FOSTER NEXThaler 100microgram/6microgram per dose 100/6

Here’s a detailed description of **FOSTER NEXThaler 100 micrograms/6 micrograms per dose (100/6)**:

1. **What it is:** A combination **inhaled corticosteroid (ICS)** and **long-acting beta2-agonist (LABA)** medication delivered via a specific dry powder inhaler device called the **NEXThaler**.
* **Brand Name:** FOSTER
* **Device:** NEXThaler
* **Active Ingredients:**
* **Beclometasone dipropionate (anhydrous):** 100 micrograms per dose (Inhaled Corticosteroid – ICS)
* **Formoterol fumarate dihydrate:** 6 micrograms per dose (Long-Acting Beta2-Agonist – LABA)

2. **Indications (What it’s used for):** Maintenance treatment of:
* **Asthma:** In adults, adolescents, and children (typically 12 years and older, but check specific regional prescribing information) where a combination of an ICS and a LABA is appropriate (e.g., patients not adequately controlled on an ICS and “as-needed” short-acting beta2-agonist, or already adequately controlled on both an ICS and a LABA).
* **Chronic Obstructive Pulmonary Disease (COPD):** In adults with severe COPD (FEV1 < 50% predicted) and a history of repeated exacerbations, who have significant symptoms despite regular bronchodilator therapy.

3. **Dosage & Administration:**
* **Dosage:** The “100/6” refers to the strength: 100 mcg beclometasone and 6 mcg formoterol **per delivered dose** (the dose that leaves the mouthpiece).
* **Standard Regimen:**
* **Asthma:** 1 or 2 inhalations (puffs) twice daily.
* **COPD:** 2 inhalations twice daily.
* **Device:** The NEXThaler is a **breath-actuated** device. This means it automatically releases the dose when the patient inhales forcefully and deeply through the mouthpiece. It does not require hand-breath coordination like traditional pressurised Metered Dose Inhalers (pMDIs).
* **Important:** The dose is **prescribed by a doctor** and depends on the severity of the condition and individual patient response. **Never exceed the prescribed dose.**

4. **Mechanism of Action (How it works):**
* **Beclometasone (ICS):** Reduces inflammation, swelling, and mucus production in the airways over time. This is the foundation for controlling chronic asthma and reducing exacerbations in COPD.
* **Formoterol (LABA):** Relaxes the muscles around the airways (bronchodilation) for up to 12 hours, making breathing easier and helping to prevent symptoms like wheezing, shortness of breath, and chest tightness. It also has a relatively fast onset of action (within 1-3 minutes).

5. **Key Features of the NEXThaler Device:**
* **Breath-Actuated:** Easier to use correctly for many patients compared to pMDIs.
* **Dose Counter:** Shows exactly how many doses are left (counts down from 60 or 120 depending on pack size), helping patients know when to get a refill.
* **Feedback Mechanism:** Provides tactile and auditory feedback (a click) when the patient inhales correctly, confirming dose delivery.
* **Low Inhalation Effort:** Designed to be easy to inhale from.

6. **Common Side Effects:**
* **Local Effects (Mouth/Throat):** Oral candidiasis (thrush), hoarseness, throat irritation. **Rinsing the mouth with water after each use helps prevent these.**
* **Other Common Effects:** Headache, tremor, palpitations (usually mild and transient), muscle cramps.
* **Potential Systemic Effects (especially with higher doses/long-term use):** Possible effects on adrenal function, bone mineral density, eyes (cataracts, glaucoma), and growth in children (monitoring required).
* **Hypersensitivity Reactions:** Rare, but possible (rash, itching, swelling).

7. **Important Warnings & Contraindications:**
* **Not for Acute Attacks:** It is **NOT** a rescue inhaler for sudden asthma attacks or acute bronchospasm. Patients must have a separate **short-acting beta2-agonist (SABA)** inhaler (e.g., salbutamol/albuterol) for rapid relief.
* **Black Box Warning (US – specific to asthma):** LABAs may increase the risk of asthma-related death. Data show that when formoterol is used in combination with an ICS (as it is in Foster), this risk is not significantly increased compared to ICS alone. **However, it underscores that LABAs should NEVER be used alone for asthma and must always be combined with an ICS.**
* **Hypersensitivity:** Contraindicated in patients with known hypersensitivity to beclometasone, formoterol, or any excipient.
* **Paradoxical Bronchospasm:** Can occur immediately after inhalation (treat with SABA and discontinue if severe).
* **Cardiovascular Effects:** Use with caution in patients with cardiovascular disorders (e.g., coronary artery disease, arrhythmias, hypertension).
* **Electrolyte Effects:** May cause hypokalemia (low potassium) and hyperglycemia (high blood sugar), especially at high doses.
* **Interactions:** Potential interactions with other drugs (e.g., beta-blockers, diuretics, other QT-prolonging agents, strong CYP3A4 inhibitors). Inform the doctor about all medications.

8. **Storage:** Store below 30°C. Keep the inhaler dry. Keep in the original package until first use. Discard when the dose counter reads “0” or 3 months after opening the foil pouch, whichever comes first.

**In Summary:** Foster Nexthaler 100/6 is a maintenance inhaler combining an anti-inflammatory steroid (beclometasone 100mcg) and a long-acting bronchodilator (formoterol 6mcg) per dose. It’s used twice daily via the breath-actuated Nexthaler device to control chronic asthma and severe COPD. It is crucial to use it as prescribed, have a rescue inhaler available, rinse the mouth after use, and attend regular medical check-ups.