Seroflo 250 Ciphaler

When prescribed for an appropriate patient the combination supports the following treatment goals.

• Reduced airway inflammation

• Longer lasting bronchodilation

• Better control of recurring asthma symptoms

• Reduced need for rescue treatment when asthma control improves

Ask your pharmacist or asthma nurse to watch you use the Ciphaler. A demonstration followed by practice helps identify errors. Dry powder devices need an adequate inhalation effort. Tell the clinician if you struggle to draw a dose through the mouthpiece.

Fluticasone propionate is an inhaled corticosteroid. It reduces inflammation and swelling in the airways. This helps address an important part of asthma rather than only the sensation of tight breathing.

Salmeterol is a long acting beta 2 agonist. It relaxes airway smooth muscle and helps air move through the lungs more easily. The two ingredients work together in a maintenance treatment plan.

The full treatment benefit develops with regular use. Do not judge the inhaler by whether it gives immediate relief after one puff. Continue the prescribed schedule even on days when breathing feels comfortable.

Seroflo contains salmeterol rather than formoterol. It is not used for maintenance and reliever therapy with extra doses for sudden symptoms. Follow your separate rescue treatment instructions instead.

Cipla  prescribing information lists one inhalation twice daily for Seroflo 250 Ciphaler. Use the dose and schedule selected by your prescriber. The 250 mcg and 50 mcg figures describe the ingredients in one dose.

Do not copy the puff schedule from a Seroflo spray inhaler. One Ciphaler inhalation is a different dose presentation. Ask a pharmacist to check the exact product if the prescription or carton is unclear.

The 50 mcg and 250 mcg Ciphaler leaflet provides dosing for adults and adolescents aged 12 years and older. Younger children need a separate treatment assessment. Confirm age suitability from the supplied product leaflet.

For the standard thumbgrip and lever Ciphaler the basic steps are as follows.

• Open the device using the thumbgrip

• Slide the loading lever fully until it clicks

• Breathe out comfortably away from the mouthpiece

• Place your lips around the mouthpiece

• Breathe in steadily and deeply through your mouth

• Remove the device and hold your breath for about ten seconds or as long as comfortable

• Breathe out away from the device

• Rinse your mouth with water and spit it out

• Close the Ciphaler after use

Follow the actual leaflet and ask a pharmacist to watch your technique. Do not breathe into the device or repeatedly move the lever. Repeated loading wastes doses.

For a missed dose take the next scheduled dose at the usual time. Do not double it. Seek prompt medical advice if you use more than prescribed. Chest pain or severe breathing difficulty requires emergency help.

Reported side effects of fluticasone and salmeterol include headache and trembling. Throat irritation and a hoarse voice also occur. The steroid component increases the risk of oral thrush. White patches or soreness in the mouth need a pharmacist or clinician's assessment. Rinsing and spitting after each dose helps reduce local side effects. Report symptoms that persist or interfere with daily life.

Get emergency help for severe breathing difficulty or swelling of the face or throat. If wheezing increases immediately after inhalation then stop using that inhaler and seek urgent medical advice. Use your prescribed rescue treatment as directed. Chest pain or fainting requires immediate attention. Report a fast or irregular heartbeat promptly. Longer term steroid treatment also requires review for effects on the eyes and other health risks. Report blurred vision or other new visual symptoms.

Do not use Seroflo if you are allergic to either active ingredient or an excipient in the supplied product. Ciphaler powder formulations contain lactose with traces of milk proteins. A severe milk protein allergy requires a different product selected by a clinician. Lactose intolerance is a separate concern to discuss with a pharmacist. These situations also need review.

• Heart disease or an irregular heartbeat

• High blood pressure

• An overactive thyroid

• Diabetes

• Low blood potassium

• Current or previous tuberculosis

• Other significant infections

• Glaucoma or cataracts

• Osteoporosis or increased fracture risk

• Pregnancy or breastfeeding

Children need an age appropriate strength and device assessment. Do not use an adult prescription for a child. Growth monitoring is relevant when children use inhaled corticosteroids over time.

Do not start Seroflo as an emergency response to an asthma attack. Follow the prescribed rescue plan and seek help when symptoms are severe or fail to improve.

Ask a pharmacist to check everything you take. Include inhalers and tablets as well as supplements. The following groups need attention.

• Other long acting beta agonists

• Beta blockers such as propranolol

• Ritonavir and cobicistat

• Strong antifungals such as ketoconazole and itraconazole

• Diuretics that lower potassium

• Theophylline and related medicines

• Systemic corticosteroids

• Monoamine oxidase inhibitors and tricyclic antidepressants

Do not add another inhaler containing a long acting beta agonist yourself. Different brand names contain overlapping ingredients. Show your pharmacist the packaging before changing treatment.

Some medicines increase exposure to fluticasone or salmeterol. Others affect heart rhythm or blood potassium. The clinician decides whether a combination should be avoided or monitored.

• Follow the storage conditions printed on the supplied pack

• Keep the device closed when not in use

• Protect it from excessive heat and moisture

• Keep the powder inhaler dry

• Wipe the mouthpiece with a dry tissue as directed

• Do not wash the device in water

• Keep it out of sight and reach of children

• Check the expiry date and remaining dose counter

• Return unused or expired medicine to a pharmacy for disposal

The counter shows the number of doses remaining. Arrange a replacement before it reaches zero. Do not rely on shaking the device to judge whether it still contains medicine.