The usual recommended dosage for adults is 100 to 400 mcg, taken twice daily, depending on the severity of the condition and the individual patient's response.

For children aged 5 to 12 years, the typical starting dose is usually 50 to 200 mcg twice daily, and for children under 5 years, a dose adjustment is often required based on the physician's recommendations. It is crucial for patients to use Clenil regularly, even when they are feeling well, to maintain effective control of their symptoms.

Before each use, patients should shake the inhaler well and exhale fully, then inhale deeply and slowly while activating the inhaler to ensure optimal drug delivery. If multiple puffs are prescribed, patients should wait about 30 seconds between inhalations.

Patients should be instructed to rinse their mouths after using Clenil to help prevent oral thrush and throat irritation, which are potential side effects. Always follow the specific dosage instructions provided by a healthcare professional for the best therapeutic outcome.

Always use this medication exactly as your clinician has told you. Check with our clinical team or your GP or pharmacist if you are not sure.

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Just because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.

Common Side Effects

• Oral Thrush (Candidiasis): One of the most common side effects, it can occur due to local immunosuppression in the oral cavity. Symptoms include white patches, soreness, or discomfort in the mouth.
• Hoarseness and Dysphonia: Patients may experience changes in their voice, including hoarseness or difficulty speaking clearly, as a result of throat irritation or vocal cord impact.
• Cough: Some users may develop a persistent cough after inhalation, which is generally mild.
• Throat Irritation: Irritation or soreness in the throat can occur after using the inhaler, resulting in discomfort.

Less Common Side Effects

• Headache: Mild to moderate headaches can occur as a side effect of using Clenil.
• Nausea: Some patients may experience gastrointestinal upset or nausea.
• Fatigue: General feelings of tiredness or fatigue can occur in some individuals.
• Skin Reactions: Rashes or skin irritations may develop, though these are uncommon.

Rare Side Effects

• Paradoxical Bronchospasm: In rare cases, there may be worsening of wheezing and breathlessness immediately after using the inhaler, which necessitates immediate discontinuation and medical evaluation.
• Adrenal Suppression: Long-term use, particularly at high doses, can lead to suppression of the adrenal glands, leading to insufficient steroid production.
• Growth Suppression in Children: Prolonged use of inhaled corticosteroids in children may potentially affect growth velocity.
• Immunosuppression: Systemic effects, though rare, can occur, leading to a higher susceptibility to infections.

For full information on side effects and correct use, see the patient information leaflet. If any side effects concern you, or you are experiencing any of the side effects mentioned in the patient information leaflet whilst taking this medication, please contact our clinical team or speak to your GP.

While it is effective for controlling symptoms and inflammation, there are specific cautions and warnings to consider. Here’s a detailed overview:

Cautions

• Systemic Effects: Long-term use of inhaled corticosteroids, including Clenil, can lead to systemic corticosteroid effects, particularly at high doses. Monitoring for signs of adrenal suppression, Cushing's syndrome, and other corticosteroid-related side effects is important.
• Oral Candidiasis: Patients should be cautioned about the risk of developing oral thrush (candidiasis) due to local immunosuppression in the mouth and throat. To reduce this risk, rinsing the mouth after each use is essential.
• Growth in Children: Prolonged use of inhaled corticosteroids in children may affect growth velocity. Regular monitoring of growth should be conducted for children using Clenil.
• Pre-existing Conditions: Caution is advised in patients with a history of tuberculosis, fungal infections, or other viral infections, as corticosteroids may exacerbate these conditions.
• Concurrent Medications:Patients should inform their healthcare provider about any other medications they are taking, particularly other corticosteroids or drugs that may affect liver enzymes, as these may alter the effectiveness of Clenil.

Warnings

• Not for Acute Relief: Clenil is not a rescue medication and should not be used for the immediate relief of acute asthma attacks or bronchospasms. Patients should have a short-acting beta-agonist inhaler available for such situations.
• Paradoxical Bronchospasm: In rare cases, Clenil can cause paradoxical bronchospasm, characterized by worsening wheezing and difficulty breathing immediately following inhalation. If this occurs, the medication should be discontinued, and medical attention should be sought.
• Underlying Systemic Steroid Use: If patients are transitioning from systemic corticosteroids to Clenil, careful monitoring is necessary, as there may be a risk of adrenal insufficiency. Doses may need adjustment as the body acclimates to lower steroid levels.
• Monitoring: Regular follow-ups are essential for patients on Clenil, especially for long-term use. Healthcare providers should monitor lung function, symptom control, and any potential side effects.

Get emergency medical help if you have signs of an allergic reaction to this medication. These include:

• Hives
• Dizziness
• Fast or pounding heartbeats
• Wheezing
• Difficult breathing
• Swelling of your face, lips, tongue, or throat.

It is important that you let us know which prescription, over-the-counter medicines and recreational drugs you are currently taking. You must also tell us about any other medical conditions that you currently have (or had in the past). This will help us ensure the prescribed medication is safe and appropriate for you to take.

For full information on warnings, medication interactions and contraindications, refer to the Patient Information Leaflet. Please read all packaging and the Patient Information Leaflet before taking any new medicine and inform our clinical team or your GP of medicines you are taking or intend to take.