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Systemic effects may occur with any inhaled corticosteroid, particularly at high doses prescribed for long periods. Potentially serious hypokalaemia may result from systemic beta2-agonist therapy, but following inhalation at therapeutic doses, plasma levels of salmeterol are very low. Single dose pharmacokinetic data have demonstrated that the systemic exposure to salmeterol and fluticasone propionate may be increased as much as two-fold when the spacer device is used with seroflo inhaler as compared without the spacer device.

Children and adolescents 1000mcgday) may be at particular risk. This possibility of residual impairment should always be borne in mind in emergency and elective situations likely to produce stress, and appropriate corticosteroid treatment must be considered. .

These effects are much less likely to occur than with oral corticosteroids. Presenting symptoms are typically vague and may include anorexia, abdominal pain, weight loss, tiredness, headache, nausea, vomiting, hypotension, decreased level of consciousness, hypoglycaemia, and seizures. Prolonged treatment of patients with high doses of inhaled corticosteroids may result in adrenal suppression and acute adrenal crisis.

Possible systemic effects include cushings syndrome, cushingoid features, adrenal suppression, growth retardation in children and adolescents, decrease in bone mineral density, cataract and glaucoma. It is important, therefore, that the patient is reviewed regularly and the dose of inhaled corticosteroid is reduced to the lowest dose at which effective control of asthma is maintained. Inhalation aerosol mdi with dose indicator)  inhaled corticosteroid (ics) and bronchodilator salmeterol xinafoate as selective beta seroflo inhaler is indicated in the regular treatment of asthma, where use of a combination (long-acting beta2-agonist and inhaled corticosteroid) has been found to be appropriate, and in patients with severe copd.

It is recommended that the height of children receiving prolonged treatment with inhaled corticosteroid is regularly monitored. Seroflo inhaler is contraindicated in the primary treatment of status asthmaticus or other acute episodes of asthma where intensive measures are required. Seroflo inhaler should not be used for transferring patients from systemic corticosteroid therapy.

Additional systemic corticosteroid cover should be considered during periods of stress or elective surgery. As with all inhaled medication containing corticosteroids, seroflo inhaler should be administered with caution in patients with pulmonary tuberculosis. Seroflo inhaler should not be used to treat acute asthma symptoms for which a fast and short acting bronchodilator is required. In such a case, seroflo inhaler should be discontinued immediately, the patient assessed and alternative therapy instituted, if necessary. Seroflo inhaler should be discontinued immediately, the patient assessed and alternative therapy instituted if necessary.


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    These effects are much less likely to occur than with oral corticosteroids. Seroflo inhaler is contraindicated in patients with a history of hypersensitivity to any of the component of the product. Seroflo inhaler should not be used for transferring patients from systemic corticosteroid therapy. Children and adolescents 1000mcgday) may be at particular risk. As with all inhaled medication containing corticosteroids, seroflo inhaler should be administered with caution in patients with pulmonary tuberculosis.

    Additional systemic corticosteroid cover should be considered during periods of stress or elective surgery. It is important, therefore, that the patient is reviewed regularly and the dose of inhaled corticosteroid is reduced to the lowest dose at which effective control of asthma is maintained. Therefore seroflo inhaler should be used with caution in patients with severe cardiovascular disorders, heart rhythm abnormalities, diabetes mellitus, thyrotoxicosis, uncorrected hypokalaemia or patients predisposed to low levels of serum potassium. Systemic absorption of salmeterol and fluticasone propionate is largely through the lungs. As with other inhalation therapy paradoxical bronchospasm may occur with an immediate increase in wheezing after dosing.

    Potentially serious hypokalaemia may result from systemic beta2-agonist therapy, but following inhalation at therapeutic doses, plasma levels of salmeterol are very low. This possibility of residual impairment should always be borne in mind in emergency and elective situations likely to produce stress, and appropriate corticosteroid treatment must be considered. Single dose pharmacokinetic data have demonstrated that the systemic exposure to salmeterol and fluticasone propionate may be increased as much as two-fold when the spacer device is used with seroflo inhaler as compared without the spacer device. Possible systemic effects include cushings syndrome, cushingoid features, adrenal suppression, growth retardation in children and adolescents, decrease in bone mineral density, cataract and glaucoma. Systemic effects may occur with any inhaled corticosteroid, particularly at high doses prescribed for long periods. Patients should be made aware that seroflo inhaler must be used daily for optimum benefit, even when asymptomatic. Care should be taken when transferring patients to seroflo inhaler therapy, particularly if there is any reason to suppose that adrenal function is impaired from previous systemic steroid therapy. Seroflo inhaler should not be used to treat acute asthma symptoms for which a fast and short acting bronchodilator is required. Prolonged treatment of patients with high doses of inhaled corticosteroids may result in adrenal suppression and acute adrenal crisis. Patients should be advised to have their medicinal product to be used for relief in an acute asthma attack available at all times.

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