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Clenil Modulite (Maximum Dose)

Hi everyone.

Hope wou are all well

My little girl (just tured 7) seen the cons the other day and he changed her from budesonide nebules to clenil modulite 400mcg bd.

Picked up the prescription today and she's been prescribed 200mcg to take two puffs twice a day. I read the accompanying leaflet and it clearly says in big bold writing that the 200mcg dose is not suitable for children but the 100 mcg is.

I phoned the chemist as docs is closed now but they said that the surgery wouldn't prescribe 100mcg inhalers as it wouldn't be cost effective given that she'd need to take 4 puffs.

I know that the 400mcg is within acceptable limits for children but I'm curious if anyone knows why the leaflet is saying that the 200mcg dose is not suitable for children when the 100mcg is.

Would much appreciate any input



4 Replies

kids and safety

Hi Anne

I should think that this is mostly a safety thing. Most kids would be on a lower dose of steroid than your daughter seems to need, and by having it at 100mcg, there is less of a chance of those kids being overdosed. (Also, by having 2 puffs of 100mcg, they're more likely to get a good dose than by having one puff of 200mcg.) Even though she has the 200mcg puffer, by using her spacer she is likely to get an appropriate dose.

Best regards



Children: under 12 Clenil Modulite 50 micrograms & 100 micrograms:

The usual starting dose is 100 micrograms twice daily. Depending on the severity of asthma, the daily dose may be increased up to 400 micrograms administered in two to four divided doses.

Clenil Modulite 200 micrograms & 250 micrograms are not recommended for children.

Clenil Modulite must always be used with the Volumaticâ„¢ spacer device when administered to children and adolescents 12 years of age and under, whatever dose has been prescribed.

As your daughter has been prescribed 400mcg twice daily, then using the 200mcg is OK as she still wouldn't exceed the maximum dose. see table 2 of here tinyurl.com/ygq9nqr


Hi Anne my son Ryan is also on the 200mg inhaler and he is only just 8 know. My doctor also said it would not be cost efficive to give Ryan the 100mg inhaler. As he would go through an inhlaer in roughtly a fortnight. My doctor always gives me enough on presdription to do a 3 month period instead of monthy periods and when the prescription is due for re-newal he does a review to see if he still needs that does or if it needs lowering or uping. It is fine throught he spacer device but not on it's own. Hope this si resuring for you and I hope the inhlaer works for your daughter


Its all to do with what is licensed. Sometimes doctors use doses higher than the licensed dose because the asthmas is bad. Also the drug companies don't bother doing the trials in kids as they know the docs will prescribe anyway, so they don't get the license for the higher dose. Doesn't mean its not safe though.

The leaflet only says what is licensed. Its not a problem to use it off license - in fact very common in paediatric medicine

Better to get a higher dose of inhaled steroids going just to the lungs than needing oral prednisolone - which would have more side effects. Make sure you don't stop the high dose suddenly though or you'll get re-bound problems. Step up, but when you step down, step down slowly


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