Medicine update  9/2/2021

Changes to Bricanyl (Terbutaline) Turbuhaler

People with asthma are advised to carry reliever medicine with them. Relievers bring quick relief by relaxing the tight muscles around the airways which is one of the causes of asthma symptoms 

A new version of the existing reliever medication Bricanyl {Terbutaline) Turbuhaler has been developed in Australia. Asthma Australia would like to inform and empower you to know your options and make the best choices for you and your family. 

What is asthma?

Asthma is a long-term lung condition of the airways (the passage that transports air into our lungs). At the moment there is no cure, but for most people, it can be managed. Asthma is recognised by the following: 

  • Tightening of the airways 
  • Swelling and inflammation in the airways 
  • Mucus production inside the airways 

These lead to asthma symptoms which are commonly experienced as breathlessness, cough, chest tightness, and wheeze.  

How is asthma treated?

Preventers

The main goal of asthma treatment is to stay in control of your breathing and prevent ‘asthma attacks or ‘flare-ups’. The most important treatment is a medicine that treats the inflammation which causes asthma symptoms and which can lead to flare-ups

Preventers treat the swelling and mucus production which cause the symptoms and in doing so they make your airways less reactive to triggers. This treatment is effective for most people with asthma in keeping symptoms awayPreventers are usually inhaled, so they work in the lungs, where the inflammation happens.  

Relievers

The other part of medical treatment in asthma involves the use of a bronchodilator, which aims to relax the muscles in the airways. These medicines are referred to as relievers or dual purpose relievers, which are also inhaled and provide quick relief of symptoms. Relievers are usually used alongside preventers to treat symptoms that breakthrough despite tailored preventer treatment. 

Dual purpose relievers may be prescribed as a standalone treatment to relieve the symptoms and reduce inflammation that causes symptoms. You may also recognise dual purpose relievers when used to relieve symptoms as part of maintenance and reliever therapy. 

Combination preventers

Some inhaled preventers come in combination form, and they are called combination preventer inhalers. They contain both the preventer and reliever types of medications and they work by both reducing the inflammation in the airways and relaxing the tight airway muscles. Combination preventers contain two medications: an inhaled corticosteroid to reduce inflammation, and a long-acting medication to relax tight airway muscles.  

What is Bricanyl Turbuhaler?

Bricanyl Turbuhaler is a reliever inhaler available by prescription and over the counter when provided by a pharmacist in a pharmacy. It should be used as directed by your doctor or pharmacist to treat asthma symptoms. Like other reliever inhalers, Bricanyl works within minutes by relaxing the tight muscles around your airways and relieving symptoms.  

It may also be prescribed to treat asthma which is worse during exercise (exercise induced asthma) or in an asthma first aid situation 

As a dry powder inhaler, the Bricanyl Turbuhaler is usually only recommended for people with asthma five years or older. Please refer to our medications and devices information brochure for instructions on how to use your Bricanyl Turbuhaler. We always encourage you to ask your doctor or pharmacist to review your inhaler device technique, and to do this at least once per year. 

Reliever inhalers should only be needed infrequently to relieve symptoms that breakthrough despite an optimum asthma management plan which includes the regular use of preventers. If you find you need your inhaler more than two days per week, this could be a sign that your asthma is not well controlled and you should see your doctor for an asthma review.  

What has changed?

A new Bricanyl Turbuhaler was introduced in Australia on February 1. 1

The new Bricanyl Turbuhaler device has been redesigned with:  

  • numerical dose counter  
    • This will give people with asthma clarity around how much medicine is in their device, so they know exactly when to replace it 
  • A different mouthpiece 
    • It may feel easier to use for some people with asthma 
  • New package labelling 
    • Addition of lactose as an inactive ingredient 
  • A new pack size with 120 doses (previously packs contained 100 doses) 
    • The device will last longer, needing to replaced less frequently. 

People with asthma and a known allergy to lactose are advised not to use Bricanyl.  

How will this change impact me?

If you have been using Bricanyl Turbuhaler as your reliever, this change should not affect you significantly, unless you are allergic to lactose in which case you advised not to use it. 

If Bricanyl is part of your asthma management plan, this might be a good time to arrange a review with your doctor and update your Written Asthma Action Plan to ensure you have clear and manageable instructions around what to do in case of worsening asthma – this should include at a minimum how to adjust your reliever dose, whether and how to adjust your preventer dose and when to contact your doctor. 

How to use Bricanyl Turbuhaler

Your doctor or pharmacist will advise you on how to use your inhaler. Usually, adults will be advised to take 1 inhalation to treat their symptoms. They may take up to 3 inhalations in case of severe symptoms. Children (over 5 years) will also be advised to take 1 inhalation in case of symptoms and up to 2 inhalations if severe. Adults should not use more than 12 inhalations and children not more than 8 in a 24 hour period. ii  

In case of an episode of severe symptoms, we recommend visiting your doctor. 

How to use your Turbuhaler

  1. Unscrew and lift off cap 
  2. Hold Turbuhaler upright, twist coloured base around all the way, and then back all the way (you can use a level surface to make sure it stays upright during this step) 
  3. Breathe out gently away from the Turbuhaler (do not blow into it) 
  4. Put the mouthpiece in mouth ensuring a good seal is formed with lips, breathe in through mouth forcefully and deeply, remove Turbuhaler from the mouth and hold breath for 5 seconds or as long as is comfortable 
  5. Breathe out gently away from Turbuhaler, to take more medication repeat steps 2-4, replace the cap. 

Other important points:iii 

  • The manufacturer recommends rinsing and spitting after using Bricanyl 
  • Always keep the Turbuhaler dry and clean by wiping with a dry tissue 
  • Try to keep your device in a cool, dry place 
  • Keep an eye on the dose counter and see your doctor or pharmacist for a replacement when it’s low. We would recommend urgently replacing when the counter is on 20 to ensure you don’t run out. 

For step-by-step instructions on how to use devices, follow this link. 

In summary

  • The manufacturer of Bricanyl has updated the device but your prescription or routine should not change unless you are allergic to lactose 
  • Bricanyl Turbuhaler reliever is only recommended to be used to relieve symptoms 
  • In case symptoms are frequent or severe, you should see a doctor urgently 
  • An easy way to think about this is if you are needing your Bricanyl reliever more than two days per week 
  • Ensure your written Asthma Action Plan is current and you can understand and follow it 
  • Bricanyl can be used in exercise-induced asthma when prescribed by your doctor and may be used in an asthma first aid situation 
  • Bricanyl can be prescribed by your doctor under certain circumstances and otherwise may be purchased over the counter when provided by a pharmacist in a pharmacy. 

Want to know more?

For more information about Bricanyl Turbuhaler or to speak with an Asthma Educator about your asthma, call 1800 ASTHMA (1800 276 462). 

 

 


REFERENCES

i Astra Zeneca, 2021, Bricanyl Turbuhaler consumer medicine information; and information provided directly by email  

ii Astra Zeneca, 2021, Bricanyl Turbuhaler product information 

iii Astra Zeneca, 2021, Bricanyl Turbuhaler consumer medicine information