Not to be discontinued abruptly. Contact physician if patient finds treatment ineffective or max daily dose exceeded & consider need for increased therapy w/ corticosteroids. Rescue inhaler must be available at all times. Not to be initiated to treat severe exacerbations. Patients must take maintenance dose as prescribed, even when asymptomatic. Reliever inhalations are not intended for regular prophylactic use. Discontinue use if paradoxical bronchospasm occurs. Systemic effects may occur in high doses & long-term treatment eg, adrenal suppression, growth retardation in childn & adolescents, decrease in bone mineral density, cataracts, glaucoma. Regularly monitor height of childn receiving prolonged treatment. Initial small but temporary reduction in growth in childn & adolescents during 1st yr of treatment. Patients transferred from oral or systemic steroid therapy; who have required high dose emergency corticosteroid therapy in the past or had prolonged treatment w/ high dose of inhaled corticosteroids. Rinse mouth out after each inhalation to minimize risk of candida infection. Concomitant treatment w/ itraconazole, ritonavir & other potent CYP3A4 inhibitors; β2
-agonists & drugs which can induce hypokalaemia eg, xanthine derivatives, steroids, duretics. Patients w/ thyrotoxicosis, phaeochromocytoma, DM, untreated hypokalaemia, hypertrophic obstructive cardiomyopathy, idiopathic sub-valvular aortic stenosis, severe HTN, aneurysm or other severe heart disease, tachyarrhythmia or severe heart failure; prolongation of the QTc interval; active or quiescent pulmonary TB; fungal & viral infections in the airways. Monitor serum K levels. Additional blood glucose controls in diabetic patients. Contains lactose (<1 mg/inhalation) which amount does not normally cause problem in lactose intolerant people, but may cause allergic reactions. Increased risk of pneumonia. Pregnancy & lactation.