Asthma/COPD:

Indications for QVAR REDIHALER:

Maintenance treatment of asthma as prophylactic therapy. Limitations of use: not for the relief of acute bronchospasm.

Limitations of Use:

Not for the relief of acute bronchospasm.

Adult:

Previously not on inhaled corticosteroids: initially 40–80mcg twice daily (approx. 12hrs apart). Previously on inhaled corticosteroids: initially 40–320mcg twice daily. Both: if insufficient response after 2 weeks, increasing the dose may provide additional asthma control; max 320mcg twice daily. Titrate to lowest effective dose after stability achieved. Rinse mouth after use.

Children:

<4yrs: not established. 4–11yrs: initially 40mcg twice daily (approx. 12hrs apart). If insufficient response after 2 weeks, increasing the dose may provide additional asthma control; max 80mcg twice daily. Titrate to lowest effective dose after stability achieved. Rinse mouth after use.

Contraindications:

Primary treatment of status asthmaticus or other acute episodes of asthma requiring intensive measures.

Warnings/Precautions:

Do not exceed recommended dose. Risk of local infections (eg, mouth/pharynx candidiasis). Prescribe a short-acting, inhaled β2-agonist for acute symptoms; monitor for increased need. Immunosuppression: active or quiescent tuberculosis, systemic infections, ocular herpes simplex. If exposed to chickenpox or measles, consider immune globulin or antiviral ­prophylactic therapies. Monitor for signs/symptoms of adrenal insufficiency when transferring from systemic corticosteroids. May need supplemental systemic corticosteroids during periods of stress or a severe asthma attack. May unmask previously suppressed allergic conditions. Eosinophilic conditions. Reevaluate periodically. Monitor for hypercorticism and HPA axis suppression (if occurs, discontinue gradually), growth in children, or any visual changes. Discontinue if paradoxical bronchospasm occurs; use alternative therapy. Assess bone mineral density if risk factors exist (eg, prolonged immobilization, osteoporosis, or chronic use of drugs that can reduce bone mass [eg, anticonvulsants, oral steroids]). Elderly. Pregnancy: monitor closely. Nursing mothers.

Pharmacologic Class:

Steroid.

Adverse Reactions:

Oral candidiasis, upper respiratory tract infection, nasopharyngitis, allergic rhinitis, oropharyngeal pain, sinusitis; rare: hypersensitivity reactions, psychiatric events and behavioral changes (esp in children).

Metabolism:

Hepatic (CYP3A).

Elimination:

Fecal.

Generic Availability:

NO

How Supplied:

Inhalation aerosol (w. dose counter)—10.6g (120 inh)