Salmeflo Special Precautions

MDI: Increasing use of short acting bronchodilators to relieve symptoms indicates deteriorations of control and patients should be reviewed by the physicians. Sudden and progressive deterioration in control of asthma is potentially life-threatening and patient should be reviewed by the physician. Consideration should be given to increasing corticosteroid therapy. Also, where the current dosage of salmeterol + Fluticasone propionate has failed to give adequate control of ROAD, the patient should be reviewed by physician. For patients with COPD, considerations should be given to additional corticosteroid therapies and administration of antibiotics if an exacerbation is associated with infection. Treatment with salmeterol + fluticasone propionate should not be stopped abruptly in patients with asthma due to risk exacerbation; therapy should be titrated-down under physician supervision. For patients with COPD, cessation of therapy may be associated with symptomatic decomposition and should be supervised by physician.
Should be administered with caution in patients with active or quiescent pulmonary tuberculosis, thyrotoxicosis, systemic effects may occur with inhaled corticosteroid, particularly at high doses prescribed for long periods; these effects are much likely to occur than with oral corticosteroids. Possible systemic effects include adrenal suppression, growth retardation in children and adolescents, decrease in bone mineral density, cataract and glaucoma. It is recommended that the height of children receiving prolonged treatment with inhaled corticosteroid is regularly monitored.
DPI: Avoid using salmeterol as sole agent for asthma control. Patients should be instructed to stop salmeterol when they have breakthrough asthma symptoms or acute asthma exacerbation and to shift to short acting selective B2-agonist. Avoid use during pregnancy.