacerbations decrease. With inhalation of budesonide, in comparison with therapy with systemic corticosteroids, there is a lower incidence of serious unwanted disorders.
Against the background of the use of budesonide, the severity of edema of the bronchial mucosa, mucus production, decreases in the formation of sputum and hyperresponsiveness of the respiratory tract. How the anti-inflammatory effect of GCS is carried out is currently unknown.
Formoterol is a selective β 2 -adrenergic agonist (has a selective agonistic effect on β 2 -adrenergic receptors). The use of the substance promotes rapid and long-term relaxation of the smooth muscles of the bronchi in patients with reversible airway obstruction.
The bronchodilating effect of formoterol is dose-dependent, it develops within 1-3 minutes after inhalation and, as a result of taking a single dose, persists for at least 12 hours.
The effect of formisonide-native on pulmonary function in BA therapy is similar to that in the combination of formoterol and budesonide monopreparations, but it exceeds the therapeutic effect of budesonide alone.
In the course of two studies conducted for 1 year in the treatment of COPD in patients with moderate and severe disease with an initial pre-bronchodilatory FEV 1 (forced expiratory volume in the first second) less than 50% of the due and the median post-bronchodilatory FEV 1 - 42% of the due against the background of combined treatment with budesonide and formoterol, a significant decrease in the frequency of exacerbations of the disease was observed. In comparison with therapy with formoterol alone, the average frequency of exacerbations was 1.4 and in the placebo / formoterol group - 1.8–1.9. There were no differences between the effect of budesonide in combination with formoterol and formoterol as monotherapy on FEV 1.
Pharmacokinetics
Pharmacokinetic parameters of budesonide and formoterol are comparable after their administration as monopreparations and with simultaneous use. For budesonide, in the case of administration as part of a combination drug, the AUC value (area under the concentration-time curve) is slightly higher, absorption is faster, the C max (maximum concentration) value in blood plasma is higher.
For formoterol used as a part of a combined agent, C max in blood plasma coincides with that in the case of its use as a monopreparation.
From 32 to 44% of the taken dose of budesonide in inhalation form is deposited in the lungs, where it is rapidly absorbed and reaches C max in 20-30 minutes. Systemic bioavailability is approximately 39–49% of the dose received. The cumulation index of the substance (when applied 2 times a day, 2 inhalations) is 1.32.
The peak C max of budesonide in blood plasma after oral administration is noted after 1–2 hours. The absolute systemic bioavailability ranges from 6 to 13% of the inhaled dose.
In the lungs, 28–49% of the dose of inhaled formoterol is deposited, where the substance is rapidly absorbed and reaches C max 5–10 minutes after inhalation. Systemic bioavailability is approximately 61% of the dose received. The cumulation index of the substance (when applied 2 times a day, 2 inhalations) is 1.77.
Budesonide practically does not bind to KSG (corticosteroid binding globulin). With plasma proteins, the binding of the substance is constant in the concentration range (1–100 nmol / L) for the recommended and exceeding doses, it is approximately 90%.
The V d (volume of distribution) of budesonide is approximately 3 l / kg. The substance passes into breast milk.
For formoterol, in the entire concentration range of 10–500 nmol / L, binding to plasma proteins for the RR and SS enantiomers of the substance is 46 and 58%, respectively, on average - 50%. The V d value is 4 l / kg.
Budesonide undergoes intensive biological transformation (approximately 90% of the dose) during the first passage through the liver, while the formation of metabolites with low glucocorticosteroid activity occurs. The metabolism of the substance is carried out mainly with the participation of the isoenzyme CYP3A4.
The main metabolites are 16-α-hydroxyprednisolone and 6-β-hydroxybudesonide, their glucocorticosteroid activity is not higher than 1% of the same activity of budesonide.
Metabolism of formoterol occurs mainly in the liver with the participation of CYP2D6 and CYP2C enzymes through conjugation, while the formation of active O-demethylated derivatives, mainly inactivated conjugates, occurs. Secondary metabolism consists in the destruction of the molecule and sulfate conjugation.
There is no information confirming the interaction of metabolites or substitution reactions between the active components of Formisonide-native.
Excretion of budesonide occurs with feces and urine in the form of conjugates, only a small amount of the substance is excreted unchanged. Budesonide has a high systemic clearance (about 1.2 L / min). T 1/2 (half-life) is in the range of 2-3.6 hours.
After inhalation, from 8 to 13% of the obtained formoterol is excreted in the form of an unchanged substance, mainly with urine and feces (62 and 24%, respectively). Systemic clearance of formoterol is high (approximately 1.4 L / min). Average T 1/2 - 17 hours.
In patients with renal insufficiency, the pharmacokinetic processes of formoterol have not been studied. The plasma concentration of the active components of Formisonide-native in liver diseases may increase.
Indications for use
- bronchial asthma (BA): as a maintenance treatment and for the relief of seizures in patients with insufficient control of the disease with inhaled corticosteroids and short-acting β 2 -adrenomimetics, as therapy on demand or in patients with adequately controlled inhaled GCS and long-term β 2 -adrenomimetics actions;
- chronic obstructive pulmonary disease (COPD): symptomatic therapy in patients with a severe course of the disease with FEV 1 less than 70% of the estimated calculated level and with a burdened history of recurrent exacerbations, in the presence of pronounced signs of the disease, even during therapy with long-acting bronchodilators.
Contraindications
Absolute:
- lactose intolerance, glucose-galactose malabsorption or lactase deficiency;
- age up to 6 (for a dosage of 80 μg + 4.5 μg and 160 μg + 4.5 μg) or up to 12 years (for a dosage of 320 μg + 9 μg);
- individual intolerance to the components of the drug.
Relative (Formisonide-native is prescribed under medical supervision):
- arterial hypertension in severe course;
- idiopathic hypertrophic subaortic stenosis;
- prolongation of the QT interval (the use of formoterol can lead to a prolongation of the QT c interval);
- aneurysm of any localization or other severe cardiovascular diseases, including ischemic heart disease, tachyarrhythmia, or severe heart failure;
- pheochromocytoma;
- uncontrolled hypokalemia;
- decreased function of the adrenal cortex;
- hypertrophic obstructive cardiomyopathy;
- fungal, bacterial, or viral respiratory infections;
- active / inactive form of pulmonary tuberculosis;
- thyrotoxicosis;
- diabetes;
- pregnancy and lactation.
Formisonide-native, instructions for use: method and dosage
Bronchial asthma
Formisonide-native is not intended for the initial treatment of asthma of intermittent and mild persistent course.
The selection of the dose of active substances is carried out individually, it is determined by the severity of the disease. This must be taken into account not only when starting the use of Formisonide-native, but also when changing the maintenance dose. In cases where individual patients need a different combination of doses of active substances, corticosteroids and / or β 2 -adrenomimetics are prescribed separately in different inhalers. The dose should be reduced to the smallest, against the background of which the optimal control of asthma symptoms is maintained.
For an adequate dose selection of Formisonide-native, patients should be under constant medical supervision. At the next stage, after achieving complete control over BA symptoms, monotherapy with inhaled corticosteroids can be tested.
There are two approaches to prescribing Formisonide-native:
- Supportive therapy: the drug is used as a constant supportive therapy in combination with a separate β 2 -adrenomimetic short-acting to relieve seizures (the patient must always have a separate inhaler with such a drug).
- Supportive therapy and use to relieve seizures: the drug is used both as a permanent supportive therapy and when symptoms appear on demand.
Supportive therapy
The recommended dosage regimen for BA treatment, depending on the patient's age:
- adults: Formisonide-native 160 + 4.5 mcg or 80 + 4.5 mcg - 2 times a day for 1-2 inhalations. If necessary, a single dose can be increased to four inhalations. The drug 320 mcg + 9 mcg is prescribed 2 times a day for 1 inhalation, if necessary, a single dose can be increased to two inhalations. After the optimal control of asthma symptoms has been achieved, the dose can be reduced down to the use once a day at the lowest dose;
- children 12–17 years old: Formisonide-native is applied 2 times a day; containing 80 or 160 mcg of budesonide - 1–2 inhalations, 320 mcg - 1 inhalations;
- children 6-12 years old: Formisonide-native is applied 1-2 times a day, containing 80 mcg of budesonide - 1-2 inhalations. After the optimal control of asthma symptoms has been achieved, the dose can be reduced to the lowest effective dose once a day if, according to the doctor, the patient requires supportive treatment in combination with a long-acting bronchodilator.
If the need for the use of short-acting β 2 -adrenomimetics increases, anti-asthma therapy should be reviewed, as this indicates a deterioration in overall disease control.
Supportive therapy and use to relieve seizures
The patient must have the drug with him at all times.
As a systematic supportive therapy and in order to relieve seizures, the use of Formisonide-native is especially indicated for patients with asthma, who have the following conditions:
- insufficient control over asthma and the need for frequent use of drugs to relieve seizures;
- burdened history of exacerbations of bronchial asthma, which required medical intervention.
It is necessary to carefully monitor dose-related adverse reactions in patients who use a large number of inhalations to stop seizures.
For systematic maintenance therapy, adults are recommended to use Formisonide-native containing 80 or 160 mcg budesonide, 2 inhalations per day (in the morning and in the evening, 1 inhalations, or once only in the morning or only in the evening 2 inhalations).
In some cases, the appointment of 2 inhalations of Formisonide-native 160 + 4.5 mcg 2 times a day is required. When symptoms appear, one additional inhalation is indicated. In the event of a further increase in symptoms, another additional inhalation can be applied for several minutes, but more than 6 inhalations should not be used to stop one attack.
Usually, the appointment of more than 8 inhalations per day is not required, but for a short time you can increase the number of inhalations to 12 per day. Patients who receive more than 8 inhalations per day are advised to consult a doctor to review therapy.
For children under 12 years of age, Formisonide-native is not prescribed as maintenance therapy and for relief of seizures.
Chronic obstructive pulmonary disease
For adult patients over 18 years of age, for the treatment of COPD, Formisonide-native containing 160 mcg of budesonide is prescribed 2 inhalations 2 times a day or at a dosage of 320 mcg - 1 inhalation 2 times a day.
Inhaler CDM Inhaler Application Guide
The capsules are intended for inhalation use only and must not be swallowed. Take out the capsule from the cell packaging immediately before use.
To ensure the correct use of Formisonide-native it is necessary to use the Inhaler CDM device. This is a single-dose inhaler that allows you to dose and inhale very small doses of the drug. The active components of the drug enter the patient's respiratory tract along with the air flows when active inhalation is performed through the mouthpiece.
Step-by-step instructions for using Inhaler CDM:
- Before use, you need to remove the transparent cap from the inhaler.
- Firmly holding the device with one hand, the thumb and forefinger of the other hand, open the capsule compartment, for which it is necessary to press the index finger on the inscription on the body - "PRESS" in the moving part of the inhaler, moving the compartment in the opposite direction.
- Holding the device in one hand, insert the capsule with Formisonide-native into the slot of the compartment.
- Make sure the capsule is inserted correctly.
- The inhaler is held strictly vertically and the compartment is closed by pressing the thumb against the stop in the opposite direction until a click is heard.
- In order to bring the device into working condition, it is necessary to press the mouthpiece with effort so that the arrow applied to the body disappears beyond the boundaries of the lower part of the device to the upper line. After that, you should release the mouthpiece so that it returns to its original position. In this case, the capsule is pierced and access to the drug opens into the mouthpiece lumen. It is important to take into account that small pieces of gelatin, which appear due to the destruction of the capsule, as a result of inhalation can enter the mouth or throat. To minimize this phenomenon, do not pierce the capsule more than once.
- Breathe out before inhaling. You cannot exhale through the mouthpiece.
- Gently grip the mouthpiece with your teeth, wrap your lips tightly around it, and take a strong and deep breath through your mouth. At the same time, a vibrating sound is heard emanating from the capsule compartment, this indicates that the capsule is rotating and the drug dissipates. You cannot chew and squeeze the mouthpiece with your teeth. Do not press down on the mouthpiece while inhaling, as this can block the movement of the capsule. After inhaling, you must hold your breath for about 10 seconds or longer (as much as possible). Then you need to remove the inhaler from your mouth and exhale slowly. After that, you can breathe normally.
- To ensure that the full dose of Formisonide-native is inhaled, steps 7-8 must be repeated to inhale the drug.
- After the end of inhalation, it is necessary to open the capsule compartment, remove the spent capsule and then close the mouthpiece compartment.
When carrying out inhalation, it is important to try not to close the holes that are located on the sides of the mouthpiece, as this can impede the free movement of air inside the inhaler and, as a result, lead to a decrease in the dispersion of the contents of the capsule.
After use, you should always close the inhaler tightly with the cap to keep the mouthpiece clean. Regularly (about once a week), clean the outside of the mouthpiece with a dry cloth.
Side effects
With the combined use of budesonide and formoterol, an increase in the incidence of adverse reactions is not observed.
Possible adverse reactions (> 10% - very common;> 1% and 0.1% and 0.01% and <0.1% - rarely; <0.01% - very rare):
- digestive system: often - discomfort in the stomach; rarely - vomiting; very rarely - dysphagia, nausea;
- immune system: rarely - bronchospasm (including paradoxical), anaphylactic reactions (including angioedema);
- respiratory system: often - hoarseness, cough, sore throat; rarely - dysphonia (it disappears after the abolition of Formisonide-native or its dose reduction);
- nervous system: often - headache;
- endocrine system: rarely - hypokalemia; very rarely - symptoms characteristic of the systemic use of GCS (including hypercorticism, hypocorticism), hyperglycemia;
- cardiovascular system: often - palpitations; infrequently - tachycardia; rarely - arrhythmias (including supraventricular tachycardia, atrial fibrillation, extrasystole); very rarely - changes in blood pressure (arterial hypo- or hypertension), angina pectoris, ventricular and atrial tachyarrhythmias;
- psyche: infrequently - anxiety, psychomotor agitation, dizziness, anxiety, sleep disturbances; very rarely - disturbances in taste, depression, nervousness, aggressive behavior, behavioral disturbances;
- organ of vision: very rarely - increased intraocular pressure, cataracts, glaucoma (against the background of prolonged use of high doses);
- musculoskeletal system: often - tremor; infrequently - muscle cramps; rarely - back pain, osteoporosis;
- skin and subcutaneous tissue: infrequently - bruising; rarely - rash, itching, urticaria, dermatitis; very rarely - redness of the facial skin;
- infectious / parasitic diseases: often - upper respiratory tract infections, nasal congestion, rhinopharyngitis, sinusitis, bronchitis, candidiasis of the mucous membrane of the larynx and mouth (oropharyngeal candidiasis).
With prolonged use of Formisonide-native in high doses, the systemic effect of inhaled GCS can be observed.
Therapy with β 2 -adrenomimetics can lead to an increase in the content of insulin, glycerol, free fatty acids, ketone derivatives in the blood.
Overdose
The main symptoms are:
- budesonide: acute overdose - clinically significant symptoms are not expected; prolonged use of the drug in excessive doses - the development of the systemic action of GCS;
- formoterol: metabolic acidosis, palpitations, tremors, dizziness, insomnia, nervousness, headache, tachycardia, changes in blood pressure, angina pectoris; in some cases - hypokalemia, hyperglycemia, prolongation of the QT C interval, muscle spasms, arrhythmias, increased nervous excitability, nausea.
Therapy: supportive and symptomatic.
special instructions
At the end of the course of treatment, the dose of Formisonide-native should be reduced gradually, abrupt withdrawal of therapy is not recommended.
The drug at a dosage of 80 mcg + 4.5 mcg and 320 mcg + 9 mcg is not intended for the treatment of severe asthma.
Formisonide-native cannot be used for the initial selection of treatment in the first stages of BA and COPD therapy.
If there is insufficient effectiveness of therapy or there is a need to use doses exceeding the maximum recommended, a revision of treatment tactics is required.
An increase in the frequency of use of bronchodilators as an emergency aid indicates a deterioration in the course of the underlying disease. This is the basis for revising the tactics of AD treatment. Progressive and unexpected worsening of asthma or COPD symptom control is a potentially life-threatening condition that requires urgent medical attention. In such a situation, the possibility of increasing the dose of GCS should be considered, i.e., the appointment of a course of GCS for oral administration or the use of antibiotics (in cases of infection).
Patients should always have emergency medications with them: Formisonide-native (if it is used for maintenance treatment and to relieve seizures) or short-acting β 2 -adrenomimetics (if Formisonide-native is used only as a supportive treatment).
The drug in maintenance doses should be used regularly, even in cases where there are no symptoms of the disease.
Formisonide-native is not indicated for regular prophylactic use, i.e. before exercise. In such cases, a separate short-acting β 2 -adrenomimetic should be used.
You should not start therapy during BA exacerbation.
As in the case of using any other inhaled drug, after taking a dose of Formisonide-native, paradoxical bronchospasm with an immediate increase in wheezing may occur, which requires discontinuation of the drug, revision of treatment tactics and, if necessary, prescribing alternative treatment.
Against the background of the use of any inhaled corticosteroids, especially in high doses for a long period of time, a manifestation of systemic action is possible. During inhalation therapy, the manifestation of a systemic effect is less likely than in the case of using oral GCS. Systemic effects include glaucoma, cataracts, decreased bone mineral density, and suppression of adrenal function.
Patients with risk factors for osteoporosis require more careful medical supervision, which is associated with the effect of the drug on bone mineral density.
If it is assumed that during the previous systemic therapy with GCS, the function of the adrenal glands was impaired, precautions should be taken when transferring the patient to Formisonide-native.
With inhalation therapy with budesonide, the need to take oral corticosteroids is usually minimized, however, in patients who stop using oral corticosteroids, adrenal insufficiency may persist for a long time. Patients who in the past had a need for urgent high-dose GCS, or who underwent long-term therapy with high doses of inhaled GCS, may also belong to this risk group. In such patients, it is necessary to take into account the likelihood of residual adrenal dysfunction in extreme situations and in any cases that can lead to stress (including during surgical interventions). In these patients, adequate treatment of GCS should be provided. In some cases (depending on the degree of adrenal dysfunction), a specialist consultation may be required prior to performing the recommended procedures.
During the period of therapy, a candidal infection of the oral cavity may develop. In order to reduce the risk, patients are advised to rinse their mouth thoroughly with water after each inhalation. In the case of the development of candidal infection of the oral cavity without stopping the use of Formisonide-native, it is possible to carry out local antifungal treatment.
Patients with unstable asthma who use short-acting β 2 -adrenomimetics in order to relieve seizures during exacerbation of severe asthma should take special precautions, since the risk of hypokalemia increases with hypoxia and in other conditions when the likelihood of developing symptoms of hypokalemic action increases. In these cases, monitoring of serum potassium in the blood is recommended.
During the period of therapy, it is necessary to monitor the concentration of glucose in the blood in patients with diabetes mellitus.
The use of formoterol in a daily dose exceeding 54 μg (more than 12 inhalations at a dosage of 80 μg + 4.5 μg or 160 μg + 4.5 μg or more than 6 inhalations at a dosage of 320 μg + 9 μg) may cause positive test results for doping.
Influence on the ability to drive vehicles and complex mechanisms
If during the period of therapy, the development of side effects such as muscle cramps or tremors is noted, driving should be abandoned.
Application during pregnancy and lactation
Formisonide-native is used with caution during pregnancy / lactation. Therapy is possible only in cases where the expected benefit is higher than the existing risk.
There are no clinical data on the use of Formisonide-native or the combined use of its active components as monotherapy during gestation. Pregnant women should use the minimum effective dose of budesonide that provides adequate control of asthma symptoms.
Inhaled budesonide is excreted in breast milk, however, no effect on the child in the case of use in therapeutic doses was noted. It is unknown whether formoterol passes into breast milk.
Pediatric use
Age restrictions depending on the dosage:
- Formisonide-native 80 mcg + 4.5 mcg and Formisonide-native 160 mcg + 4.5 mcg: contraindicated up to 6 years;
- Formisonide-native 320 mcg + 9 mcg: contraindicated under 12 years of age.
Drug interactions
With the combined ingestion of 200 mg of ketoconazole 1 time per day and 3 mg of budesonide, the plasma concentration of the latter increases by an average of 6 times. If budesonide is taken first, and after 12 hours ketoconazole, such an increase occurs on average 3 times. There is no information on the development of such an interaction with budesonide during inhalation use, but one should expect that its plasma concentration will increase markedly.
The use of Formisonide-native as a maintenance therapy and for the purpose of relieving seizures in patients receiving potent CYP3A4 inhibitors (including clarithromycin, itraconazole, nelfinavir, ketoconazole, amiodarone) is not recommended. This is due to the fact that there are no instructions for dose selection. If necessary, the combined use of these drugs, the intervals between their use should be maximized. Reducing the dose of budesonide should also be considered.
Possible interactions of Formisonide-native with other drugs:
- β-blockers (including as part of eye drops): simultaneous use, except in forced cases, is not recommended, since these drugs can inhibit / weaken the effect of formoterol;
- levothyroxine sodium, levodopa, ethanol, oxytocin: the tolerance of the heart muscle to the action of β 2 -adrenomimetics may decrease;
- quinidine, disopyramide, procainamide, phenothiazines, antihistamines (terfenadine), monoamine oxidase inhibitors and tricyclic antidepressants: prolongation of the QT C interval may develop and the risk of ventricular arrhythmias may increase;
- preparations of halogenated hydrocarbons (during anesthesia): there is an increased risk of arrhythmias;
- monoamine oxidase inhibitors and drugs that have similar properties (procarbazine, furazolidone): blood pressure may increase;
- xanthine derivatives, diuretics, mineral derivatives of GCS: the hypokalemic effect of β 2 -adrenomimetics can be enhanced, while there is an increase in the predisposition to the development of arrhythmias in patients who take cardiac glycosides;
- β-agonists: side effects of formoterol may increase;
- estrogens, methandienone: with combined use, an increase in the action of budesonide is observed.
Analogs
Analogs of Formisonide-native are Symbicort Turbuhaler, DuoResp Spiromax, Foradil Combi, Foster, etc.
Terms and conditions of storage
Store in a place protected from light at temperatures up to 25 ° C. Keep out of the reach of children.
Shelf life is 2 years.
Terms of dispensing from pharmacies
Dispensed by prescription.
Reviews about Formisonide-native
In reviews of Formisonide-native, the drug is most often compared with its analogue - Symbicort Turbuhaler. Patients note that Formisonide-native is cheaper, but has a less pronounced therapeutic effect, which is associated with the design flaws of the inhaler. They also indicate the development of side effects, manifested by shortness of breath and wheezing when breathing, chest pains, and asthma attacks.
Price for Formisonide-native in pharmacies
Approximate price for Formisonide-native, dosed capsules with powder for inhalation, 60 pcs. in the package, depending on the dosage:
- 80 mcg + 4.5 mcg - 693-738 rubles;
- 160 mcg + 4.5 mcg - 975-1202 rubles;
- 320 mcg + 9 mcg - 1680-1729 rubles.
Formisonide-native: prices in online pharmacies
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Drug name Price Pharmacy |
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Formisonid-Nativ powder for in. in capsules 80 mcg + 4.5 mcg 60 pcs. (with device for in.) 740 RUB Buy |
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Formisonide-native 80 mcg + 4.5 mcg / dose powder for inhalation, dosed 60 pcs. 740 RUB Buy |
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Formisonide-native 160 mcg + 4.5 mcg / dose powder for inhalation, dosed 60 pcs. 965 RUB Buy |
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Formisonide-native 80 mcg + 4.5 mcg / dose powder for inhalation, dosed 120 pcs. RUB 1505 Buy |
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Formisonid-Nativ powder for in. in capsules 80 mcg + 4.5 mcg 120 pcs. 1597 RUB Buy |
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Formisonide-native 160 mcg + 4.5 mcg / dose powder for inhalation, dosed 120 pcs. 1865 RUB Buy |
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Formisonide-native 320 mcg + 9 mcg / dose powder for inhalation, dosed 60 pcs. 1900 RUB Buy |
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Formisonid-Nativ powder for in. in capsules 320 mcg + 9 mcg No. 60 (in a set with a device for ingestion) 2090 RUB Buy |
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Maria Kulkes Medical journalist About the author
Education: First Moscow State Medical University named after I. M. Sechenov, specialty "General Medicine".
Information about the drug is generalized, provided for informational purposes only and does not replace the official instructions. Self-medication is hazardous to health!