Flutiform contains both fluticasone propionate and formoterol fumarate; therefore, the risks associated with overdosage for the individual components are given as follows.
Formoterol fumarate: An overdose of formoterol would likely lead to an exaggeration of effects that are typical for beta2-agonists: angina, hypertension or hypotension, palpitations, tachycardia, arrhythmia, prolonged QT-interval, headache, tremor, nervousness, muscle cramps, dry mouth, insomnia, fatigue, malaise, seizures, metabolic acidosis, hypokalemia, hyperglycaemia, nausea and vomiting.
Treatment of formoterol overdose consists of discontinuation of the medication together with institution of appropriate symptomatic and/ or supportive therapy. The judicious use of cardio selective beta receptor blockers may be considered, bearing in mind that such medication can induce bronchospasm. There is insufficient evidence to determine if dialysis beneficial in cases of formoterol overdose. Cardiac monitoring is recommended in cases of overdosage.
Fluticasone propionate: The potential for acute toxic effect following overdose of fluticasone is low. The only harmful effect after inhalation of a large amount of the drug over a short period is suppression of hypothalamic pituitary adrenocortical (HPA) axis function. HPA axis function usually recovers in a few days.
In the management of chronic overdose oral or systemic corticosteroids may be required in situations of stress. All patients deemed to be chronically overdosed should be treated as if steroid dependent with a suitable maintenance dose of a systemic corticosteroid.