BiResp Spiromax 200/6 (budesonide–formoterol) inhaler
For people 18 years and over

Signs that someone is having an asthma attack
Shortness of breath, cough, chest tightness or wheezing
Not sure it’s asthma?
If a person stays conscious and their main problem seems to be breathing, give BiResp Spiromax. This medicine is unlikely to harm them even if they do not have asthma.
If someone is unconscious, follow the DRSABCD steps for life support.
Severe allergic reactions/anaphylaxis
If someone has sudden breathing problems (e.g., wheeze, cough, hoarse voice) AND they are allergic to foods, insect stings or medicines:
Call 000 for an ambulance
Give adrenaline first. Use their own autoinjector (e.g., EpiPen) if available.
Do this even if there are no other signs of an allergic reaction.
Then follow the asthma first aid steps.
Allergic reactions Signs of mild-to-moderate allergic reaction: · swelling of lips, face, eyes · tingling mouth · hives or welts · abdominal pain, vomiting (these are signs of anaphylaxis for insect allergy) WATCH FOR ANY ONE OF THE FOLLOWING SIGNS OF ANAPHYLAXIS (SEVERE ALLERGIC REACTION): · difficult or noisy breathing · swelling of tongue · swelling or tightness in throat · wheeze or persistent cough · difficulty talking or hoarse voice · persistent dizziness or collapse · pale and floppy (young children) ALWAYS GIVE ADRENALINE INJECTOR FIRST, and then asthma reliever puffer if someone with known asthma and allergy to food, insects or medication has SUDDEN BREATHING DIFFICULTY (including wheeze, persistent cough or hoarse voice), even if there are no skin symptoms. |
How to give reliever in first aid using BiResp Spiromax 200/6
The inhaler is labelled as:
BiResp Spiromax. Budesonide/formoterol (eformoterol) fumarate dihydrate 200/6

When to call 000 for an ambulance Person is getting drowsy Person looks blue around lips The person has allergies to foods, insect stings, or medicines Person isn’t getting better You aren’t sure what to do |
How to use BiResp Spiromax
- Hold upright with mouthpiece cover at the bottom. (Do not shake.)
- Open cover downwards until it clicks.
- Get the person to breathe out, away from inhaler.
- Put mouthpiece between the person’s teeth and seal lips around it. (Do not cover air vents.)
- Ask the person to take a big strong breath in.
- Take out of mouth. Ask the person to breathe out slowly, away from the inhaler.
- Close mouthpiece cover.
Note: This information is for first aid in an emergency. People usually don’t need more than 1 or 2 doses of BiResp Spiromax in one day for relief of symptoms. It is not recommended to take more than 6 doses at one time, or more than 12 in one day.
Tremor (e.g. shaky hands) can be a side-effect of this medicine. High doses can cause rapid pulse rate. Use it as needed for asthma symptoms. After the person is breathing normally again, do not keep giving extra doses.