Drug interactions- summary

Increased flucatisone levels with CYP 3A4  inhibitors eg ritonavir, ketoconazole,
itraconazole-

Additive effects with other beta agonists

Asthma
Chronic obstructive pulmonary disease (COPD )
 

Mouth and throat candidiasis, throat irritation, hoarseness/dyspnonia

Nasopharnygitis, lower respiratory tract infections eg pneumonia and bronchitis,
Hypokalaemia,

Headache, tremors, palpitations, muscle cramps

Prolonged high dose may cause Cushings syndrome, Cushinoid features,
Adrenal suppression, retardation of growth in child and adolescences

BMD  decrease, cataract, glaucoma,

Paradoxical bronchospasm

Not for primary treatment of asthmaticus or other acute attacks of asthma

Special Precautions-

Pulmonary TB , severe CV disorders, heart rhythm abnormalities
DM throtoxicosis, hypokalemia

Patients at risk of decreased bone mineral content eg smoking, old age,
 sedentary life style, poor nutrition,

Family history of osteoporosis or long term of drugs that may decrease bone mass.
eg anticonvulsants, and corticosteroids

Do not stop therapy abruptly, should be titrated

Advice patients to rinse mouth after inhalation

Monitor height of child on prolonged therapy

Pregnancy. lacatation

Indication-

Asthma
Chronic obstructive pulmonary disease

Dosage-
Adult-
50mcg salmeterol + 100/250/500 mcg flucatisone propionate - 1 inhalation bid
25mcg salmeterol + 50/125/250 mcg flucastione propionate - 2 inhalation bid

Child- 4-12 yrs
50mcg salmeterol + 100mcg of flucastione - 1 inhalation bid
> 12yrs - salmeterol 50mcg + 100/250/500 mcg flucatisone - 1 inhalation bid
50mcg salmeterol + 50/125/250 mcg flucatisone - 2 inhalation bid

Chronic obstructive pulmonary disease -
 50mcg salmeterol + 500mcg flucatisone - 1 inhalation bid
 

Use contraindicated.Observe caution