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SALMETEROL/FLUTICASONE INHALATION-ORAL (cont.)

HOW TO USE: Learn all preparation and usage instructions in the product package. If any information is unclear, consult your doctor or pharmacist. Inhale this medication usually twice daily, in the morning and in the evening (12 hours apart); or as directed by your doctor. This medication should be used regularly to receive the most benefit from it. Remove the cap from the mouthpiece. Shake the canister well each time before use. Exhale slowly and deeply. Unless your doctor or pharmacist has told you differently, place the mouth piece between your lips, leaving your mouth open. As you start to inhale through your mouth, press the canister down to release the medication. Continue to inhale slowly and deeply. Hold your breath for as long as is comfortable to allow the medication to be absorbed. Exhale slowly. If you are to use more than one puff, wait at least 2 to 3 minutes and repeat this process. When you have completed your dose, replace the cap over the mouthpiece. Gargle and rinse your mouth after using this medication to help prevent dryness, relieve throat irritation, and to prevent mouth infections (e.g., thrush). Do not swallow the rinse solution. Clean the inhaler as instructed in the patient instructions at least one time weekly. Use this medication exactly as prescribed; do not use it more frequently or use more inhalations than prescribed. Doing so would decrease the effectiveness of the drug and increase the risk of side effects. Do not stop taking this medication without consulting your doctor. Some conditions may become worse when the drug is suddenly stopped. Your dose may need to be gradually decreased. If you have been using a "quick relief" beta-agonist inhaler (such as salbutamol/albuterol) on a regular daily schedule (such as 4 times daily), you must discontinue this schedule and only use it "as needed" for acute asthma attacks. Consult your doctor. If you find that your "quick-relief" (short-acting) inhaler is not working as well or if you need to use it more often than usual (i.e., using 4 or more puffs daily, or using more than 1 inhaler every 8 weeks), tell your doctor or pharmacist promptly. It may be a sign of worsening asthma which is a serious condition. It may take 1 week or longer before the full benefit of this drug takes effect. Inform your doctor if your condition persists or worsens.

SIDE EFFECTS: Hoarseness (dysphonia), headache, cough, dry mouth or throat may occur. If any of these effects persist or worsen, notify your doctor or pharmacist promptly. Tell your doctor immediately if any of these serious side effects occur: white patches on tongue or mouth, swollen or painful mouth/tongue, sinus infection/congestion, stomach pain. Tell your doctor immediately if any of these unlikely but serious side effects occur: vision changes, trouble sleeping, tremors. Tell your doctor immediately if any of these highly unlikely but very serious side effects occur: seizures, severe muscle weakness or cramping, fast/irregular heartbeat, numbness or tingling of hands or feet, chest pain, worsening of asthma symptoms (e.g., wheezing, coughing). An allergic reaction to this drug is unlikely, but seek immediate medical attention if it occurs. Symptoms of an allergic reaction include: rash, itching, swelling, dizziness, trouble breathing. Rarely, your wheezing might actually increase immediately after using this medication (paradoxical bronchospasm). If this occurs, use your "quick-relief" inhaler (such as salbutamol/albuterol). Seek immediate medical attention is your breathing does not improve at that time. If you notice other effects not listed above, contact your doctor or pharmacist.



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