Asthma Management Handbook
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Table. Initial preventer treatment for children aged 6 years and over

Pattern of symptoms *

Management options and notes †

Infrequent intermittent asthma ‡

Regular preventer treatment is not recommended

Frequent intermittent asthma

Consider a treatment trial with montelukast 5 mg once daily; assess response after 2–4 weeks

A cromone (sodium cromoglycate or nedocromil) can be trialled as an alternative§

Mild persistent asthma

Consider a treatment trial with montelukast 5 mg once daily; assess response after 2–4 weeks

If inadequate response after checking adherence, consider treatment trial with inhaled corticosteroid (low dose)

A cromone (sodium cromoglycate or nedocromil) can be trialled as an alternative§

Moderate-to-severe persistent asthma

Consider a treatment trial with regular inhaled corticosteroid (low dose); assess response after 4 weeks.

  • Advise parents about potential adverse psychiatric effects of montelukast

* Pattern of symptoms when not taking regular preventer treatment

† In addition to use of rapid-onset inhaled beta2 agonist when child experiences difficulty breathing

‡ Also applies to children who wheeze only during upper respiratory tract infections and do not have a diagnosis of asthma

§ E.g. sodium cromoglycate 5 mg/actuation; 10 mg (two inhalations) three times daily, then 10 mg twice daily when stable. Note: Cromone inhaler device mouthpieces require daily washing to avoid blocking

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