What Are the Most Common Inhaler Side Effects?

Symbiotox is not intended for the initial treatment of asthma. This product should be individualized, and the dose should be adjusted according to the severity of the disease. This requires attention when starting to use the compound preparation. If a patient requires more than the recommended dose, an appropriate dose of -receptor agonist and / or corticosteroid should be prescribed.

Symbios Inhaler

Symbiotox is not intended for the initial treatment of asthma. This product should be individualized, and the dose should be adjusted according to the severity of the disease. This requires attention when starting to use the compound preparation. If a patient requires more than the recommended dose, an appropriate dose of -receptor agonist and / or corticosteroid should be prescribed.

Drug Name

Symbios Inhaler

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prescription

Athletes use with caution

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Drug Name:

Symbiotox is suitable for routine treatment of asthma patients who require a combination of inhaled corticosteroids and long-acting 2-receptor agonists:

-Patients whose symptoms are not well controlled by inhaled corticosteroids and "on-demand" use of short-acting 2-receptor agonists or patients who have inhaled corticosteroids and long-acting 2-receptor agonists whose symptoms have been completely controlled.

Note: Symbioco (80 mcg / 4.5 mcg / inhalation) is not suitable for severe asthma patients.

Patients should be reviewed regularly by a physician to ensure that they are using the best dose of Symbol. The dose should be gradually reduced to the minimum dose that can effectively control the symptoms of asthma in the patient. If the symptoms are still well controlled after using the minimum recommended amount, the next step is to consider trying inhaled corticosteroids alone.

Recommended dose:

Adults and adolescents (12 and over):

Symbiotics are guaranteed 80 micrograms / 4.5 micrograms / suction: 1-2 intakes / times, 2 times a day

Symbico is 160 mcg / 4.5 mcg / suction: 1-2 intakes / times, 2 times a day

In conventional treatment, when two doses a day can effectively control symptoms, the dose should be gradually reduced to

Because budesonide formoterol powder inhaler contains budesonide and formoterol, adverse effects of these two drugs can also occur when using budesonide formoterol powder inhaler. After the combination of the two drugs, the incidence of adverse reactions did not increase.

The most common adverse reactions are predictable pharmacological adverse reactions to 2-receptor agonists, such as tremor and palpitations. These reactions usually weaken or disappear within a few days of treatment.

The adverse reactions associated with budesonide or formoterol are listed below.

Common (> 1/100):

Central nervous system: headache

Cardiovascular system: palpitations

Skeletal Muscle System: Tremor

Respiratory tract: Candidiasis of the oropharynx, mild irritation of the pharynx, cough, and hoarseness.

rare:

Cardiovascular System: Tachycardia

The musculoskeletal system: muscle cramps

Central nervous system: anxiety, restlessness, nervousness, nausea, dizziness, sleep disturbances

Rare (<1/1000):

Skin: rash, hives, itching

Respiratory tract: bronchospasm

Very rare but some of these potentially serious adverse reactions include:

Budesonide: psychiatric symptoms such as depression, behavioral abnormalities (mainly seen in children), symptoms and signs of systemic effects of glucocorticoids (including adrenal insufficiency), rapid and delayed allergic reactions (including dermatitis, angioedema And bronchospasm), and bruising.

Formoterol: angina pectoris, hyperglycemia, abnormal taste, and abnormal blood pressure.

As with other inhalation treatments, unusual bronchospasm is rare.

Arrhythmias such as atrial fibrillation, supraventricular tachycardia, and premature beats have been seen with other 2-agonists.

A gradual reduction in dose is required when stopping budesonide formoterol powder inhalation.

An increase in the use of bronchodilators indicates an exacerbation of the disease and the need to reassess the treatment of asthma. Sudden or progressive exacerbation of asthma symptoms can be life-threatening, and patients need urgent evaluation of treatment. In this case, consideration should be given to the need to increase corticosteroid therapy or to add systemic anti-inflammatory therapy, such as a course of oral corticosteroids, or antibiotics in the presence of infection.

There are no data on the use of budesonide formoterol powder inhalers for acute asthma attacks. Patients should be advised to carry emergency medicine with them.

Budesonide formoterol powder inhaler should not be started when the disease worsens.

Like other inhalation treatments, abnormal bronchospasm can occur. Wheezing worsened immediately after inhaling the drug. If severe reactions occur, re-evaluate treatment options and replace therapy if necessary.

Systemic effects can occur with any inhaled corticosteroid, especially when chronically high doses are used. These effects occur much less frequently when inhaled than when administered orally. Possible systemic effects include: adrenal function depression, growth retardation in children and adolescents, decreased bone density, cataracts and glaucoma. Therefore, it is important that inhaled corticosteroids be adjusted to the minimum effective maintenance dose.

If there is any reason to suspect that adrenal function has been impaired in the past with systemic corticosteroids, caution should be exercised when switching to budesonide formoterol powder inhalation.

The benefits of inhaled budesonide often reduce the use of oral corticosteroids, but when switching from oral corticosteroids to inhaled hormones, the risk of impaired adrenal reserve function remains for a long time.

Those patients who had previously required high-dose stress corticosteroids also had the same risk. The possibility of this residual adrenal impairment should be kept in mind, and appropriate treatment with corticosteroids should be considered in the case of first aid or selective conditions prone to stress. The degree of impaired adrenal function before choosing a treatment option requires expert evaluation and advice.

To reduce the risk of oropharyngeal candidiasis, patients should be instructed to rinse their mouth with water after each dose.

Concomitant use of ketoconazole or other strong CYP3A4 inhibitors should be avoided. If combined use cannot be avoided, the interval between the two drugs should be as long as possible.

Budesonide formoterol powder inhaler should be used with caution in the following conditions, including thyrotoxicosis, pheochromocytoma, diabetes, untreated hypokalemia, hypertrophic obstructive cardiomyopathy, congenital subvalvular disease Arterial stenosis, severe hypertension, aneurysms, or other serious cardiovascular diseases such as ischemic heart disease, tachyarrhythmia, or severe heart failure.

Care should be taken when treating patients with prolonged QTc-intervals. Formoterol itself may cause an extension of the QTc-interval.

The use of high dose 2-receptor agonists may cause severe hypokalemia. Concomitant use of drugs that cause hypokalemia may increase the likelihood of high-dose 2-receptor agonists producing hypokalemia.

In acute severe asthma, special attention should be paid to the fact that the associated risk can be increased by hypoxia. This hypokalemia effect may be exacerbated by a combination of xanthine inducers, steroids, and diuretics. Monitoring of potassium in acute severe asthma is recommended.

As with all 2-receptor agonists, increased control of blood glucose is needed for diabetic patients.

Budesonide formoterol powder inhaler contains lactose (<1 mg / inhalation). This dose is usually not a problem for patients with lactose intolerance.

Impact on the ability to drive and operate machines: Budesonide and Formoterol do not affect the ability to drive and operate machines.

There is no clinical information on the use of formoterol and budesonide in pregnant women. Data from an embryo study in rats show that there is no evidence that compound preparations have additional effects.

There is insufficient information on the use of formoterol by pregnant women. Animal tests have shown that formoterol has adverse effects on reproduction at high systemic exposures.

This product is only used during pregnancy when the benefits outweigh the potential dangers. Budesonide should be used at the lowest effective dose to properly control asthma.

Budesonide is secreted into milk, however, a therapeutic dose of budesonide has no effect on infants. It is unclear whether formoterol can enter human milk.

In rats, small doses of formoterol can be detected in breast milk. This product should only be used in breastfeeding women when the expected benefit to the mother outweighs the possible danger to the child.

Budesonide formoterol powder inhaler contains formoterol and budesonide, which have synergistic effects in reducing the exacerbation of asthma through different modes of action.

The mechanisms of action of the two components are as follows:

Budesonide:

The inhaled recommended dose of budesonide has anti-inflammatory effects on the lungs of glucocorticoids, which can reduce the symptoms of asthma, prevent the disease from worsening, and has fewer relative side effects than systemic medication. The detailed mechanism of this anti-inflammatory effect is unknown.

Formoterol:

Formoterol is a selective 2-adrenergic receptor agonist that relaxes bronchial smooth muscle in patients with reversible airway obstruction. The bronchodilator effect works quickly, it takes effect within 1 to 3 minutes after inhalation, and a single dose can be maintained for 12 hours.

Budesonide formoterol powder inhaler:

In clinical trials, the addition of formoterol to budesonide can improve asthma symptoms and lung function and reduce the deterioration of the condition.

In a 12-week study, the effects of budesonide formoterol powder on lung function were equivalent to the free combination of budesonide and formoterol, but better than budesonide alone. The anti-asthmatic effect does not diminish with prolonged use.

In another 12-week study involving 85 children between 6 and 11 years of age, the budesonide formoterol powder inhaler (80 micrograms / 4.5 micrograms / inhalation, 2 times a day, 2 times a day), The child's lung function was improved and well tolerated.

Correct usage

Dubao is driven by inhaled air, that is, when a patient inhales medicine through a mouthpiece, the medicine will enter the airway with the inhaled air.

Note: It is very important to instruct the patient (to ensure proper use):

Dubao is a multi-dose microinhaler. When the medicine is inhaled, the powder will be brought to the lungs, so it is important to use a strong and deep inhalation when inhaling the medicine through the mouthpiece.

Before using this product for the first time, you need to initialize the Dubao device. The initialization steps are as follows:

Unscrew and pull out the cap, making sure that the red handle is below.

Hold the straight Dubo, hold the red knob part and the middle part of Dubo, rotate it in one direction to the end, and then rotate it in the opposite direction to the end. You will hear a "click" sound during this process.

Repeat step 2 once.

Initialization is complete after completing steps 2 and 3.

After the initialization is completed, the usage method is as follows:

1. Unscrew and pull out the cap, making sure that the red knob is below.

2. Straighten Dubao, hold the red part at the bottom and the middle part of Dubao, rotate it in one direction to the end, and then rotate it in the opposite direction to the end. During this process, you will hear a "click" sound.

3. Exhale, do not exhale towards the mouthpiece.

4. Gently place the mouthpiece between the upper and lower teeth, cover the mouthpiece with your lips, and inhale strongly and deeply with your mouth.

5. Remove the mouthpiece from your mouth, hold your breath for about 5 seconds, then exhale.

6. If multiple doses are required in the prescription, repeat steps 2-5.

7. Tighten the lid.

8. After inhaling the medicine, you must rinse your mouth with water. ^[1]