To help you remember, use it at the same times each day. There is a linear increase in systemic exposure with increasing inhaled dose.The disposition of fluticasone propionate is characterised by high plasma clearance (1150 mL/min), a large volume of distribution at steady-state (approximately 300 L) and a terminal half-life of approximately 8 hours.Fluticasone propionate is cleared very rapidly from the systemic circulation. SEROFLO Inhaler may be used with a Zerostat/Zerostat VT Spacer ... SEROFLO 250 Inhaler 25 mcg 25 mcg 25 mcg 50 mcg 125 mcg 250 mcg ... Each sales pack contains 30 metered doses. However, animal studies showed no effects of salmeterol or fluticasone propionate on fertility.A large amount of data on pregnant women (more than 1000 pregnancy outcomes) indicate no malformative or feto/neonatal toxicity related to salmeterol and fluticasone propionate. It can make you more likely to get infections or may worsen any current infections. However, these animal experimental results do not seem to be relevant for man given recommended doses. The adjusted odds ratio for MCMs diagnosed by 1 year was 1.1 (95%CI: 0.5 – 2.3) for FP exposed vs non-FP ICS exposed women with moderate asthma and 1.2 (95%CI: 0.7 – 2.0) for women with considerable to severe asthma. The small increase in β agonist-related adverse events should be taken into account if doubling the dose of the salmeterol and fluticasone propionate fixed-dose combination is considered by the physician in adult patients requiring additional short-term (up to 14 days) inhaled corticosteroid therapy.The Salmeterol Multi-center Asthma Research Trial (SMART) was a 28-week US study that evaluated the safety of salmeterol compared to placebo added to usual therapy in adult and adolescent subjects. The remainder of the inhaled dose may be swallowed but contributes minimally to systemic exposure due to the low aqueous solubility and pre-systemic metabolism, resulting in oral availability of less than 1%. The time on treatment for 50% of subjects to achieve a first individual well-controlled week was 16 days for the salmeterol and fluticasone propionate fixed-dose combination compared to 37 days for the ICS group. To use the inhalation powder: Take the inhaler from the foil pouch before you use it for the first time. 175 Ml. This may lead to an increase in the incidence of other systemic effects of salmeterol treatment (e.g. Both hoarseness and incidence of mouth and throat candidiasis may be relieved by rinsing the mouth with water and/or brushing the teeth after using the product. If you notice other effects not listed above, contact your doctor or Call your doctor for medical advice about side effects. Very rare cases of adrenal suppression and acute adrenal crisis have also been described with doses of fluticasone propionate between 500 and less than 1000 micrograms. Between doses: If you have shortness of breath in between doses, use … In patients with asthma a lesser degree of systemic exposure to inhaled fluticasone propionate has been observed.Systemic absorption occurs mainly through the lungs and is initially rapid then prolonged. Therefore these patients should be treated with special care and adrenocortical function regularly monitored. The study was not designed to assess the impact of concurrent inhaled corticosteroid use, and only 47% of subjects reported ICS use at baseline.Two multi-centre 26-week studies were conducted to compare the safety and efficacy of salmeterol-FP versus FP alone, one in adult and adolescent subjects (AUSTRI trial), and the other in paediatric subjects 4-11 years of age (VESTRI trial). In these cases, the recommended initial dose is two inhalations of 25 micrograms salmeterol and 50 micrograms fluticasone propionate twice dailyThe dose of the inhaled corticosteroid may need to be increased to achieve control of asthma symptoms but once control is attained treatment should be reviewed and the dose of the inhaled corticosteroid titrated downwards to the lowest dose at which effective control of symptoms is maintained.Consideration may be given as to whether patients should be stepped down to an inhaled corticosteroid alone from the lowest strength combination product.Regular review of patients as treatment is stepped down is important.A clear benefit has not been shown as compared with inhaled fluticasone propionate alone used as initial maintenance therapy when one or two of the criteria of severity are missing. Interaction with other medicinal products and other forms of interaction6.6 special precautions for disposal and other forms interaction6.6! 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