salmeterol MDPI.
When such an infection develops, it should be treated with appropriate local or systemic (i.e.oral) antifungal therapy while treatment with AirDuo Digihaler continues, but at times therapywith AirDuo Digihaler may need to be interrupted. Advise the patient to rinse his/her mouth withwater without swallowing following inhalation to help reduce the risk of oropharyngealcandidiasis.
5.5 Immunosuppression
Persons who are using drugs that suppress the immune system are more susceptible to infectionsthan healthy individuals. Chickenpox and measles, for example, can have a more serious or evenfatal course in susceptible adolescents or adults using corticosteroids. In such patients who havenot had these diseases or who have not been properly immunized, particular care should be takento avoid exposure. How the dose, route and duration of corticosteroid administration affect therisk of developing a disseminated infection is not known. The contribution of the underlyingdisease and/or prior corticosteroid treatment to the risk is also not known. If a patient is exposedto chickenpox, prophylaxis with varicella-zoster immune globulin (VZIG) or pooled intravenousimmunoglobulin (IVIG) may be indicated. If a patient is exposed to measles, prophylaxis withpooled intramuscular immunoglobulin (IG) may be indicated. (See the respective package insertsfor complete VZIG and IG prescribing information.) If chickenpox develops, treatment withantiviral agents may be considered.
Inhaled corticosteroids should be used with caution, if at all, in patients with active or quiescenttuberculosis infections of the respiratory tract; systemic fungal, bacterial, viral, or parasiticinfections; or ocular herpes simplex.
5.6 Transferring Patients from Systemic Corticosteroid TherapyParticular care is needed for patients who are transferred from systemically active corticosteroids
to inhaled corticosteroids because deaths due to adrenal insufficiency have occurred in patientswith asthma during and after transfer from systemic corticosteroids to less systemically available Increasing use of inhaled, short-acting beta2-agonists is a marker of deteriorating asthma. In thissituation, the patient requires immediate reeva luation with reassessment of the treatmentregimen, giving special consideration to the possible need for replacing the current strength ofAirDuo Digihaler with a higher strength, adding additional inhaled corticosteroid, or initiatingsystemic corticosteroids. Patients should not use more than 1 inhalation twice daily of AirDuodigihaler.
AirDuo Digihaler should not be used for the relief of acute symptoms, i.e., as rescue therapy forthe treatment of acute episodes of bronchospasm. An inhaled, short-acting beta2-agonist, notAirDuo Digihaler, should be used to relieve acute symptoms such as shortness of breath. Whenprescribing AirDuo Digihaler, the healthcare provider should also prescribe an inhaled,short-acting beta2-agonist (e.g., albuterol) for treatment of acute symptoms, despite regulartwice-daily use of AirDuo Digihaler.
inhaled corticosteroids. After withdrawal from systemic corticosteroids, a number of months arerequired for recovery of hypothalamic-pituitary-adrenal (HPA) function.
Patients who have been previously maintained on 20 mg or more of prednisone (or itsequivalent) may be most susceptible, particularly when their systemic corticosteroids have beenalmost com |
