In patients with bronchial asthma, Formoterol Ishihler should be used only as an additional treatment for inadequate efficacy of inhaled glucocorticosteroids (in medium and small doses) or in severe form of the disease requiring the use of two maintenance therapies, including Formoterol Ishihler. When the drug is prescribed patients, not receiving anti-inflammatory therapy, it should be started simultaneously with the use of Formoterol Ishihler.Lesion of the kidneys and liver
Data on the need to adjust the dose of the drug Formoterol Ishihler in patients with impaired renal or hepatic function.
The duration of formoterol is about 12 hours. Treatment in all cases should be carried out with minimally effective doses of the drug.
The current recommendations for the treatment of bronchial asthma indicate the need to use long-acting beta2-adrenomimetics for maintenance bronchodilator therapy in addition to therapy with glucocorticosteroids. In addition, they recommend the use of short-acting beta2-adrenomimetics in the event of an attack of bronchial asthma.
Patients should be advised for the period of inclusion in the treatment regimen Formoterol Ishihler not to stop taking and not change the regimen of treatment with glucocorticosteroids, even if the symptoms of bronchial asthma have decreased.
If the symptoms of the disease persist or worsen, or if the recommended dosages of Formoterol Ishihler do not allow them to be controlled (providing relief of seizures), this condition is usually a sign of worsening of the course of bronchial asthma and the need to revise the treatment regimen.
The frequent need for medicines (ie preventive care, for example, glucocorticosteroids and beta2-adrenomimetics of prolonged action) to prevent bronchospasm during exercise several times a week, despite adequate supportive therapy may be a sign of inadequate control of asthma symptoms and requires a review of anti-asthmatic treatment and an assessment of its compliance. When transferring patients to therapy with inhaler Formoterol Ishihler from other inhalers, the treatment regimen should be selected individually. In this case, it is necessary to take into account the features of the previously used drug, treatment regimens, methods of application drug substance.
In patients with cirrhosis of the liver, an increase in excretion is expected;
formoterol initially eliminated
through hepatic metabolism.
The Ishidler inhaler is controlled by the flow of air formed on the inhalation, which means that when the patient inhales air through the mouthpiece, the drug enters the respiratory tract along with the inhaled air.
Note: it is important to teach the patient to inhale through the mouthpiece quite actively and deeply, in order to ensure the optimal dose of the drug in the bronchial tissue.
If a patient needs regular admission of prolonged beta2-adrenomimetics, he should also receive regular and sufficient doses systematic anti-inflammatory treatment (inhalation or oral glucocorticosteroids). Formoterol Ishihler should be used only in patients who require prolonged therapy with bronchodilators. In the case of an attack of bronchial asthma, it is recommended that short-range beta2-adrenomimetics.
When prescribing the drug, it is necessary to assess whether the activity of the anti-inflammatory therapy administered to the patient is sufficient.
During an exacerbation of a current of a bronchial asthma therapy
inhaler should not be started. Care should be taken when use of Formoterol Ishiheler and theophylline to patients with heart disease.
Given the ability of beta2-adrenomimetics to cause
hyperglycaemia, in patients with diabetes it is recommended to carry out additional control of the concentration of glucose in the blood.
With therapy beta2-adrenomimetics can lead to life-threatening hypokalemia. Particular caution should be exercised in severe exacerbations of bronchial asthma, since the risk of hypokalemia at This increases against the background of the developing hypoxia.
Hypokalemic action can be enhanced by simultaneous therapy with xanthine derivatives, glucocorticosteroids and diuretics. In these cases, it is recommended to monitor the potassium concentration in the blood serum.
As with other types of inhalation therapy, one should not forget about the risk of developing paradoxical bronchospasm. If such bronchospasm develops, the drug should be stopped immediately, replacing it with an alternative treatment. Each dose of Formoterol Ishihler contains about 8 mg of lactose. Usually, this amount of lactose in individuals suffering from lactose intolerance does not cause clinical manifestations.
The drug should not be used for persons with lactase deficiency, lactose intolerance and glucose-galactose malabsorption.