Buventol Easyhaler Special Precautions

Rapidly increasing use of short-acting inhaled beta₂-agonists to relieve symptoms, indicates deterioration of asthma control (especially if peak expiratory flow rate value falls and/or becomes irregular). Patients should therefore be advised that in these cases the doctor's advice should be obtained as soon as possible, and therapeutic management should then be reassessed.
A regular anti-inflammatory controller medication taken on a daily basis is required, as soon as the patient needs inhaled beta₂-agonists more than twice a week.
Salbutamol should be given with caution in patients suffering from thyrotoxicosis, cardiac insufficiency, hypokalaemia, myocardial ischemia, tachyarrhythmia and hypertrophic obstructive cardiomyopathy.
Potassium levels should be monitored in severe asthma as hypokalaemia potentially caused by salbutamol may be potentiated by concomitant treatment and by hypoxia (see Interactions).
Rarely inhalation therapy may cause bronchospasm after dosing. In this event, treatment with Salbutamol Easyhaler must be immediately discontinued and, if need be, replaced with another therapy.
Cardiovascular effects may be seen with sympathomimetic drugs, including salbutamol. There is some evidence from post-marketing data and published literature of rare occurrences of myocardial ischaemia associated with salbutamol. Patients with underlying severe heart disease (e.g. ischaemic heart disease, arrhythmia or severe heart failure) who are receiving salbutamol should be warned to seek medical advice if they experience chest pain or other symptoms of worsening heart disease. Attention should be paid to assessment of symptoms such as dyspnoea and chest pain, as they may be of either respiratory or cardiac origin.
One dose contains less than 10 mg lactose, which probably does not cause symptoms in lactose intolerant patients. Patients with rare hereditary problems of galactose intolerance, the Lapp lactase deficiency or glucose-galactose malabsorption should not take this medicine.
Effects on ability to drive and use machines: The effect of Salbutamol Easyhaler on the ability to drive and use machines has not been directly studied. From the well-known pharmacological actions of salbutamol and decades of clinical experience such effects are, however, regarded as unlikely.