Flixotide 0.5mg GSK treatment for bronchial asthma (10 tubes x 2ml)
Dosage form Box x 2ml
Specifications Fluticasone Propionate
Ingredient
Thành phần cho 2ml
| Composition information | Content |
| Fluticasone Propionate | 0.5 |
Uses
Indications
Flixotide is indicated in the following cases:
Adults and young people over 16 years old
Preventive treatment in severe bronchial asthma (patients who need high -dose or oral corticosteroid treatment): Many patients are dependent on body corticosteroids to control symptoms, when using inhaled Flixotide can be significantly reduced or without oral corticosteroids.
Treatment of acute bronchial asthma attacks: The next maintenance dose may be more convenient when using powder or inhalation.
Children and teenagers from 4 to 16 years old
Treatment of acute bronchial asthma attacks: The next maintenance dose may be more convenient when using powder or inhalation.
Pharmacokology
Flixotide is used in the recommended dose by inhaled lines that have strong anti -inflammatory effects in the lung -style glucocorticoid style, leading to reduced symptoms and drama of bronchial asthma.
pharmacokinetic
absorption
Fluticason Propionate's absolute bioavailability in each existing inhaler is estimated to be within and between the values of inhaled and intravenous pharmacokinetics. In patients with bronchial asthma or COPD (chronic obstructive pulmonary disease), observed the level of systemic exposure less with Fluticason propionate inhaled.
The whole body absorption takes place mainly in the lungs and at first happens quickly and then lasts. The rest of the inhaled dose can be swallowed but contributed very small to the body exposure due to low water soluble and metabolism before absorbing the whole body, resulting in oral bioavailing that reaches less than 1%. There is a linear increase in the body exposure level with an increase in the dose.
Distribution
Fluticason Propionate has a large distribution in a stable stage (approximately 300 l). Moderate plasma protein binding (91%).
Metabolism
Fluticason Propionate is quickly excreted from the circulatory system, mainly by converting into non -activated carboxylic acid metabolites by CYP3A4 enzyme of the Cytochrom P450 system. Be cautious when used simultaneously with the known CYP3A4 inhibitors, because it is likely to increase the body exposure to Fluticason Propionate.
Elimination
Fluticason propionat's excretion is characterized by high plasma clearance (1150 ml/minute) and the final waste time is about 8 hours. The renal clearance of Fluticason Propionate is negligible (
Before taking Flixotide 0.5mg GSK treatment for bronchial asthma (10 tubes x 2ml)
How to use
should let patients know the nature of inhaled Flixotide treatment is preventive and should be inhaled regularly even without symptoms.
Should use Flixotide Nebules in the form of aerosol created by gas sprayer (Jet Nebuliser) as instructed by a physician. Because the distribution of the drug can be affected by many factors, please refer to the instructions of the stilt house on the gas spray equipment.
generally do not recommend using Flixotide Nebules with a gas machine by ultrasound.
Flixotide for gas, not injected.
Flixotide for inhaled aerospm and must use a suck tube. If you need to use the mask, you can inhale with the nose.
Maximum improvement of bronchial asthma can be achieved within 4 to 7 days after starting the drug. However, Flixotide has been shown to treat immediately 24 hours after taking the drug in patients who have never been treated with inhaled steroids.
Patients should see a doctor as soon as they see treatment with bronchodilators, short -effective bronchodilators become less effective or need to inhale more than usual.
To help the use of a small amount of phlegm or if it is necessary to extend the drug distribution time, it is necessary to dilute the Flixotide mixture for aerosole with sodium chlorid the injection type right before use.
Due to many types of aerosol machine operating on the principle of continuous air flow, it is likely that the gas drug will be released into the surrounding environment. Therefore, Flixotide should be used in the room with good ventilation, especially in the hospital when many patients use one at the same time.
Dosage
Bronchial asthma
Adults and teenagers over 16 years old: 500 to 2000 micrograms 2 times/day.
Children and teenagers aged 4 to 16: 1000 micrograms 2 times/day.
Give patients using Flixotide aerospm with the starting dose to suit the severity of the disease. The dose adjustment should then be adjusted until the disease is controlled or the lowest is reduced to the lowest dose depending on the response of each patient.
To treat the acute drama of bronchial asthma, the maximum dose should be used up to 7 days after the drama.
then consider to reduce the dose.
Special patient group
No dose adjustment in elderly patients or patients with liver or kidney failure.
Note: The above dose is for reference only. Specific dosage depends on the condition and level of progression of the disease. For a suitable dose, you need to consult a doctor or medical specialist.
What to do when overdose? No need for emergency treatment due to adrenal function will return to normal after a few days when checking by quantitative cortisol in plasma. However, if the dose is higher than the recommended dose for a long time can lead to adrenal inhibition to some extent. The adrenal reserve may be required. In the case of Flixotide overdose, it is possible to continue treating with appropriate doses to control symptoms.
Should closely monitor patients with higher doses than the recommended dose and should reduce the dose slowly.
What to do when you forget a dose? However, if close to the next dose, skip the forgotten dose and take the next dose at the time as planned. Note that it should not be used double the prescribed dose.
Side Effects
When using Nebules Flixotide, you may experience unwanted effects (ADR).
Common, ADR> 1/100
Skin and subcutaneous tissue: bruises (bruises).
Uncommon, 1/1000 Rare, ADR Mental system: anxiety, sleep disorders and behavior changes include increased activity and stimulation (mainly in children). Instructions on how to handle ADR Candida infections in the mouth and throat (thrush) appear in some patients. Fungal infections may be limited by rinse with water right after taking the drug. It is possible to treat symptoms of fungal infections with local antifungal drugs while continuing Flixotide treatment. Flixotide inhaled can cause hoarseness in some patients. This unwanted effect can be reduced by rinse with water immediately after inhalation. Notify the doctor with unwanted effects when taking the drug.
Warnings
Before using the drug you need to read the instructions carefully and refer to the information below.
Contraindicated
drug A contraindicated in the following cases:
History of hypersensitivity to any ingredients of the drug.
Precautions when using
Increasing the use of beta - 2 short -effects inhaled effects to control the symptoms of bronchial asthma shows that the disease controls worsening and then re -evaluating the patient treatment regimen.
Sudden or progressive bronchial control control can be life -threatening patients, so it should be considered to increase corticosteroid dose. Maybe need to monitor daily peaks in patients who are considered to be at risk.
may have systemic effects when using any inhaled corticosteroids, especially when taking high doses for a long time. These effects are often much less appearing than using oral corticosteroids. Systemic effects may include cushing syndrome, cushing manifestations, adrenal inhibition, developmental retardation in children and adolescents, reducing bone mineral density, cataracts and glaucoma. Therefore, it is important to detect the lowest inhaled corticosteroid dose and still maintain effective bronchial asthma control.
Should regularly check the height of children treated with inhaled corticosteroids for a long time.
Due to the ability to respond to the adrenal renal, especially careful caution and check the adrenal skin function regularly in patients who move from oral steroids to inhaled Flixotide.
After starting to use inhaled Flixotide, it is necessary to stop using systemic corticosteroids slowly and the patient should carry a steroid warning card indicating situations that need additional treatment in emergency cases.
should always consider the ability to respond to the adrenal impairment in emergency cases (including surgery) and even in non -urgent cases that can cause stress, especially in patients with high doses for a long time. Consider the treatment with additional corticosteroids suitable for certain clinical illnesses.
Similarly, replacement of systemic steroid treatment may no longer control other allergies such as allergic or eczema, which have been previously controlled by systemic steroids.
Do not stop treating with Flixotide suddenly.
There are very few reports on the effect of hyperglycemia and this should be considered for treatment for patients with a history of diabetes.
as well as all other inhaled corticosteroids, should be careful especially in patients with pulmonary tuberculosis or silence.
During use after the drug is circulated, there are reports on clinical interactions in patients using Fluticason propionat and ritonavir, leading to corticosteroids including cushing syndrome and adrenal inhibition. Therefore, Fluticason Propionat and Ritonavir should be avoided, unless the patient's benefits are overwhelming the risk of corticosteroid side effects.
Like other inhaled drugs, paradoxical bronchospasm can appear along with increasing wheezing immediately after taking the drug. Should be treated immediately with bronchodilators inhaled quickly. Flixotide Nebules should be stopped immediately, evaluated patients and replaced treatment if necessary.
Do not use Flixotide Nebules merely to reduce the symptoms of acute bronchospasm, which also needs to use short -shaped inhaled bronchodilators (such as salbutamol). Flixotide Nebules is used for daily treatment and is anti -inflammatory treatment in acute drama of bronchial asthma.
Need to check regularly in case of severe bronchial asthma due to being life -threatening. Corticosteroid dose may be needed under the emergency supervision of a doctor when symptoms deteriorate.
Do not use Flixotide Nebules instead of injection corticosteroids or oral forms in emergency cases.
Patients who are being treated with Flixotide must be warned that if the clinical disease is suddenly worse, they must not increase the dose or increase the frequency of use but need to go to the doctor.
Patients are recommended to use Flixotide when used through the suck tube to avoid the possibility of facial atrophy may appear when using long -term gas masks.
When using the mask, it is recommended to protect the face of the face with cream with cream or washing your face thoroughly immediately after use.
Should reduce the dose from the time of using Flixotide aerobic for a long time, not suddenly reduced unless there is a doctor's supervision.
The ability to drive and operate machinery
Flixotide usually does not affect the ability to drive and operate machinery.
Pregnancy
There is no full research and good control of Fluticason Propionate in pregnant women, still not knowing the influence of Fluticason Propionate in human pregnancy. Research on animal fertility can only see the typical effects of glucocorticosteroid at the level of systemic exposure much larger than the body exposure level when using the recommended dose for treatment with inhalation. No possibility of causing mutations in gene mutations.
However, like other drugs, only consideration of using Fluticason Propionate during pregnancy when the benefits gives the mother superior risk that can cause embryos.
Breastfeeding period
Not surveyed on the excretion ability of Fluticason Propionate into the mother's milk. After subcutaneous injection Fluticason Propionate for the experimental mice is breastfeeding, when quantifying the concentration of drugs in plasma is also the time to detect Fluticason propionate in milk. However, plasma concentrations in patients after using Fluticason Propionate inhaled with the suggestion are usually low.
Drug interaction
under normal conditions, due to the initial transformation and high body elimination through the cytochrom P450 3A4 intermediaries in the intestine and liver, the fluticason propionate concentration in plasma is low after the inhaling dose. Therefore, it is less likely to have clinical drug interactions via Fluticason Propionate.
In a study of drug interaction in healthy people shows that Ritonavir (strong inhibitor of Cytochrom P450 3A4) can cause increased plasma fluticason propionat levels, resulting in a significant reduction in serum cortisol levels. During the use of the drug after being allowed to circulate, there was a report on clinical drug interactions in patients using Fluticason Propionate nasal spray or inhalation and ritonavir, resulting in the systemic effect of corticosteroids including cushing syndrome and adrenal inhibition. Therefore, avoid simultaneous use of Fluticason propionat and ritonavir unless the benefits are superior to the risk of corticosteroid side effects.
Studies show that other Cytochrom P450 3A4 inhibitors increased insignificantly (erythromycin) and slightly increased (Ketoconazol) of fluticason propionat -contaminated body without significantly reducing serum cortisol levels in serum. However, be careful when using a combination of strong Cytochrom P450 3A4 (such as Ketoconazole) due to the potential to increase the exposure of Fluticason Propionate.
Storage
Leave a cool place, avoid light, temperature below 30⁰C.
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