Table 7.

Modification of medication in the case of asthma exacerbation

Existing medication	Modification (for 1–2 weeks)
Reliever (or C&R): – SABA – Low-dose ICS/formoterol (C&R)	Increase reliever: – Increase SABA frequency – Increase reliever use (up to 72 µg/day formoterol)
Controller: – ICS/formoterol (C&R)a – ICS + SABA – ICS/formoterol (C)  + SABA – ICS/salmeterol + SABA	Increase controller: – Increase ICS/formoterol use (up to 72 µg/day formoterol) – Double ICS dose/increase to high-dose therapy step – Quadruple ICS/formoterol use (up to 72 µg/day formoterol) – Increase to high-dose ICS/salmeterol or ICS separately
Any therapy	Add OCS and seek medical assistance: – OCS for severe exacerbations (for criteria, see above) – Adults: 5–7 days 1 mg/kg/d prednisolone (max. 50 mg) – Children: 3–5 days 1–2 mg/kg/day prednisolone (max. 40 mg) – No wash-out phase required if administered <2 weeks – Double ICS dose/increase to high-dose therapy step – Quadruple ICS/formoterol use (up to 72 µg/day formoterol) – Increase to high-dose ICS/salmeterol or ICS separately

C as controller, R as reliever

^aNot approved for children under 12 years of age