Special groups of patients : No special dose adjustment in elderly patients and in patients with buy equipoise impaired renal or hepatic function in the appointment of the recommended normal doses of the drug (see “Special Instructions” section.).
Common (> 1/100)
Central nervous system: Headache
Cardiovascular system: heart palpitations
Musculoskeletal system: tremors
Central nervous system: agitation, anxiety, sleep disorders
Musculoskeletal system: muscle cramps
Cardiovascular system: tachycardia, blood pressure variation
Very rare (<1/1000)
Skin: rash, hives, itching
Cardiovascular system: atrial fibrillation, supraventricular tachycardia, arrhythmia
Metabolic disorders: hypokalemia / hyperkalemia
Tremor and palpitations are temporary and are in the process of treatment. As with every inhalation therapy, in very rare cases may develop paradoxical bronchospasm.
Described isolated cases of the following side effects: nausea, taste disturbance, dizziness, angina pectoris, prolongation of the QTc interval, hypersensitivity reactions, changes in blood pressure and hyperglycemia. Use of β 2 -simpatomimetikov may lead to an increase in blood insulin, free fatty acids, glycerol and ketone.
Clinical experience of treatment in the absence of an overdose. Most likely, the symptoms are typical for other β will be observed with an overdose of 2 -adrenomimetikov: tremor, headache, palpitations. In some cases, it was reported on the development of tachycardia, hyperglycemia, hypokalemia, lengthening the QTc interval, arrhythmia, nausea and vomiting. Displaying symptomatic and supportive treatment.
Perhaps the appointment of cardioselective β-blockers, but it must be done with great care, since the appointment of blockers β-adrenergic receptors can provoke bronchospasm development. At the same time necessary to monitor the level of potassium in the blood serum.
The interaction with other drugs and other interactions
Special studies on the interaction of Oxis turbuhaler with other drugs have not been conducted.
The combined use with other sympathomimetics, such as β 2 -adrenomimetiki or ephedrine, may lead to the development of side effects of Oxis turbuhaler and may require dose selection.
Co-administration with xanthine derivatives, steroids, or diuretics such as thiazides and loop diuretics may provoke the development of a rare side effect of β 2 -adrenomimetikov as hypokalemia.Hypokalemia may enhance susceptibility to arrhythmias buy equipoise in patients receiving cardiac glycosides.
There is a possibility of increased risk of ventricular arrhythmia due to a pharmacodynamic interaction with formoterol coadministered with other drugs that prolong the QTc interval. Such drugs include anti-histamines, such as terfenadine, astemizole, mizolastine, certain antiarrhythmic drugs (such as quinidine, disopyramide, procainamide), erythromycin and tricyclic antidepressants. There is an increased risk of arrhythmias in patients on the background at the same time of anesthesia halogenated hydrocarbons.
Beta-blockers can weaken or inhibit the effect of Oxis pharmacological turbuhaler. In this connection, the preparation is not recommended for use in conjunction with the adrenergic receptor blockers (including eye drops) except for emergency application sharing.
Formoterol, contained in the product gets into the respiratory tract of the patient along with the air flow when the active inhalation through the mouthpiece turbuhaler.
It is important to clearly instruct the patient to hold strong and deep breath in through the mouthpiece turbuhaler to guarantee getting the optimal dose of the drug to the respiratory tract.
It is also important to instruct the patient never do not chew or not to chew the mouthpiece, do not use Symbicort in the event of damage to the die or disconnect the mouthpiece of turbuhaler body.
The patient may not taste or feel the medication after using Oxis turbuhaler, due to a small amount of delivered material.
Patients suffering from bronchial asthma and regularly host β 2 -adrenomimetiki should receive optimal anti-inflammatory therapy with corticosteroids. Patients should be advised to continue anti-inflammatory therapy, even in those cases when, after the application of Oxis turbuhaler comes improvement. Saving the symptoms or the occurrence of the need to increase the dosage of β 2 -adrenomimetikov is a sign of the deterioration of the patient’s condition and requires a review of anti-asthmatic therapy. Do not start treatment with the drug and increasing the dose in severe exacerbation of the disease.
Do not exceed the maximum daily dose. There are no data on safety during prolonged continuous use of the drug at higher doses such as 36 mg per day for adults and 18 mg per day in children with asthma and 18 micrograms per day in patients with COPD.
Frequent use of the drug for prevention of symptoms of bronchial asthma caused by exercise, may indicate inadequate control of the disease course and cause a review of the treatment regimen used and the patient’s assessment of the degree of commitment to the observance of the therapy scheme. If the need for the prevention of asthma symptoms caused by exercise, occurs several times in one week against the background of adequate maintenance therapy (corticosteroids and β 2 -adrenomimetiki long-acting), it is necessary to revise the current treatment regimen specialist.
In patients with diabetes, at the beginning of treatment should be added to control the level of blood glucose as β 2 -adrenomimetiki have a hyperglycemic effect.
As a result, the use of β 2 -adrenomimetikov could potentially develop severe hypokalemia. It should be particularly careful during exacerbation of severe asthma, because the risk of hypokalemia may be exacerbated by hypoxia. Hypokalemia may be exacerbated by concomitant therapy with xanthine derivatives, steroids and diuretics. In these cases it is necessary to monitor the level of potassium in the blood serum.
Also, as with other inhalation therapy, you need to consider the possibility of paradoxical bronchospasm.
Children under 6 years of age should not receive drug treatment, as there is insufficient information for this age group. Abnormal liver function and kidney: The effect on the pharmacokinetics of formoterol decreased renal or hepatic function, and are not described pharmacokinetics in the elderly. As formoterol is excreted from the body by metabolism in patients with severe liver cirrhosis buy equipoise should expect a slowdown Withdrawal. Is delivered dose contains 450 mg of lactose (equivalent to 600 micrograms per dose measured). Such an amount is usually not a problem for people with lactose intolerance.
Instructions for use turbuhaler
Symbicort – a multidose inhaler, which allows to dose and inhale the drug in very small doses (Figure 1.). When you breathe in, turbuhaler powder delivered to the lungs. Therefore, it is important that you are strong and deeply inhaled through a mouthpiece. Running low dose t3 clen cycle trying to lose bodyfat isn’t a real hot idea imo.