Figure. Stepped approach to adjusting asthma medication in children
|Before considering stepping up, check symptoms are due to asthma, inhaler technique is correct, and adherence is adequate.|
|Consider stepping up if good control is not achieved.|
When asthma is stable and well controlled for more than 3 months, consider stepping down (e.g. reducing inhaled corticosteroid dose to low).
ICS: inhaled corticosteroid; SABA: short-acting beta2 agonist; LABA: long-acting beta2 agonist
* Or low-dose budesonide/formoterol combination, only for children aged 12 years or over who are using this combination as both maintenance and reliever.
§ In addition, manage flare-ups with extra treatment when they occur, and manage exercise-related asthma symptoms as indicated.