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AirDuo Respiclick (fluticasone / salmeterol) Disease Interactions

There are 11 disease interactions with AirDuo Respiclick (fluticasone / salmeterol):

Moderate

Beta- 2 Adrenergic Bronchodilators (Includes AirDuo Respiclick) ↔ Cardiovascular

Moderate Potential Hazard, Moderate plausibility

Applies to: Hyperthyroidism, Heart Disease, Hypertension

Adrenergic bronchodilators can stimulate cardiovascular beta- 1 and beta- 2 receptors, resulting in adverse effects such as tachycardia, palpitation, peripheral vasodilation, blood pressure changes, and ECG changes (e.g., flattening of the T wave; prolongation of the QT interval; ST segment depression). Direct stimulation of cardiac tissues is mediated by beta- 1 receptors and thus less likely to occur with beta-2-selective agents such as albuterol. However, beta-2-selectivity is not absolute and can be lost with larger doses. High dosages of these agents have been associated with precipitation or aggravation of angina, myocardial ischemia, and cardiac arrhythmias. Therapy with adrenergic bronchodilators should be administered cautiously in patients with sensitivity to sympathomimetic amines, hyperthyroidism, and/or underlying cardiovascular disorders such as coronary insufficiency, cardiac arrhythmias, or hypertension. The recommended dosages should not be exceeded.

References

  1. Price AH, Clissold SP "Salbutamol in the 1980s. A reappraisal of its clinical efficacy." Drugs 38 (1989): 77-122
  2. "Product Information. Brethaire (terbutaline)." Novartis Pharmaceuticals, East Hanover, NJ.
  3. Chodosh S, Crooks LA, Tuck J "Comparative effects of pirbuterol acetate, metaproterenol, and placebo aerosols on pulmonary function and incidence of cardiac ectopy." J Asthma 26 (1989): 309-15
  4. Richards DM, Brogden RN "Pirbuterol. A preliminary review of its pharmacological properties and therapeutic efficacy in reversible bronchospastic disease." Drugs 30 (1985): 6-21
  5. Tranfa CME, Pelaia G, Grembiale RD, Naty S, Durante S, Borrello G "Short-term cardiovascular effects of salmeterol." Chest 113 (1998): 1272-6
  6. Maguire GP, Emirgil C "Bronchodilator and side effects of different modes of administration of metaproterenol: inhaled, oral, and in combination." Am J Med Sci 291 (1986): 168-74
  7. Maconochie JG, Forster JK "Dose-response study with high-dose inhaled salmeterol in healthy subjects." Br J Clin Pharmacol 33 (1992): 342-5
  8. Finch JS "Cardiovascular toxicity: clinical evaluation of albuterol, isoproterenol and placebo in rising dose tolerance trial." Ann Allergy 47 (1981): 402-4
  9. Hibbard JU "Chronic terbutaline therapy and peripartum cardiomyopathy: a case-control study." Hypertens Pregnancy 15 (1996): 183-91
  10. Spitzer WO, Suissa S, Ernst P, Horwitz RI, Habbick B, Cockcroft D, Boivin JF, McNutt M, Buist AS, Rebuck AS "The use of beta-agonists and the risk of death and near death from asthma." N Engl J Med 326 (1992): 501-6
  11. "Product Information. Severent (salmeterol)." Glaxo Wellcome, Research Triangle Park, NC.
  12. Bierman CW, Kemp JP, Nathan RA "Efficacy and safety of inhaled bitolterol mesylate via metered-dose inhaler in children with asthma." Ann Allergy Asthma Immunol 76 (1996): 27-35
  13. "Product Information. Tornalate Metered Dose (bitolterol)." Dura Pharmaceuticals, San Diego, CA.
  14. Brogden RN, Faulds D "Salmeterol xinafoate. A review of its pharmacological properties and therapeutic potential in reversible obstructive airways disease." Drugs 42 (1991): 895-912
  15. Larsson S "Long-term treatment with beta2-adrenostimulants in asthma. Side effects, selectivity, tolerance, and routes of administration." Acta Med Scand Suppl 608 (1977): 1-40
  16. Suissa S, Hemmelgarn B, Blais L, Ernst P "Bronchodilators and acute cardiac death." Am J Respir Crit Care Med 154 (1996): 1598-602
  17. Wong CS, Pavord ID, Williams J, Britton JR, Tattersfield AE "Bronchodilator, cardiovascular, and hypokalaemic effects of fenoterol, salbutamol, and terbutaline in asthma." Lancet 336 (1990): 1396-9
  18. Ence TJ, Tashkin DP, Ho D, Child JS "Acute bronchial and cardiovascular effects of oral pirbuterol and metaproterenol." Ann Allergy 43 (1979): 229-36
  19. "Adverse effects and complications of treatment with beta-adrenergic agonist drugs. Committee on drugs, the American Academy of Allergy and Immunology." J Allergy Clin Immunol 75 (1985): 443-9
  20. Chazan R, Droszcz W, Maruchin JE "Pharmacodynamics of salbutamol in humans." Int J Clin Pharmacol Ther Toxicol 26 (1988): 385-7
  21. Breeden CC, Safirstein BH "Albuterol and spacer-induced atrial fibrillation." Chest 98 (1990): 762-3
  22. Kinney EL, Trautlein JJ, Harbaugh CV, Lambert D, Zelis RF "Ventricular tachycardia after terbutaline." JAMA 240 (1978): 2247
  23. Al-Hillawi AH, Hayward R, Johnson NM "Incidence of cardiac arrhythmias in patients taking slow release salbutamol and slow release terbutaline for asthma." Br Med J (Clin Res Ed) 288 (1984): 367
  24. Jenne JW "Can oral beta(2) agonists cause heart failure?" Lancet 352 (1998): 1081-2
  25. "Product Information. Ventolin (albuterol)." Glaxo Wellcome, Research Triangle Park, NC.
  26. Neville E, Corris PA, Vivian J, Nariman S, Gibson GJ "Nebulised salbutamol and angina." Br Med J (Clin Res Ed) 285 (1982): 796-7
  27. Littner MR, Tashkin DP, Calvarese B, Bautista M "Acute bronchial and cardiovascular effects of increasing doses of pirbuterol acetate aerosol in asthma." Ann Allergy 48 (1982): 14-20
  28. Godfrey S "Worldwide experience with albuterol (salbutamol)." Ann Allergy 47 (1981): 423-6
  29. Wolfe JD, Yamate M, Biedermann AA, Chu TJ "Comparison of the acute cardiopulmonary effects of oral albuterol, metaproterenol, and terbutaline in asthmatics." JAMA 253 (1985): 2068-72
  30. Trautlein J, Allegra J, Gillin M "Aerosolized terbutaline sulfate--an evalution of efficacy and side effects in patients with reversible airway disease." J Clin Pharmacol 17 (1977): 76-80
  31. Wagner JM, Morton MJ, Johnson KA, O'Grady JP, Speroff L "Terbutaline and maternal cardiac function." JAMA 246 (1981): 2697-701
  32. Vathenen AS, Britton JR, Ebden P, Cookson JB, Wharrad HJ, Tattersfield AE "High-dose inhaled albuterol in severe chronic airflow limitation." Am Rev Respir Dis 138 (1988): 850-5
  33. "Product Information. Proventil (albuterol)." Schering Laboratories, Kenilworth, NJ.
  34. Lampert MB, Hibbard J, Weinert L, Briller J, Lindheimer M, Lang RM "Peripartum heart failure associated with prolonged tocolytic therapy." Am J Obstet Gynecol 168 (1993): 493-5
  35. Meyer JM, Wenzel CL, Kradjan WA "Salmeterol: a novel, long-acting beta 2-agonist." Ann Pharmacother 27 (1993): 1478-87
  36. "Product Information. Maxair (pirbuterol)." 3M Pharmaceuticals, St. Paul, MN.
  37. Mettauer B, Rouleau JL, Burgess JH "Detrimental arrhythmogenic and sustained beneficial hemodynamic effects of oral salbutamol in patients with chronic congestive heart failure." Am Heart J 109 (1985): 840-7
  38. "Product Information. Xopenex (levalbuterol)." Sepracor, Marlborough, MA.
  39. Sanders JP, Potter DE, Ellis S, Bee DE, Grant JA "Metabolic and cardiovascular effects of carbuterol and metaproterenol." J Allergy Clin Immunol 60 (1977): 174-9
  40. Gawchik SM, Saccar CL, Noonan M, Reasner DS, DeGraw SS "The safety and efficacy of nebulized levalbuterol compared with racemic albuterol and placebo in the treatment of asthma in pediatric patients." J Allerg Clin Immunol 103 (1999): 615-21
  41. Bengtsson B, Fagerstrom PO "Extrapulmonary effects of terbutaline during prolonged administration." Clin Pharmacol Ther 31 (1982): 726-32
  42. Braden GL, Germain MJ, Mulhern JG, Hafer JG, Bria WF "Hemodynamic, cardiac, and electrolyte effects of low-dose aerosolized terbutaline sulfate in asthmatic patients." Chest 114 (1998): 380-7
  43. "Product Information. Alupent (metaproterenol)." Boehringer-Ingelheim, Ridgefield, CT.
  44. Larsson S, Svedmyr N "Bronchodilating effect and side effects of beta2- adrenoceptor stimulants by different modes of administration (tablets, metered aerosol, and combinations thereof). A study with salbutamol inasthmatics." Am Rev Respir Dis 116 (1977): 861-9
  45. Shovlin CL, Tam FW "Salbutamol nebuliser and precipitation of critical cardiac ischaemia." Lancet 336 (1990): 1258
  46. Katz M, Robertson PA, Creasy RK "Cardiovascular complications associated with terbutaline treatment for preterm labor." Am J Obstet Gynecol 139 (1981): 605-8
  47. Brogden RN, Speight TM, Avery GS "Terbutaline: a preliminary report of its pharmacological properties and therapeutic efficacy in asthma." Drugs 6 (1973): 324-32
  48. Pinnas JL, Bhatt BD, Campbell SC, Kemp JP, Tinkelman DG "Dose-response study of nebulized bitolterol mesylate solution in asthmatic patients." Chest 91 (1987): 533-9
  49. Whitsett TL, Manion CV, Wilson MF "Cardiac, pulmonary and neuromuscular effects of clenbuterol and terbutaline compared with placebo." Br J Clin Pharmacol 12 (1981): 195-200
  50. Nathan RA, Bronsky EA, Dockhorn RJ, Kemp JP "Multicenter dose-ranging study of bitolterol mesylate solution for nebulization in children with asthma." Ann Allergy 72 (1994): 209-16
View all 50 references
Moderate

Beta- 2 Adrenergic Bronchodilators (Includes AirDuo Respiclick) ↔ Diabetes

Moderate Potential Hazard, Low plausibility

Applies to: Diabetes Mellitus

Adrenergic bronchodilators may cause increases in blood glucose concentrations. These effects are usually transient and slight, but may be significant with dosages higher than those normally recommended. Large doses of IV albuterol (not commercially available in the U.S.) and terbutaline sulfate have been reported to cause exacerbation of preexisting diabetes mellitus and ketoacidosis. Therapy with adrenergic bronchodilators should be administered cautiously in patients with diabetes mellitus. Closer monitoring of blood glucose concentrations may be appropriate. Systemic adverse effects are minimized, but not abolished, by administration of these agents via oral inhalation.

References

  1. "Product Information. Ventolin (albuterol)." Glaxo Wellcome, Research Triangle Park, NC.
  2. Gawchik SM, Saccar CL, Noonan M, Reasner DS, DeGraw SS "The safety and efficacy of nebulized levalbuterol compared with racemic albuterol and placebo in the treatment of asthma in pediatric patients." J Allerg Clin Immunol 103 (1999): 615-21
  3. Bengtsson B, Fagerstrom PO "Extrapulmonary effects of terbutaline during prolonged administration." Clin Pharmacol Ther 31 (1982): 726-32
  4. "Product Information. Xopenex (levalbuterol)." Sepracor, Marlborough, MA.
  5. Price AH, Clissold SP "Salbutamol in the 1980s. A reappraisal of its clinical efficacy." Drugs 38 (1989): 77-122
  6. Meyer JM, Wenzel CL, Kradjan WA "Salmeterol: a novel, long-acting beta 2-agonist." Ann Pharmacother 27 (1993): 1478-87
  7. "Product Information. Maxair (pirbuterol)." 3M Pharmaceuticals, St. Paul, MN.
  8. Maconochie JG, Forster JK "Dose-response study with high-dose inhaled salmeterol in healthy subjects." Br J Clin Pharmacol 33 (1992): 342-5
  9. "Product Information. Tornalate Metered Dose (bitolterol)." Dura Pharmaceuticals, San Diego, CA.
  10. "Product Information. Severent (salmeterol)." Glaxo Wellcome, Research Triangle Park, NC.
  11. Hastwell G, Lambert BE "The effect of oral salbutamol on serum potassium and blood sugar." Br J Obstet Gynaecol 85 (1978): 767-9
  12. Chazan R, Droszcz W, Maruchin JE "Pharmacodynamics of salbutamol in humans." Int J Clin Pharmacol Ther Toxicol 26 (1988): 385-7
  13. "Product Information. Brethaire (terbutaline)." Novartis Pharmaceuticals, East Hanover, NJ.
  14. "Product Information. Alupent (metaproterenol)." Boehringer-Ingelheim, Ridgefield, CT.
  15. "Product Information. Proventil (albuterol)." Schering Laboratories, Kenilworth, NJ.
View all 15 references
Moderate

Beta- 2 Adrenergic Bronchodilators (Includes AirDuo Respiclick) ↔ Hypokalemia

Moderate Potential Hazard, Low plausibility

Applies to: Hypokalemia

Adrenergic bronchodilators may cause decreases in serum potassium concentrations, primarily when given by nebulization or intravenous administration. Although this effect is usually transient and does not require supplementation, clinically significant hypokalemia may occur in some patients, with the potential to induce cardiovascular adverse effects. The relevance of these observations to oral or oral aerosol/powder for inhalation therapy is unknown. Therapy with adrenergic bronchodilators should be administered cautiously in patients with or predisposed to hypokalemia.

References

  1. "Product Information. Alupent (metaproterenol)." Boehringer-Ingelheim, Ridgefield, CT.
  2. Gelmont DM, Balmes JR, Yee A "Hypokalemia induced by inhaled bronchodilators." Chest 94 (1988): 763-6
  3. Allon M, Dunlay R, Copkney C "Nebulized albuterol for acute hyperkalemia in patients on hemodialysis." Ann Intern Med 110 (1989): 426-9
  4. "Product Information. Proventil (albuterol)." Schering Laboratories, Kenilworth, NJ.
  5. Wong CS, Pavord ID, Williams J, Britton JR, Tattersfield AE "Bronchodilator, cardiovascular, and hypokalaemic effects of fenoterol, salbutamol, and terbutaline in asthma." Lancet 336 (1990): 1396-9
  6. Whyte KF, Addis GJ, Whitesmith R, Reid JL "The mechanism of salbutamol-induced hypokalaemia." Br J Clin Pharmacol 23 (1987): 65-71
  7. Gawchik SM, Saccar CL, Noonan M, Reasner DS, DeGraw SS "The safety and efficacy of nebulized levalbuterol compared with racemic albuterol and placebo in the treatment of asthma in pediatric patients." J Allerg Clin Immunol 103 (1999): 615-21
  8. "Product Information. Ventolin (albuterol)." Glaxo Wellcome, Research Triangle Park, NC.
  9. Meyer JM, Wenzel CL, Kradjan WA "Salmeterol: a novel, long-acting beta 2-agonist." Ann Pharmacother 27 (1993): 1478-87
  10. "Product Information. Maxair (pirbuterol)." 3M Pharmaceuticals, St. Paul, MN.
  11. Sanders JP, Potter DE, Ellis S, Bee DE, Grant JA "Metabolic and cardiovascular effects of carbuterol and metaproterenol." J Allergy Clin Immunol 60 (1977): 174-9
  12. Larsson S, Svedmyr N "Bronchodilating effect and side effects of beta2- adrenoceptor stimulants by different modes of administration (tablets, metered aerosol, and combinations thereof). A study with salbutamol inasthmatics." Am Rev Respir Dis 116 (1977): 861-9
  13. Braden GL, vonOeyen PT, Germain MJ, Watson DJ, Haag BL "Ritodrine- and terbutaline-induced hypokalemia in preterm labor: Mechanisms and consequences." Kidney Int 51 (1997): 1867-75
  14. Windom H, Grainger J, Burgess C, Crane J, Pearce N, Beasley R "A comparison of the haemodynamic and hypokalaemic effects of inhaled pirbuterol and salbutamol." N Z Med J 103 (1990): 259-61
  15. "Product Information. Brethaire (terbutaline)." Novartis Pharmaceuticals, East Hanover, NJ.
  16. Hurlbert BJ, Edelman JD, David K "Serum potassium levels during and after terbutaline." Anesth Analg 60 (1981): 723-5
  17. Kantola I, Tarssanen L "Hypokalemia from usual salbutamol dosage ." Chest 89 (1986): 619-20
  18. "Hypokalaemia due to salbutamol overdosage." Br Med J (Clin Res Ed) 283 (1981): 500-1
  19. Hastwell G, Lambert BE "The effect of oral salbutamol on serum potassium and blood sugar." Br J Obstet Gynaecol 85 (1978): 767-9
  20. Tveskov C, Djurhuus MS, Klitgaard NAH, Egstrup K "Potassium and magnesium distribution, ECG changes, and ventricular ectopic beats during beta(2)-adrenergic stimulation with terbutaline in healthy subjects." Chest 106 (1994): 1654-9
  21. "Product Information. Tornalate Metered Dose (bitolterol)." Dura Pharmaceuticals, San Diego, CA.
  22. Bengtsson B, Fagerstrom PO "Extrapulmonary effects of terbutaline during prolonged administration." Clin Pharmacol Ther 31 (1982): 726-32
  23. Montoliu J, Almirall J, Ponz E, Campistol JM, Revert L "Treatment of hyperkalaemia in renal failure with salbutamol inhalation." J Intern Med 228 (1990): 35-7
  24. "Product Information. Xopenex (levalbuterol)." Sepracor, Marlborough, MA.
  25. Rakhmanina NY, Kearns GL, Farrar HC "Hypokalemia in an asthmatic child from abuse of albuterol metered dose inhaler." Pediatr Emerg Care 14 (1998): 145-7
  26. Price AH, Clissold SP "Salbutamol in the 1980s. A reappraisal of its clinical efficacy." Drugs 38 (1989): 77-122
  27. "Product Information. Severent (salmeterol)." Glaxo Wellcome, Research Triangle Park, NC.
  28. Maconochie JG, Forster JK "Dose-response study with high-dose inhaled salmeterol in healthy subjects." Br J Clin Pharmacol 33 (1992): 342-5
  29. Gross TL, Sokol RJ "Severe hypokalemia and acidosis: a potential complication of beta- adrenergic treatment." Am J Obstet Gynecol 138 (1980): 1225-6
View all 29 references
Moderate

Beta- 2 Adrenergic Bronchodilators (Includes AirDuo Respiclick) ↔ Seizures

Moderate Potential Hazard, Low plausibility

Applies to: Seizures

Adrenergic bronchodilators may cause CNS stimulation. Therapy with adrenergic bronchodilators should be administered cautiously in patients with seizure disorders. Systemic adverse effects are minimized, but not abolished, by administration of these agents via oral inhalation.

References

  1. "Product Information. Proventil (albuterol)." Schering Laboratories, Kenilworth, NJ.
  2. "Product Information. Alupent (metaproterenol)." Boehringer-Ingelheim, Ridgefield, CT.
  3. "Product Information. Ventolin (albuterol)." Glaxo Wellcome, Research Triangle Park, NC.
  4. "Product Information. Xopenex (levalbuterol)." Sepracor, Marlborough, MA.
  5. Price AH, Clissold SP "Salbutamol in the 1980s. A reappraisal of its clinical efficacy." Drugs 38 (1989): 77-122
  6. "Product Information. Severent (salmeterol)." Glaxo Wellcome, Research Triangle Park, NC.
  7. "Product Information. Maxair (pirbuterol)." 3M Pharmaceuticals, St. Paul, MN.
  8. "Product Information. Tornalate Metered Dose (bitolterol)." Dura Pharmaceuticals, San Diego, CA.
  9. Larsson S, Svedmyr N "Bronchodilating effect and side effects of beta2- adrenoceptor stimulants by different modes of administration (tablets, metered aerosol, and combinations thereof). A study with salbutamol inasthmatics." Am Rev Respir Dis 116 (1977): 861-9
  10. "Product Information. Brethaire (terbutaline)." Novartis Pharmaceuticals, East Hanover, NJ.
View all 10 references
Moderate

Inhaled Corticosteroids (Includes AirDuo Respiclick) ↔ Hepatic Impairment

Moderate Potential Hazard, Moderate plausibility

Applies to: Liver Disease

Corticosteroids are predominantly cleared by hepatic metabolism and impairment of the liver function may lead to their accumulation. Patients with hepatic disease should be closely monitored.

Moderate

Inhaled Corticosteroids (Includes AirDuo Respiclick) ↔ Hyperadrenocorticism

Moderate Potential Hazard, Moderate plausibility

Applies to: Hyperadrenocorticism

The use of inhaled and nasal corticosteroids may rarely precipitate or aggravate conditions of hyperadrenocorticism. Although adverse effects of corticosteroids may be minimized by local rather than systemic administration, the risks are not entirely abolished. Inhaled and nasally applied drug may be absorbed into the circulation, especially when large doses are used. It is important that the recommended dosages of the individual products not be exceeded and that the lowest effective dosage be used. The development of symptoms such as menstrual irregularities, acneiform lesions, cataracts and cushingoid features during inhaled or nasal corticosteroid therapy may indicate excessive use.

References

  1. Monk B, Cunliffe WJ, Layton AM, Rhodes DJ "Acne induced by inhaled corticosteroids." Clin Exp Dermatol 18 (1993): 148-50
  2. "Product Information. Vancenase (beclomethasone)." Glaxo Wellcome, Research Triangle Park, NC.
  3. Barnes PJ "Drug therapy: inhaled glucocorticoids for asthma." N Engl J Med 332 (1995): 868-75
  4. "Product Information. Nasalide (flunisolide)." Syntex Laboratories Inc, Palo Alto, CA.
  5. "Product Information. Nasacort (triamcinolone nasal)." Rhone-Poulenc Rorer, Collegeville, PA.
  6. "Product Information. Flovent (fluticasone)." Glaxo Wellcome, Research Triangle Park, NC.
  7. "Product Information. Rhinocort (budesonide)." Astra USA, Westborough, MA.
  8. "Product Information. Flonase (fluticasone)." Glaxo Wellcome, Research Triangle Park, NC.
  9. Messerli C, Studer H, Scherrer M "Systemic side effects of beclomethasone dipropionate aerosols (becotide, aldecine, sanasthmyl) in otherwise non steroid treated asthmatic patients." Pneumonologie 153 (1975): 29-42
  10. "Product Information. Azmacort (triamcinolone)." Rhone-Polenc Rorer, Collegeville, PA.
  11. Stevens DJ "Cushing's syndrome due to the abuse of betamethasone nasal drops." J Laryngol Otol 102 (1988): 219-21
  12. Edsbacker S, Andersson KE, Ryrfeldt A "Nasal bioavailability and systemic effects of the glucocorticoid budesonide in man." Eur J Clin Pharmacol 29 (1985): 477-81
  13. Wiseman LR, Benfield P "Intranasal fluticasone propionate: A reappraisal of its pharmacology and clinical efficacy in the treatment of rhinitis." Drugs 53 (1997): 885-907
  14. Clark TJ "Safety of inhaled corticosteroids." Eur J Respir Dis Suppl 122 (1982): 235-42
  15. "Product Information. Pulmicort Turbuhaler (budesonide)." Astra USA, Westborough, MA.
  16. Wales D, Makker H, Kane J, McDowell P, ODriscoll BR "Systemic bioavailability and potency of high-dose inhaled corticosteroids - A comparison of four inhaler devices and three drugs in healthy adult volunteers." Chest 115 (1999): 1278-84
  17. McEvoy CE, Niewoehner DE "Adverse effects of corticosteroid therapy for COPD - A critical review." Chest 111 (1997): 732-43
  18. Derom E, Schoor JV, Verhaeghe W, Vincken W, Pauwels R "Systemic effects of inhaled fluticasone propionate and budesonide in adult patients with asthma." Am J Respir Crit Care Med 160 (1999): 157-61
  19. Thorsson L, Dahlstrom K, Edsbacker S, Kallen A, Paulson J, Wiren JE "Pharmacokinetics and systemic effects of inhaled fluticasone propionate in healthy subjects." Br J Clin Pharmacol 43 (1997): 155-61
  20. Kimmerle R, Rolla AR "Iatrogenic Cushing's syndrome due to dexamethasone nasal drops." Am J Med 79 (1985): 535-7
  21. Robinson DS, Geddes DM "Inhaled corticosteroids: benefits and risks." J Asthma 33 (1996): 5-16
  22. "Product Information. Nasonex nasal spray (mometasone topical)." Schering Laboratories, Kenilworth, NJ.
  23. Brogden RN, Heel RC, Speight TM, Avery GS "Beclomethasone dipropionate. A reappraisal of its pharmacodynamic properties and therapeutic efficacy after a decade of use in asthma and rhinitis." Drugs 28 (1984): 99-126
  24. Howland WC "Fluticasone propionate: topical or systemic effects?" Clin Exp Allergy 26 ( Suppl (1996): 18-22
  25. "Product Information. Beclovent (beclomethasone)." Glaxo Wellcome, Research Triangle Park, NC.
  26. Grahnen A, Eckernas SA, Brundin RM, Lingandersson A "An assessment of the systemic activity of single doses of inhaled fluticasone propionate in healthy volunteers." Br J Clin Pharmacol 38 (1994): 521-5
  27. van As A, Bronsky E, Grossman J, Meltzer E, Ratner P, Reed C "Dose tolerance study of fluticasone propionate aqueous nasal spray in patients with seasonal allergic rhinitis." Ann Allergy 67 (1991): 156-62
  28. "Product Information. Aerobid (flunisolide)." Forest Pharmaceuticals, St. Louis, MO.
View all 28 references
Moderate

Inhaled Corticosteroids (Includes AirDuo Respiclick) ↔ Infections

Moderate Potential Hazard, Moderate plausibility

Applies to: Infection - Bacterial/Fungal/Protozoal/Viral, Tuberculosis -- Latent

The immunosuppressant and anti-inflammatory effects of corticosteroids, particularly in higher dosages, may decrease host resistance to infectious agents, decrease the ability to localize infections, and mask the symptoms of infection. Secondary infections may be more likely to develop. Therapy with inhaled and nasal corticosteroids should be administered cautiously in patients with an infection, particularly active or quiescent tuberculosis infection of the respiratory tract or any untreated systemic fungal, bacterial, parasitic, or viral infection. Although adverse effects of corticosteroids may be minimized by local rather than systemic administration, the risks are not entirely abolished. Inhaled and nasally applied drug may be absorbed into the circulation, especially when large doses are used. It is important that the recommended dosages of the individual products not be exceeded and that the lowest effective dosage be used.

References

  1. Executive Committee American Academy of Allergy and Immunology "Inhaled corticosteroids and severe viral infections." J Allergy Clin Immunol 92 (1993): 223-8
  2. Messerli C, Studer H, Scherrer M "Systemic side effects of beclomethasone dipropionate aerosols (becotide, aldecine, sanasthmyl) in otherwise non steroid treated asthmatic patients." Pneumonologie 153 (1975): 29-42
  3. Webb EL "Nasal candidiasis in a patient on long-term topical intranasal corticosteroid therapy." J Allergy Clin Immunol 91 (1993): 680-1
  4. McEvoy CE, Niewoehner DE "Adverse effects of corticosteroid therapy for COPD - A critical review." Chest 111 (1997): 732-43
  5. Carrel TP, Schaffner A, Schmid ER, Schneider J, Bauer EP, Laske A, von Segesser LK, Turina MI "Fatal fungal pericarditis after cardiac surgery and immunosuppression." J Thorac Cardiovasc Surg 101 (1991): 161-4
  6. "Product Information. Azmacort (triamcinolone)." Rhone-Polenc Rorer, Collegeville, PA.
  7. "Product Information. Flonase (fluticasone)." Glaxo Wellcome, Research Triangle Park, NC.
  8. "Product Information. Nasalide (flunisolide)." Syntex Laboratories Inc, Palo Alto, CA.
  9. "Product Information. Nasacort (triamcinolone nasal)." Rhone-Poulenc Rorer, Collegeville, PA.
  10. "Product Information. Flovent (fluticasone)." Glaxo Wellcome, Research Triangle Park, NC.
  11. Toogood JH, Jennings B, Greenway RW, Chuang L "Candidiasis and dysphonia complicating beclomethasone treatment of asthma." J Allergy Clin Immunol 65 (1980): 145-53
  12. "Product Information. Vancenase (beclomethasone)." Glaxo Wellcome, Research Triangle Park, NC.
  13. Edsbacker S, Andersson KE, Ryrfeldt A "Nasal bioavailability and systemic effects of the glucocorticoid budesonide in man." Eur J Clin Pharmacol 29 (1985): 477-81
  14. Milne LJ, Crompton GK "Beclomethasone dipropionate and oropharyngeal candidiasis." Br Med J 3 (1974): 797-8
  15. Shaikh WA "Pulmonary tuberculosis in patients treated with inhaled beclomethasone." Allergy 47 (1992): 327-30
  16. "Product Information. Rhinocort (budesonide)." Astra USA, Westborough, MA.
  17. Howland WC "Fluticasone propionate: topical or systemic effects?" Clin Exp Allergy 26 ( Suppl (1996): 18-22
  18. "Product Information. Beclovent (beclomethasone)." Glaxo Wellcome, Research Triangle Park, NC.
  19. "Product Information. Nasonex nasal spray (mometasone topical)." Schering Laboratories, Kenilworth, NJ.
  20. Brogden RN, Heel RC, Speight TM, Avery GS "Beclomethasone dipropionate. A reappraisal of its pharmacodynamic properties and therapeutic efficacy after a decade of use in asthma and rhinitis." Drugs 28 (1984): 99-126
  21. Horton DJ, Spector SL "Clinical pulmonary tuberculosis in an asthmatic patient using a steroid aerosol." Chest 71 (1977): 540-2
  22. Kesten S, Hyland RH, Pruzanski WR, Kortan PP "Esophageal candidiasis associated with beclomethasone dipropionate aerosol therapy." Drug Intell Clin Pharm 22 (1988): 568-9
  23. Thorsson L, Dahlstrom K, Edsbacker S, Kallen A, Paulson J, Wiren JE "Pharmacokinetics and systemic effects of inhaled fluticasone propionate in healthy subjects." Br J Clin Pharmacol 43 (1997): 155-61
  24. Derom E, Schoor JV, Verhaeghe W, Vincken W, Pauwels R "Systemic effects of inhaled fluticasone propionate and budesonide in adult patients with asthma." Am J Respir Crit Care Med 160 (1999): 157-61
  25. Grahnen A, Eckernas SA, Brundin RM, Lingandersson A "An assessment of the systemic activity of single doses of inhaled fluticasone propionate in healthy volunteers." Br J Clin Pharmacol 38 (1994): 521-5
  26. Vogt FC "The incidence of oral candidiasis with use of inhaled corticosteroids." Ann Allergy 43 (1979): 205-10
  27. Wales D, Makker H, Kane J, McDowell P, ODriscoll BR "Systemic bioavailability and potency of high-dose inhaled corticosteroids - A comparison of four inhaler devices and three drugs in healthy adult volunteers." Chest 115 (1999): 1278-84
  28. "Product Information. Pulmicort Turbuhaler (budesonide)." Astra USA, Westborough, MA.
  29. "Product Information. Aerobid (flunisolide)." Forest Pharmaceuticals, St. Louis, MO.
View all 29 references
Moderate

Inhaled Corticosteroids (Includes AirDuo Respiclick) ↔ Ocular Herpes Simplex

Moderate Potential Hazard, Moderate plausibility

Applies to: Ocular Herpes Simplex

Pharmacologic dosages of corticosteroids may increase the risk of corneal perforation in patients with ocular herpes simplex. Therapy with inhaled and nasal corticosteroids should be administered cautiously in such patients.

References

  1. "Product Information. Pulmicort Turbuhaler (budesonide)." Astra USA, Westborough, MA.
  2. "Product Information. Aerobid (flunisolide)." Forest Pharmaceuticals, St. Louis, MO.
  3. "Product Information. Azmacort (triamcinolone)." Rhone-Polenc Rorer, Collegeville, PA.
  4. "Product Information. Flonase (fluticasone)." Glaxo Wellcome, Research Triangle Park, NC.
  5. "Product Information. Nasalide (flunisolide)." Syntex Laboratories Inc, Palo Alto, CA.
  6. "Product Information. Flovent (fluticasone)." Glaxo Wellcome, Research Triangle Park, NC.
  7. "Product Information. Rhinocort (budesonide)." Astra USA, Westborough, MA.
  8. "Product Information. Nasacort (triamcinolone nasal)." Rhone-Poulenc Rorer, Collegeville, PA.
  9. "Product Information. Vancenase (beclomethasone)." Glaxo Wellcome, Research Triangle Park, NC.
  10. "Product Information. Nasonex nasal spray (mometasone topical)." Schering Laboratories, Kenilworth, NJ.
  11. "Product Information. Beclovent (beclomethasone)." Glaxo Wellcome, Research Triangle Park, NC.
View all 11 references
Moderate

Inhaled Corticosteroids (Includes AirDuo Respiclick) ↔ Ocular Toxicities

Moderate Potential Hazard, Low plausibility

Applies to: Glaucoma/Intraocular Hypertension, Cataracts

Prolonged use of corticosteroids may cause posterior subcapsular cataracts and elevated intraocular pressure, the latter of which may lead to glaucoma and/or damage to the optic nerves. Therapy with inhaled and nasal corticosteroids has only rarely produced these effects but should be administered cautiously nonetheless in patients with a history of cataracts, glaucoma, or increased intraocular pressure. Although adverse effects of corticosteroids may be minimized by local rather than systemic administration, the risks are not entirely abolished. Inhaled and nasally applied drug may be absorbed into the circulation, especially when large doses are used. It is important that the recommended dosages of the individual products not be exceeded and that the lowest effective dosage be used.

References

  1. Allen MB, Ray SG, Leitch AG, Dhillon B, Cullen B "Steroid aerosols and cataract formation." BMJ 299 (1989): 432-3
  2. Barnes PJ "Drug therapy: inhaled glucocorticoids for asthma." N Engl J Med 332 (1995): 868-75
  3. "Product Information. Vancenase (beclomethasone)." Glaxo Wellcome, Research Triangle Park, NC.
  4. Edsbacker S, Andersson KE, Ryrfeldt A "Nasal bioavailability and systemic effects of the glucocorticoid budesonide in man." Eur J Clin Pharmacol 29 (1985): 477-81
  5. Messerli C, Studer H, Scherrer M "Systemic side effects of beclomethasone dipropionate aerosols (becotide, aldecine, sanasthmyl) in otherwise non steroid treated asthmatic patients." Pneumonologie 153 (1975): 29-42
  6. Fraunfelder FT, Meyer SM "Posterior subcapsular cataracts associated with nasal or inhalation corticosteroids." Am J Ophthalmol 109 (1990): 489-90
  7. "Product Information. Rhinocort (budesonide)." Astra USA, Westborough, MA.
  8. "Product Information. Nasacort (triamcinolone nasal)." Rhone-Poulenc Rorer, Collegeville, PA.
  9. Ghanchi F "Young patients on inhaled steroids and cataract." Lancet 342 (1993): 1306-7
  10. Howland WC "Fluticasone propionate: topical or systemic effects?" Clin Exp Allergy 26 ( Suppl (1996): 18-22
  11. Cumming RG, Mitchell P, Leeder SR "Use of inhaled corticosteroids and the risk of cataracts." N Engl J Med 337 (1997): 8-14
  12. "Product Information. Nasonex nasal spray (mometasone topical)." Schering Laboratories, Kenilworth, NJ.
  13. Wales D, Makker H, Kane J, McDowell P, ODriscoll BR "Systemic bioavailability and potency of high-dose inhaled corticosteroids - A comparison of four inhaler devices and three drugs in healthy adult volunteers." Chest 115 (1999): 1278-84
  14. Agertoft L, Larsen FE, Pedersen S "Posterior subcapsular cataracts, bruises and hoarseness in children with asthma receiving long-term treatment with inhaled budesonide." Eur Resp J 12 (1998): 130-5
  15. "Product Information. Flonase (fluticasone)." Glaxo Wellcome, Research Triangle Park, NC.
  16. "Product Information. Beclovent (beclomethasone)." Glaxo Wellcome, Research Triangle Park, NC.
  17. "Product Information. Flovent (fluticasone)." Glaxo Wellcome, Research Triangle Park, NC.
  18. "Product Information. Aerobid (flunisolide)." Forest Pharmaceuticals, St. Louis, MO.
  19. "Product Information. Nasalide (flunisolide)." Syntex Laboratories Inc, Palo Alto, CA.
  20. McEvoy CE, Niewoehner DE "Adverse effects of corticosteroid therapy for COPD - A critical review." Chest 111 (1997): 732-43
  21. "Product Information. Azmacort (triamcinolone)." Rhone-Polenc Rorer, Collegeville, PA.
  22. "Product Information. Pulmicort Turbuhaler (budesonide)." Astra USA, Westborough, MA.
  23. Grahnen A, Eckernas SA, Brundin RM, Lingandersson A "An assessment of the systemic activity of single doses of inhaled fluticasone propionate in healthy volunteers." Br J Clin Pharmacol 38 (1994): 521-5
  24. Spaeth GL, Rodrigues MM, Weinreb S "Steroid-induced glaucoma: A. Persistent elevation of intraocular pressure B. Histopathological aspects." Trans Am Ophthalmol Soc 75 (1977): 353-81
  25. Thorsson L, Dahlstrom K, Edsbacker S, Kallen A, Paulson J, Wiren JE "Pharmacokinetics and systemic effects of inhaled fluticasone propionate in healthy subjects." Br J Clin Pharmacol 43 (1997): 155-61
  26. Dreyer EB "Inhaled steroid use and glaucoma." N Engl J Med 329 (1993): 1822
  27. Garbe E, LeLorier J, Boivin JF, Suissa S "Inhaled and nasal glucocorticoids and the risks of ocular hypertension or open-angle glaucoma." JAMA 277 (1997): 722-7
  28. Karim AK, Thompson GM, Jacob TJ "Steroid aerosols and cataract formation." BMJ 299 (1989): 918
  29. Kewley GD "Possible association between beclomethasone diproprionate aerosol and cataracts." Aust Paediatr J 16 (1980): 117-8
  30. Derom E, Schoor JV, Verhaeghe W, Vincken W, Pauwels R "Systemic effects of inhaled fluticasone propionate and budesonide in adult patients with asthma." Am J Respir Crit Care Med 160 (1999): 157-61
View all 30 references
Moderate

Inhaled Corticosteroids (Includes AirDuo Respiclick) ↔ Osteoporosis

Moderate Potential Hazard, Moderate plausibility

Applies to: Osteoporosis

Prolonged use of inhaled corticosteroids may be associated with a reduction in bone density. This effect appears to be dose-related and has been reported primarily with high dosages (>= 800 mcg/day of beclomethasone or equivalent for >= 1 year). Reduced levels of total body calcium have also been demonstrated in patients receiving lower dosages. Long-term therapy with inhaled and nasal corticosteroids should be administered cautiously in patients with osteoporosis. It is important that the recommended dosages of the individual products not be exceeded and that the lowest effective dosage be used.

References

  1. Luengo M, delRio L, Pons F, Picado C "Bone mineral density in asthmatic patients treated with inhaled corticosteroids: a case-control study." Eur Respir J 10 (1997): 2110-3
  2. Martinati LC, Bertoldo F, Gasperi E, Micelli S, Boner AL "Effect on cortical and trabecular bone mass of different anti-inflammatory treatments in preadolescent children with chronic asthma." Am J Respir Crit Care Med 153 (1996): 232-6
  3. Wiseman LR, Benfield P "Intranasal fluticasone propionate: A reappraisal of its pharmacology and clinical efficacy in the treatment of rhinitis." Drugs 53 (1997): 885-907
  4. Barnes PJ "Drug therapy: inhaled glucocorticoids for asthma." N Engl J Med 332 (1995): 868-75
  5. Edsbacker S, Andersson KE, Ryrfeldt A "Nasal bioavailability and systemic effects of the glucocorticoid budesonide in man." Eur J Clin Pharmacol 29 (1985): 477-81
  6. Israel E, Banerjee TR, Fitzmaurice GM, Kotlov TV, LaHive K, LeBoff MS "Effects of inhaled glucocorticoids on bone density in premenopausal women." N Engl J Med 345 (2001): 941-7
  7. Toogood JH, Baskerville JC, Markov AE, Hodsman AB, Fraher LJ, Jennings B, Haddad RG, Drost D "Bone mineral density and the risk of fracture in patients receiving long-term inhaled steroid therapy for asthma." J Allergy Clin Immunol 96 (1995): 157-66
  8. Grahnen A, Eckernas SA, Brundin RM, Lingandersson A "An assessment of the systemic activity of single doses of inhaled fluticasone propionate in healthy volunteers." Br J Clin Pharmacol 38 (1994): 521-5
  9. Reid DM, Nicoll JJ, Smith MA, Higgins B, Tothill P, Nuki G "Corticosteroids and bone mass in asthma: comparisons with rheumatoid arthritis and polymyalgia rheumatica." BMJ 293 (1986): 1463-6
  10. Thorsson L, Dahlstrom K, Edsbacker S, Kallen A, Paulson J, Wiren JE "Pharmacokinetics and systemic effects of inhaled fluticasone propionate in healthy subjects." Br J Clin Pharmacol 43 (1997): 155-61
  11. Packe GE, Douglas JG, McDonald AF, Robins SP, Reid DM "Bone density in asthmatic patients taking high dose inhaled beclomethasone diproprionate and intermittent systemic corticosteroids." Thorax 47 (1992): 414-7
  12. Boulet LP, Milot J, Gagnon L, Poubelle PE, Brown J "Long-term influence of inhaled corticosteroids on bone metabolism and density. Are biological markers predictors of bone loss?" Am J Respir Crit Care Med 159 (1999): 838-44
  13. McEvoy CE, Niewoehner DE "Adverse effects of corticosteroid therapy for COPD - A critical review." Chest 111 (1997): 732-43
  14. Derom E, Schoor JV, Verhaeghe W, Vincken W, Pauwels R "Systemic effects of inhaled fluticasone propionate and budesonide in adult patients with asthma." Am J Respir Crit Care Med 160 (1999): 157-61
  15. Kinberg KA, Hopp RJ, Biven RE, Gallagher JC "Bone mineral density in normal and asthmatic children." J Allergy Clin Immunol 94 (1994): 490-7
  16. Howland WC "Fluticasone propionate: topical or systemic effects?" Clin Exp Allergy 26 ( Suppl (1996): 18-22
  17. Konig P, Hillman L, Cervantes C, Levine C, Maloney C, Douglass B, Johnson L, Allen S "Bone metabolism in children with asthma treated with inhaled beclomethasone dipropionate." J Pediatr 122 (1993): 219-26
  18. Toogood JH, Crilly RG, Jones G, Nadeau J, Wells GA "Effect of high-dose inhaled budesonide on calcium and phosphate metabolism and the risk of osteoporosis." Am Rev Respir Dis 138 (1988): 57-61
  19. Wisniewski AF, Lewis SA, Green DJ, Maslanka W, Burrell H, Tattersfield AE "Cross sectional investigation of the effects of inhaled corticosteroids on bone density and bone metabolism in patients with asthma." Thorax 52 (1997): 853-60
  20. Packe GE, Robb O, Robins SP, Reid DM, Douglas JG "Bone density in asthmatic patients taking inhaled corticosteroids: comparison of budesonide and beclomethasone dipropionate." J R Coll Physicians Lond 30 (1996): 128-32
  21. Hanania NA, Chapman KR, Sturtridge WC, Szalai JP, Kesten S "Dose-related decrease in bone density among asthmatic patients treated with inhaled corticosteroids." J Allergy Clin Immunol 96 (1995): 571-9
  22. Wong CA, Walsh LJ, Smith CJP, Wisniewski AF, Lewis SA, Hubbard R, Cawte S, Green DJ, Pringle M, Tattersfield AE "Inhaled corticosteroid use and bone-mineral density in patients with asthma." Lancet 355 (2000): 1399-403
  23. Ali NJ, Capewell S, Ward MJ "Bone turnover during high dose inhaled corticosteroid treatment." Thorax 46 (1991): 160-4
  24. Sharma PK, Malhotra S, Pandhi P, Kumar N "Effect of inhaled steroids on bone mineral density: a meta-analysis." J Clin Pharmacol 43 (2003): 193-7
View all 24 references
Moderate

Salmeterol (Includes AirDuo Respiclick) ↔ Hepatic Dysfunction

Moderate Potential Hazard, Moderate plausibility

Applies to: Liver Disease

Salmeterol is predominantly cleared by hepatic metabolism and liver dysfunction might lead to accumulation of salmeterol in plasma. Patients with hepatic disease should be closely monitored.

AirDuo Respiclick (fluticasone / salmeterol) drug Interactions

There are 801 drug interactions with AirDuo Respiclick (fluticasone / salmeterol)

AirDuo Respiclick (fluticasone / salmeterol) alcohol/food Interactions

There is 1 alcohol/food interaction with AirDuo Respiclick (fluticasone / salmeterol)

Drug Interaction Classification

The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No information available.

Do not stop taking any medications without consulting your healthcare provider.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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