The Fostair 200 inhaler is a fixed combination preventer from Chiesi. Each puff gives two active ingredients. First, beclometasone dipropionate 200 micrograms works as an inhaled steroid. Also, formoterol fumarate dihydrate 6 micrograms works as a long-acting reliever. So one twice-daily inhaler covers both the swelling and the airway tightening behind asthma. The Fostair 200 Summary of Product Characteristics lists the ingredients and doses.
Why the extra-fine particles matter
Not every combination inhaler works the same way. Fostair uses an extra-fine spray, and the particles measure about 1.5 micrometres across. In asthma, though, much of the disease sits deep in the small airways. Standard inhalers drop most of the dose higher up. As a result, Fostair reaches further down the airways.
What Fostair 200 is used for
The licence covers adults aged 18 and over. In particular, it suits people whose asthma stays uncontrolled on a lower-strength steroid plus long-acting reliever inhaler. It also suits patients who move across from a similar high-dose combination. However, the 200 strength does not work as a MART inhaler, unlike Fostair 100. NICE NG245 sets out when a combined inhaler fits.
Key features at a glance
Active ingredients: beclometasone dipropionate 200 micrograms plus formoterol fumarate dihydrate 6 micrograms per puff
Delivered dose: 177.7 micrograms beclometasone and 5.1 micrograms formoterol
Form: pressurised metered-dose inhaler (pMDI) with an extra-fine solution
Pack size: 120 doses per canister
Maker: Chiesi Limited
Class: fixed combination (steroid plus long-acting reliever)
Legal status: Prescription Only Medicine (POM)
Contains: ethanol
Look: canister with a dark green cap in a plastic actuator
Image alt text: Fostair 200 inhaler pressurised aerosol with dose counter
Additional information
Quantity
1 inhaler, 2 inhalers, 3 inhalers
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A high-strength combination preventer for adults whose asthma needs more
If your asthma isn’t settled on a lower-strength combination inhaler, or you’re stepping up from Fostair 100, the Fostair 200 inhaler is often the next move. Firstly, it delivers 200 micrograms of beclometasone plus 6 micrograms of formoterol per puff. Additionally, it uses an extra-fine particle formulation to reach deep into the small airways. Meanwhile, it has a built-in dose counter. At Courier Pharmacy, we help you make sense of whether this high-strength option fits your control needs.
Five key takeaways
The Fostair 200 inhaler is a fixed combination of beclometasone 200 micrograms and formoterol 6 micrograms per puff.
It’s a pressurised pMDI with extra-fine particle technology for deep airway delivery.
Licensed for adults aged 18 and over with asthma not controlled on lower-strength combinations.
It has a built-in dose counter and pairs well with AeroChamber Plus spacers.
The Fostair 200 inhaler is a Prescription Only Medicine. A UK-qualified prescriber reviews every request at courierpharmacy.co.uk.
Treatment dosage Fostair 200
Adult dose
For adults aged 18 and over, the usual dose is 1 or 2 inhalations twice daily. However, the maximum dose is 4 inhalations a day. Additionally, doses are usually split across morning and evening. At 4 puffs a day, this counts as a high ICS dose.
When your reliever use signals a problem
Above all, needing your rescue reliever more than 3 times a week is a signal. Firstly, it usually means your control isn’t holding. Additionally, it flags that a review is due. In fact, NICE NG245 links heavy reliever use to worse asthma outcomes. Rather than reaching for more Fostair, contact your prescriber.
Once you’re stable
Your prescriber may step you down once your control has been stable for a while. In particular, this may mean switching to Fostair 100 or a different combination. Furthermore, any step-down should be planned. Meanwhile, never stop your preventer suddenly. As a result, disclose any recent changes to your inhaler during consultation.
What is Fostair 200 inhaler: overview
A twice-daily combination preventer containing beclometasone (a steroid) and formoterol (a long-acting reliever).
A pressurised pMDI with an extra-fine particle solution and a built-in dose counter.
Licensed for adults aged 18 and over with asthma not controlled on lower-strength combinations.
Made by Chiesi, the same company behind Trimbow.
Prescription only, and typically used for higher steroid dose requirements.
Why combination inhalers exist
Combination inhalers answer a practical problem. Before they existed, patients on both an inhaled steroid and a long-acting reliever used two separate devices. As a result, adherence often suffered. Additionally, technique varied between devices. However, a single device delivers both medicines together. Meanwhile, this improves consistency and simplifies the daily routine.
Beclometasone and formoterol together
Fostair 200 combines two established medicines. Firstly, beclometasone has been used in inhaled form since the 1970s. Additionally, formoterol offers fast onset alongside 12-hour duration. As a result, one dose covers both the underlying swelling and the airway muscle. Furthermore, twice-daily dosing keeps steady cover across each 24 hours.
The extra-fine particle advantage
Fostair uses an extra-fine particle formulation. Notably, the particles measure around 1.5 micrometres across. Meanwhile, this is much smaller than standard inhaler droplets. As a result, more medicine reaches the small airways deep in the lungs. In particular, this matters for reaching the parts of the airway where much of the disease process happens.
The pMDI device and dose counter
Fostair 200 is a pressurised metered-dose inhaler, or pMDI. Additionally, it’s a standard press-and-breathe type. It uses HFA-134a as the propellant. Notably, this is a modern ozone-friendly gas. Meanwhile, the built-in dose counter shows how many doses remain. As a result, you always know when to reorder.
Adults only
Fostair 200 is only licensed for adults aged 18 and over. However, Fostair 100/6 is licensed for adolescents too. As a result, if you or your child are under 18, a different inhaler will usually be needed. Your prescriber will guide the right option for the age group.
Why choose Courier Pharmacy for your Fostair 200 inhaler
Registered, independent, and patient-led
Courier Pharmacy is a UK-registered independent pharmacy. The General Pharmaceutical Council regulates us. Firstly, respiratory disease looks different for every patient. Additionally, your triggers, history, and device preferences all matter. As a result, our prescribers ask about those things. Getting your combination inhaler right is about the fit.
Dr Ada Jex-Cori, our brand pharmacist
Our brand pharmacist is Dr Ada Jex-Cori. She represents the spirit of what we do. Named for Ada Lovelace, Sophia Jex-Blake, and Gerty Cori, she stands for evidence-led, unafraid-of-questions medicine. Her message is straightforward. You’re not broken. The system is. We’re here to change that.
Care that keeps showing up
We don’t disappear after we’ve dispensed. Furthermore, if your control shifts, we’re here. Additionally, if a side effect appears, we help you make sense of it. For patients navigating MCAS, chronic fatigue, or fibromyalgia alongside respiratory care, that continuity matters. Care that fits you means care that keeps showing up.
Buy Fostair 200 (Prescription Only) from Courier Pharmacy
The Fostair 200 inhaler is a Prescription Only Medicine. You can request it at courierpharmacy.co.uk. Firstly, complete an online consultation. Then, a UK-qualified prescriber reviews your answers. If approved, we dispense and deliver discreetly.
Complete a quick online consultation
A UK prescriber reviews your answers
If approved, a prescription is issued
We dispense and deliver discreetly to your door
If it isn’t suitable for you, we’ll explain why and suggest the next best option.
Active ingredients in Fostair 200 inhaler
Beclometasone at a glance
Beclometasone dipropionate is an inhaled steroid. Firstly, each puff of Fostair 200 delivers 200 micrograms of it. In particular, it binds to steroid receptors in airway cells. As a result, it switches off the genes that produce inflammatory chemicals. Additionally, airway swelling reduces over 1 to 2 weeks. The NHS beclometasone page covers the medicine in patient-facing terms.
Formoterol at a glance
Formoterol fumarate is a long-acting beta-2 agonist. Meanwhile, each puff delivers 6 micrograms. Additionally, it activates beta-2 receptors on airway smooth muscle. As a result, the muscle relaxes and airways open within 1 to 3 minutes. Furthermore, the effect lasts 12 hours. In contrast to salmeterol, formoterol works fast and lasts long.
Other ingredients
Fostair 200 also contains ethanol as an excipient. Notably, this is a small amount and rarely clinically significant. Additionally, HFA-134a propellant carries each dose out of the canister. As a result, the formulation is CFC-free. However, mention any concerns about ethanol during your consultation.
What is Fostair 200 for?
Licensed for asthma maintenance
The Fostair 200 inhaler is licensed for the regular treatment of asthma in adults. In particular, it suits patients not controlled on inhaled steroids and as-needed relievers. Additionally, it suits patients already stable on a similar high-dose combination. Above all, this is a preventer, taken every day even when you feel well.
Where it fits in the treatment ladder
In practical terms, Fostair 200 is a step up. If your Fostair 100 or another lower-strength combination isn't holding, this is one route forward. Furthermore, NICE NG245 recognises higher-strength combinations as an appropriate next step. However, unlike Fostair 100, the 200 strength isn't used for MART regimens.
When you'll still need a reliever
Above all, always keep a short-acting reliever with you. Meanwhile, Fostair 200 provides some formoterol quickly, but a separate reliever is still needed for rescue use. As a result, ask your prescriber about salbutamol or terbutaline as your rescue medicine. If you're using your rescue reliever more than 3 times a week, contact your prescriber.
How does Fostair 200 work?
Beclometasone calms the swelling
Beclometasone binds to steroid receptors in airway cells. Firstly, this switches off the genes that produce inflammatory chemicals. As a result, airway swelling reduces over 1 to 2 weeks. Additionally, the airways become less twitchy. Think of it as turning down the alarm system in your airways.
Formoterol opens the airways quickly
Formoterol activates beta-2 receptors on airway smooth muscle. Meanwhile, the signal tells the muscle to relax. As a result, the airways open within 1 to 3 minutes. Additionally, the effect lasts 12 hours. Furthermore, this fast onset is unusual for a long-acting reliever.
Why extra-fine particles matter
The extra-fine particles matter for how Fostair reaches the lungs. Firstly, standard-particle inhalers deposit most medicine higher up. Meanwhile, Fostair's smaller particles reach further. Additionally, in asthma, much of the disease process is in the small airways. As a result, more medicine lands where the swelling actually is.
How long until you feel the full effect
You'll feel the bronchodilator effect from formoterol within hours of the first dose. However, the full anti-inflammatory benefit from beclometasone takes 1 to 2 weeks. Furthermore, maximum control usually shows within 4 to 6 weeks. As a result, sticking with twice-daily use matters. Above all, take it even when you feel well.
How to use Fostair 200 inhaler
Step-by-step technique
Firstly, remove the mouthpiece cap. Shake the inhaler before each use. Then, breathe out fully, away from the mouthpiece. Next, put the mouthpiece between your teeth with lips closed. Now start to breathe in slowly and press the top at the same time. Hold your breath for 10 seconds if you can.
Using a spacer
A spacer can improve delivery to the lungs. In particular, Fostair 200 pairs well with the AeroChamber Plus spacer. Additionally, using a spacer reduces the amount of medicine landing in your mouth or throat. As a result, side effects like thrush and hoarseness are less likely. Furthermore, ask your prescriber which spacer suits your inhaler.
Mouth care and storage
Rinse your mouth and spit afterwards, or brush your teeth. Additionally, inhaled steroids can cause oral thrush or a hoarse voice. Meanwhile, rinsing removes any medicine that hasn't reached your lungs. Furthermore, store the canister below 25 degrees Celsius. Never pierce or burn it, even when empty.
Warnings and precautions for Fostair 200
Who should not use it
Firstly, don't use Fostair if you're allergic to beclometasone, formoterol, or any of the other ingredients. Additionally, Fostair 200 is not licensed for anyone under 18. Similarly, tell your prescriber about heart disease, irregular heartbeat, diabetes, or thyroid problems. Furthermore, mention any lung infection or tuberculosis.
Steroid effects at high doses
Inhaled steroids can affect the body's natural steroid production. In particular, this matters at higher doses used for a long time. As a result, patients on Fostair 200 may need a steroid safety card. Above all, tell any healthcare team you're on Fostair, especially before surgery.
Cardiovascular considerations
Formoterol can slightly raise heart rate and blood pressure. However, palpitations are uncommon. Meanwhile, patients with existing heart disease need extra care. Additionally, potassium can drop at high doses. As a result, mention any cardiac history during consultation.
Paradoxical bronchospasm
Very rarely, inhalers cause paradoxical bronchospasm. This is when airways tighten straight after use. Firstly, if this happens, stop Fostair and use your reliever. Additionally, contact your prescriber urgently. Above all, don't continue with the same inhaler until reviewed.
Pregnancy and breastfeeding
Both beclometasone and formoterol have been used in pregnancy for many years. However, formoterol should not be recommended near delivery. Meanwhile, beclometasone at high doses has shown effects in animal studies. As a result, mention any pregnancy or breastfeeding during your consultation.
Side effects of Fostair 200 inhaler
Common side effects
The most common side effects affect up to 1 in 10 people. These include sore throat, hoarse voice, and oral thrush. Additionally, headache and tremor can occur. Meanwhile, some patients notice palpitations. Most are manageable with good technique and mouth care.
Uncommon side effects
Uncommon side effects (up to 1 in 100) include flu-like symptoms and sinus problems. Furthermore, muscle cramps, dizziness, and taste changes can occur. Additionally, facial flushing and blood test changes are possible. Your prescriber may check bloods if needed.
Rare and very rare side effects
Rare side effects (up to 1 in 1,000) include chest pain and irregular heartbeat. Additionally, paradoxical bronchospasm can occur. Very rare side effects (up to 1 in 10,000) include serious allergic reactions. Above all, any of these need urgent attention.
When to seek urgent help
Seek urgent help for sudden worsening breathlessness after a puff. Similarly, seek help for facial swelling or difficulty breathing. Additionally, get help for severe chest pain or an irregular heartbeat. Meanwhile, any widespread rash needs immediate attention.
Yellow Card reporting
You can report any suspected side effects directly via the MHRA Yellow Card Scheme at https://yellowcard.mhra.gov.uk. Reporting side effects helps provide more information on the safety of this medicine.
Drug interactions with Fostair 200
Beta-blockers
Firstly, beta-blockers can reduce or block the effect of formoterol. This includes non-selective ones like propranolol. Additionally, cardioselective beta-blockers can interact to a lesser extent. Meanwhile, some glaucoma eye drops contain beta-blockers. Tell your prescriber about any of these.
CYP3A inhibitors
Meanwhile, strong CYP3A inhibitors can raise blood levels of beclometasone. In particular, ritonavir and cobicistat matter. Additionally, other examples include ketoconazole and clarithromycin. As a result, disclose any of these during your consultation. Furthermore, your prescriber will monitor for systemic steroid effects if you must take them together.
Other airway medicines and diuretics
Additionally, other beta-2 agonists can add up to more side effects. Similarly, xanthines like theophylline deserve mention. In particular, diuretics that lower potassium can interact with formoterol. Furthermore, digoxin and other steroids need discussion. Above all, tell your prescriber about every medicine you take.
Frequently asked questions about Fostair 200 inhaler
How quickly does the Fostair 200 inhaler start working?
Formoterol opens your airways within 1 to 3 minutes. Additionally, some symptom relief follows within the first day. However, the full anti-inflammatory benefit takes 1 to 2 weeks. Maximum control usually shows within 4 to 6 weeks.
Can I use Fostair 200 as a rescue inhaler?
No. Fostair 200 is a maintenance preventer only. As a result, always keep a separate short-acting reliever with you. If you're using your reliever more than 3 times a week, contact your prescriber. Notably, Fostair 100 can be used for MART regimens, but Fostair 200 cannot.
What's the difference between Fostair 100 and Fostair 200?
Both contain the same 6 micrograms of formoterol per puff. However, they differ in beclometasone. Firstly, Fostair 100 delivers 100 micrograms per puff. Additionally, Fostair 200 delivers 200 micrograms. As a result, Fostair 200 is the higher steroid dose in the range.
Can I use Fostair 200 for MART?
No. Only Fostair 100 is licensed for MART (maintenance and reliever therapy). Meanwhile, Fostair 200 is a preventer-only inhaler at this strength. As a result, always keep a separate short-acting reliever with you. Discuss any MART questions with your prescriber.
Why do I need to rinse my mouth after every use?
Inhaled steroids can cause oral thrush, hoarseness, or a sore throat. As a result, rinsing removes medicine that didn't reach your lungs. Additionally, using a spacer also helps. Don't swallow the rinse water.
Can I use Fostair 200 with a spacer?
Yes. Fostair 200 pairs well with the AeroChamber Plus spacer. Additionally, this improves delivery and reduces mouth side effects. Meanwhile, your prescriber can advise which spacer suits Fostair. Above all, if your technique is imperfect, a spacer often helps significantly.
Can I stop Fostair 200 if I feel well?
No. Fostair is a preventer, and it works because you take it every day. As a result, stopping it lets airway swelling come back. Speak to your prescriber before any change. Any step-down should be planned, not sudden.
Does Fostair 200 have a dose counter?
Yes. The Fostair 200 inhaler with dose counter is the current UK version. Additionally, the counter shows how many doses remain. As a result, you always know when to reorder. Meanwhile, older versions without a dose counter are being phased out.
Can Fostair 200 be used in children?
No. Fostair 200 is only licensed for adults aged 18 and over. However, Fostair 100 is licensed for adolescents too. As a result, if you or your child are under 18, ask your prescriber about Fostair 100 or another combination. Above all, dosing decisions in children need careful specialist input.
Will Fostair 200 affect my heart?
Formoterol can slightly raise heart rate and blood pressure. Meanwhile, palpitations are uncommon. However, existing heart disease needs discussion before starting. Above all, contact your prescriber urgently for new chest pain or an irregular heartbeat.
Can Fostair 200 make me hoarse?
Yes. Hoarseness is a common side effect of inhaled steroids. Above all, it usually settles as your voice adjusts. Additionally, rinsing your mouth after use and using a spacer both reduce the risk. If it persists, tell your prescriber.
Can I use Fostair 200 during pregnancy?
Only after careful discussion. Firstly, both ingredients have been used in pregnancy. However, formoterol should not be used near delivery. Meanwhile, high steroid doses in animal studies have shown effects. As a result, if you're pregnant, planning pregnancy, or breastfeeding, tell your prescriber.
Do I need a steroid safety card with Fostair 200?
Possibly. Steroid safety cards are usually recommended for patients on high daily inhaled steroid doses. Additionally, they alert healthcare teams that you may need extra steroid cover in illness or surgery. Above all, ask your prescriber whether you need one on your dose.
Can I use Fostair 200 with other inhalers?
Only if your prescriber has agreed the combination. Firstly, some inhalers duplicate what Fostair provides. Additionally, adding another ICS-containing inhaler is generally avoided. However, a short-acting reliever like salbutamol is fine alongside Fostair. Above all, tell your prescriber about all inhalers you use.
Will Fostair 200 affect my blood sugar?
Formoterol can raise blood sugar slightly. Additionally, this matters most for people with diabetes. Meanwhile, if you have diabetes, your monitoring may need tightening after starting Fostair. Above all, disclose any diabetes during your consultation.
What happens if I miss a dose?
Take the missed dose as soon as you remember. However, if it's nearly time for the next dose, skip it. Never double up. Consistency over weeks matters more than any single missed puff.
How should I store Fostair 200?
Store below 25 degrees Celsius. Additionally, don't leave it in a hot car or direct sunlight. Never pierce or burn the canister, even when empty. Keep it out of the reach of children. Don't use it past the expiry date.
Can I fly with Fostair 200?
Yes. Inhalers are usually allowed in hand luggage. Additionally, keep your inhaler in its original packaging. Meanwhile, carry a copy of your prescription in case of security questions. Above all, don't put your inhaler in the hold, where temperature swings can affect it.
Will I need a prescription from Courier Pharmacy?
Yes. Fostair 200 is a Prescription Only Medicine. A UK-qualified prescriber must review your suitability. You can complete the consultation at courierpharmacy.co.uk. Additionally, if you're already stable on Fostair 200, mention this in the consultation.
What if Fostair 200 isn't right for me?
Sometimes another combination inhaler suits better. In other cases, a different approach is the answer. Whatever the situation, we'll explain why and suggest the next best option. Honesty over sales, every time.
More than a prescription: our community
Free fortnightly drop-in clinics in Derby
Healthcare shouldn't only happen when you're paying for it. Every fortnight, we run free drop-in talks at Insomnia, Derby, from 10 am to 12 pm. Anyone can come. No appointment. No cost. No pressure.
Topics we cover
We cover asthma control and inhaler technique. Additionally, we discuss weight management and hormone health. Furthermore, we cover MCAS, chronic fatigue, and more. Learn more about our community talks at courierpharmacy.co.uk.
Disclaimer
Disclaimer: This information is for education only and isn't a substitute for personal medical advice. Always follow your prescriber's instructions.
Electronic Medicines Compendium (2026) Fostair 200/6 micrograms per actuation pressurised inhalation solution: Patient Information Leaflet. Available at: https://www.medicines.org.uk/emc/product/5076/pil
National Institute for Health and Care Excellence (2024) Asthma: diagnosis, monitoring and chronic asthma management. NICE guideline NG245. Available at: https://www.nice.org.uk/guidance/ng245
