Children after 12 years old and adults are recommended the following drug dosages:
- 4 inhalation a day at the rate of 50 mcg of salmeterol / 100 mcg of fluticasone – twice over;
- 4 Advair doses a day at the rate of 50 mcg of salmeterol / 250 mcg of fluticasone – twice over;
- 4 inhalations a day at the rate of 50 mcg of salmeterol / 500 mcg of fluticasone – twice over.
Children of 4 -12 years old are recommended the following Advair dosage – 4 inhalations a day at the rate of 50 mcg of salmeterol / 100 mcg of fluticasone – twice over. At COPD adults are appoint no more than 4 inhalations a day – 50 mcg of salmeterol / 500 mcg of fluticasone. Inhalations are carried out twice a day.
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If 2 times a day administration provides symptoms control, as part of dosage reduction to lowest effective it is possible to decrease dosage frequency to 1 times a day.
The patient should be prescribed such a fluticasone propionate dose corresponding to the disease.
If treatment with inhaled glucocorticosteroids does not provide adequate disease control, their replacement with Advair at a dose, therapeutically equivalent to glucocorticosteroids dose, may improve bronchial asthma control. Patients who can control asthma using only inhaled glucocorticosteroids, their replacement with Advair may allow reducing glucocorticosteroids dose, necessary for asthma control.
Advair (learn more) reviews confirm that elderly patients and those who have kidneys and liver abnormalities do not require treatment regimen correction.
Overdose
Expected salmeterol overdose signs and symptoms are typical of excessive beta2-adrenergic stimulation and include:
- tremor;
- headaches;
- tachycardia;
- increased systolic arterial blood pressure;
- hypokalaemia.
Acute fluticasone propionate overdose when inhaled can cause temporary hypothalamo-pituitary-adrenal axis suppression. Usually, it doesn’t require any extra-measures because the normal adrenal function is restored within a few days.
When receiving the drug in doses higher than recommended for a long period of time, a significant inhibition of adrenocortical function is possible. There were rare cases of acute adrenal crisis, which occurred mostly in children treated with doses higher than recommended for a long time (months or years). Acute adrenal crisis manifests in hypoglycemia accompanied by confusion and/or convulsions. Situations, that can serve as triggering factors for the acute adrenal crisis, include:
- trauma;
- surgery;
- infection;
- any rapid dosage reduction of fluticasone propionate.
Treatment
There is no specific treatment for salmeterol and fluticasone propionate overdose. In case of overdose supportive therapy should be carried out, as well as patient’s condition observation. At chronic overdose reserve, adrenocortical function control is recommended.
Posted by Dr. Himanshu Singh