Indications:

Maintenance treatment of asthma and prevention of bronchospasm with reversible obstructive airway disease; prevention of exercise-induced bronchospasm; maintenance treatment of bronchospasm associated with COPD (including emphysema and chronic bronchitis).

Contraindications:

Mouth and throat candidiasis, throat irritation, hoarseness/dysphonia, nasopharyngitis, lower respiratory tract infections (e.g. pneumonia and bronchitis), hypokalaemia, headache, tremors, palpitation, muscle cramps. Prolonged high dose use may cause Cushing’s syndrome, Cushingoid features, adrenal suppression, retardation of growth in children and adolescents, bone mineral density decrease, cataract and glaucoma. Potentially Fatal: Paradoxical bronchospasm.

Adverse reactions:

Increased fluticasone levels with CYP 3A4 inhibitors e.g ritonavir, ketoconazole, itraconazole. Additive effects with other β-agonist.

Interactions:

Pulmonary TB, severe cardiovascular disorders, heart rhythm abnormalities, DM, thyrotoxicosis, hypokalaemia. Patients at risk of decreased bone mineral content (e.g. smoking, old age, sedentary lifestyle, poor nutrition, family history of osteoporosis or long term use of drugs that may decrease bone mass (e.g. anticonvulsants and corticosteroids). Do not stop therapy abruptly; therapy should be down titrated. Advise patient to rinse mouth after inhalation. Monitor height of children on prolonged therapy. Pregnancy, lactation.

Warnings:

Adult: Inhalation Asthma Per powd inhalation dose contains salmeterol 50 mcg and fluticasone propionate 100/250/500 mcg: 1 inhalation twice daily. Per pressurised inhalation contains salmeterol 25 mcg and fluticasone propionate 50/125/250 mcg: 2 inhalations twice daily. COPD Per powd inhalation dose contains salmeterol 50 mcg and fluticasone propionate 500 mcg: 1 inhalation twice daily.

Form:

SOLUTION FOR INJECTION