Fluticasone Propionate + Formoterol Fumarate interactions

Checked as Fluticasone + Formoterol in this data source.

Full monograph for Fluticasone Propionate + Formoterol Fumarate Check it against another medicine

Medicines

678 documented

Severity

Mechanism

Medicines documented to interact with Fluticasone Propionate + Formoterol Fumarate, worst severity first.
Medicine	Severity	Mechanism	Effect	Sources
Bimatoprost + Timololvia Fluticasone, Formoterol	Major	Antagonism · Unknown	Beta-blockers may antagonize the effects of beta-2 adrenergic bronchodilators and precipitate acute, life-threatening bronchospasm in patients with asthma or…3 documented mechanisms	40 sources — open the full entry
Brimonidine Tartrate + Timolol Maleatevia Fluticasone, Formoterol	Major	Antagonism · Unknown	Beta-blockers may antagonize the effects of beta-2 adrenergic bronchodilators and precipitate acute, life-threatening bronchospasm in patients with asthma or…4 documented mechanisms	40 sources — open the full entry
Brinzolamide + Timololvia Fluticasone, Formoterol	Major	Antagonism · Unknown	Beta-blockers may antagonize the effects of beta-2 adrenergic bronchodilators and precipitate acute, life-threatening bronchospasm in patients with asthma or…3 documented mechanisms	40 sources — open the full entry
Carvedilolvia Fluticasone, Formoterol	Major	Antagonism · Unknown	Beta-blockers may antagonize the effects of beta-2 adrenergic bronchodilators and precipitate acute, life-threatening bronchospasm in patients with asthma or…2 documented mechanisms	40 sources — open the full entry
Ceritinibvia Fluticasone, Formoterol	Major	Metabolism · Synergy	Coadministration with potent inhibitors of CYP450 3A4 may increase the systemic exposure to fluticasone following intranasal administration or oral inhalation…2 documented mechanisms	70 sources — open the full entry
Clarithromycinvia Fluticasone, Formoterol	Major	Metabolism · Synergy	Coadministration with potent inhibitors of CYP450 3A4 may increase the systemic exposure to fluticasone following intranasal administration or oral inhalation…2 documented mechanisms	70 sources — open the full entry
Desmopressin Acetatevia Fluticasone	Major	Synergy	Coadministration of desmopressin with loop diuretics or systemic or inhaled corticosteroids may increase the risk of severe hyponatremia. Loop diuretics and…	9 sources — open the full entry
Dorzolamide + Timololvia Fluticasone, Formoterol	Major	Antagonism · Unknown	Beta-blockers may antagonize the effects of beta-2 adrenergic bronchodilators and precipitate acute, life-threatening bronchospasm in patients with asthma or…2 documented mechanisms	40 sources — open the full entry
Esomeprazole + Amoxicillin + Clarithromycinvia Fluticasone, Formoterol	Major	Metabolism · Synergy · Unknown	Coadministration with potent inhibitors of CYP450 3A4 may increase the systemic exposure to fluticasone following intranasal administration or oral inhalation…3 documented mechanisms	70 sources — open the full entry
Itraconazolevia Fluticasone	Major	Metabolism	Coadministration with potent inhibitors of CYP450 3A4 may increase the systemic exposure to fluticasone following intranasal administration or oral inhalation…	40 sources — open the full entry
Ketoconazolevia Fluticasone, Formoterol	Major	Metabolism · Synergy	Coadministration with potent inhibitors of CYP450 3A4 may increase the systemic exposure to fluticasone following intranasal administration or oral inhalation…2 documented mechanisms	70 sources — open the full entry
Ketoconazole + Zinc Pyrithione + Aleoveravia Fluticasone, Formoterol	Major	Metabolism · Synergy	Coadministration with potent inhibitors of CYP450 3A4 may increase the systemic exposure to fluticasone following intranasal administration or oral inhalation…2 documented mechanisms	70 sources — open the full entry
Labetalol Hydrochloridevia Fluticasone, Formoterol	Major	Antagonism · Unknown	Beta-blockers may antagonize the effects of beta-2 adrenergic bronchodilators and precipitate acute, life-threatening bronchospasm in patients with asthma or…2 documented mechanisms	40 sources — open the full entry
Lansoprazole + Amoxicillin + Clarithromycinvia Fluticasone, Formoterol	Major	Metabolism · Synergy · Unknown	Coadministration with potent inhibitors of CYP450 3A4 may increase the systemic exposure to fluticasone following intranasal administration or oral inhalation…5 documented mechanisms	70 sources — open the full entry
Latanoprost + Timololvia Fluticasone, Formoterol	Major	Antagonism · Unknown	Beta-blockers may antagonize the effects of beta-2 adrenergic bronchodilators and precipitate acute, life-threatening bronchospasm in patients with asthma or…3 documented mechanisms	40 sources — open the full entry
Lopinavir + Ritonavirvia Fluticasone, Formoterol	Major	Metabolism · Synergy	Coadministration with ritonavir may significantly increase the systemic exposure to fluticasone following intranasal administration or oral inhalation. The…3 documented mechanisms	95 sources — open the full entry
Mifepristonevia Fluticasone, Formoterol	Major	Antagonism · Metabolism · Synergy	Mifepristone is a potent antiglucocorticoid and may antagonize the effects of corticosteroids. Pharmacokinetically, mifepristone may increase the plasma…2 documented mechanisms	34 sources — open the full entry
Mifepristone + Misoprostolvia Fluticasone, Formoterol	Major	Antagonism · Metabolism · Synergy · Unknown	Mifepristone is a potent antiglucocorticoid and may antagonize the effects of corticosteroids. Pharmacokinetically, mifepristone may increase the plasma…3 documented mechanisms	34 sources — open the full entry
Nelfinavirvia Fluticasone	Major	Metabolism	Coadministration with potent inhibitors of CYP450 3A4 may increase the systemic exposure to fluticasone following intranasal administration or oral inhalation…	40 sources — open the full entry
Nirmatrelvir + Ritonavirvia Fluticasone	Major	Metabolism	Coadministration with ritonavir may significantly increase the systemic exposure to fluticasone following intranasal administration or oral inhalation. The…	35 sources — open the full entry
Posaconazolevia Fluticasone, Formoterol	Major	Metabolism · Synergy	Coadministration with potent inhibitors of CYP450 3A4 may increase the systemic exposure to fluticasone following intranasal administration or oral inhalation…2 documented mechanisms	70 sources — open the full entry
Propranolol Hydrochloridevia Fluticasone, Formoterol	Major	Antagonism · Unknown	Beta-blockers may antagonize the effects of beta-2 adrenergic bronchodilators and precipitate acute, life-threatening bronchospasm in patients with asthma or…2 documented mechanisms	40 sources — open the full entry
Rabeprazole + Amoxicillin + Clarithromycinvia Fluticasone, Formoterol	Major	Metabolism · Synergy · Unknown	Coadministration with potent inhibitors of CYP450 3A4 may increase the systemic exposure to fluticasone following intranasal administration or oral inhalation…5 documented mechanisms	70 sources — open the full entry
Ribociclibvia Fluticasone, Formoterol	Major	Metabolism · Synergy	Ribociclib can cause dose-related prolongation of the QT interval. Theoretically, coadministration with other agents that can prolong the QT interval may…2 documented mechanisms	23 sources — open the full entry
Sotalol Hydrochloridevia Fluticasone, Formoterol	Major	Antagonism · Unknown	Beta-blockers may antagonize the effects of beta-2 adrenergic bronchodilators and precipitate acute, life-threatening bronchospasm in patients with asthma or…2 documented mechanisms	40 sources — open the full entry
Timolol Maleatevia Fluticasone, Formoterol	Major	Antagonism · Unknown	Beta-blockers may antagonize the effects of beta-2 adrenergic bronchodilators and precipitate acute, life-threatening bronchospasm in patients with asthma or…2 documented mechanisms	40 sources — open the full entry
Travoprost + Timolol Maleatevia Fluticasone, Formoterol	Major	Antagonism · Unknown	Beta-blockers may antagonize the effects of beta-2 adrenergic bronchodilators and precipitate acute, life-threatening bronchospasm in patients with asthma or…3 documented mechanisms	40 sources — open the full entry
Tucatinibvia Fluticasone	Major	Metabolism	Coadministration with potent inhibitors of CYP450 3A4 may increase the systemic exposure to fluticasone following intranasal administration or oral inhalation…	40 sources — open the full entry
Vonoprazan + Amoxicillin + Clarithromycinvia Fluticasone, Formoterol	Major	Metabolism · Synergy · Unknown	Coadministration with potent inhibitors of CYP450 3A4 may increase the systemic exposure to fluticasone following intranasal administration or oral inhalation…3 documented mechanisms	70 sources — open the full entry
Voriconazolevia Fluticasone, Formoterol	Major	Metabolism · Synergy	Coadministration with potent inhibitors of CYP450 3A4 may increase the systemic exposure to fluticasone following intranasal administration or oral inhalation…2 documented mechanisms	70 sources — open the full entry
Abametapirvia Fluticasone	Moderate	Metabolism	Based on in vitro inhibition data, a single topical application of abametapir lotion may increase plasma concentrations of drugs that are substrates of CYP450…	1 sources — open the full entry
Abiraterone Acetatevia Formoterol	Moderate	Synergy	Beta-2 adrenergic agonists can cause dose-related prolongation of the QT interval and potassium loss. Theoretically, coadministration with other agents that…	30 sources — open the full entry
Acarbosevia Formoterol	Moderate	Antagonism	The efficacy of insulin and other antidiabetic agents may be diminished by certain drugs, including atypical antipsychotics, corticosteroids, diuretics…	95 sources — open the full entry
Acetazolamidevia Formoterol	Moderate	Synergy	Coadministration with beta-2 adrenergic agonists may potentiate the hypokalemic effects of potassium-wasting diuretics. Beta-2 agonists can cause clinically…	8 sources — open the full entry
Adrenalinevia Fluticasone, Formoterol	Moderate	Synergy · Unknown	Coadministration of beta-2 adrenergic agonists with other adrenergic agents may potentiate the risk of cardiovascular side effects. Beta-2 adrenergic agonists…2 documented mechanisms	11 sources — open the full entry
Alfuzosin Hydrochloridevia Fluticasone, Formoterol	Moderate	Synergy · Unknown	Beta-2 adrenergic agonists can cause dose-related prolongation of the QT interval and potassium loss. Theoretically, coadministration with other agents that…2 documented mechanisms	30 sources — open the full entry
Alogliptin Benzoatevia Formoterol	Moderate	Antagonism	The efficacy of insulin and other antidiabetic agents may be diminished by certain drugs, including atypical antipsychotics, corticosteroids, diuretics…	95 sources — open the full entry
Aminophyllinevia Fluticasone, Formoterol	Moderate	Synergy · Unknown	Concomitant use of beta-2 adrenergic agonists with theophylline may increase the risk and/or severity of hypokalemia and adverse cardiovascular effects such as…2 documented mechanisms	26 sources — open the full entry
Amiodarone Hydrochloridevia Fluticasone, Formoterol	Moderate	Synergy · Unknown	Beta-2 adrenergic agonists can cause dose-related prolongation of the QT interval and potassium loss. Theoretically, coadministration with other agents that…2 documented mechanisms	30 sources — open the full entry
Amisulpridevia Formoterol	Moderate	Synergy	Beta-2 adrenergic agonists can cause dose-related prolongation of the QT interval and potassium loss. Theoretically, coadministration with other agents that…	30 sources — open the full entry
Amitriptyline Hydrochloridevia Fluticasone, Formoterol	Moderate	Synergy · Unknown	Concomitant use of beta-2 adrenergic agonists with tricyclic antidepressants (TCAs) may increase the risk and/or severity of cardiovascular adverse effects…2 documented mechanisms	11 sources — open the full entry
Amitriptyline Hydrochloride + Chlordiazepoxidevia Fluticasone, Formoterol	Moderate	Synergy · Unknown	Concomitant use of beta-2 adrenergic agonists with tricyclic antidepressants (TCAs) may increase the risk and/or severity of cardiovascular adverse effects…2 documented mechanisms	11 sources — open the full entry
Amlodipine Besilate + Atenololvia Fluticasone, Formoterol	Moderate	Others · Unknown	Although cardioselective beta-blockers do not generally inhibit the bronchodilating effect of beta-2 adrenergic agonists, they may worsen pulmonary function in…4 documented mechanisms	26 sources — open the full entry
Antazoline + Tetryzolinevia Formoterol	Moderate	Synergy	Coadministration of beta-2 adrenergic agonists with other adrenergic agents may potentiate the risk of cardiovascular side effects. Beta-2 adrenergic agonists…	11 sources — open the full entry
Apalutamidevia Fluticasone, Formoterol	Moderate	Absorption · Metabolism · Synergy	Coadministration with apalutamide may decrease the plasma concentrations and therapeutic effects of drugs that are substrates of CYP450 3A4, 2C9, 2C19, breast…2 documented mechanisms	35 sources — open the full entry
Aprepitantvia Fluticasone	Moderate	Metabolism	Coadministration with moderate inhibitors of CYP450 3A4 may increase the systemic exposure to fluticasone following intranasal administration or oral…	7 sources — open the full entry
Arformoterol Tartratevia Fluticasone, Formoterol	Moderate	Synergy	Coadministration of beta-2 adrenergic agonists with other adrenergic agents may potentiate the risk of cardiovascular side effects. Beta-2 adrenergic agonists…2 documented mechanisms	15 sources — open the full entry
Aripiprazolevia Fluticasone, Formoterol	Moderate	Others · Unknown	It is uncertain whether aripiprazole causes clinically significant prolongation of the QT interval.2 documented mechanisms	20 sources — open the full entry
Armodafinilvia Formoterol	Moderate	Synergy	Coadministration of beta-2 adrenergic agonists with other adrenergic agents may potentiate the risk of cardiovascular side effects. Beta-2 adrenergic agonists…	11 sources — open the full entry
Arsenic Trioxidevia Formoterol	Moderate	Synergy	Beta-2 adrenergic agonists can cause dose-related prolongation of the QT interval and potassium loss. Theoretically, coadministration with other agents that…	30 sources — open the full entry

Conditions

Conditions in which Fluticasone Propionate + Formoterol Fumarate needs care, as documented in this source.

Adrenocortical Hyperfunction
Moderate
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.
30 sources
1. Kimmerle R, Rolla AR "Iatrogenic Cushing's syndrome due to dexamethasone nasal drops." Am J Med 79 (1985): 535-7
2. Monk B, Cunliffe WJ, Layton AM, Rhodes DJ "Acne induced by inhaled corticosteroids." Clin Exp Dermatol 18 (1993): 148-50
3. 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
4. Clark TJ "Safety of inhaled corticosteroids." Eur J Respir Dis Suppl 122 (1982): 235-42
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. "Product Information. Beclovent (beclomethasone)." Glaxo Wellcome (2001):
7. "Product Information. Vancenase (beclomethasone)." Glaxo Wellcome (2001):
8. "Product Information. AeroBid (flunisolide)." Forest Pharmaceuticals (2022):
Show all 30 sourcesShow fewer sources
1. "Product Information. Nasalide (flunisolide)." Syntex Laboratories Inc (2001):
2. 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
3. Stevens DJ "Cushing's syndrome due to the abuse of betamethasone nasal drops." J Laryngol Otol 102 (1988): 219-21
4. 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
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. "Product Information. Flonase (fluticasone)." Glaxo Wellcome (2001):
7. Barnes PJ "Drug therapy: inhaled glucocorticoids for asthma." N Engl J Med 332 (1995): 868-75
8. "Product Information. Rhinocort (budesonide)." Astra-Zeneca Pharmaceuticals (2001):
9. Robinson DS, Geddes DM "Inhaled corticosteroids: benefits and risks." J Asthma 33 (1996): 5-16
10. Howland WC "Fluticasone propionate: topical or systemic effects?" Clin Exp Allergy 26 ( Suppl (1996): 18-22
11. "Product Information. Flovent (fluticasone)." Glaxo Wellcome (2001):
12. 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
13. McEvoy CE, Niewoehner DE "Adverse effects of corticosteroid therapy for COPD - A critical review." Chest 111 (1997): 732-43
14. 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
15. "Product Information. Nasonex (mometasone nasal)." Scherer Laboratories Inc
16. "Product Information. Pulmicort Turbuhaler (budesonide)." Astra-Zeneca Pharmaceuticals (2001):
17. "Product Information. Azmacort (triamcinolone)." Rhone Poulenc Rorer (2001):
18. "Product Information. Nasacort (triamcinolone nasal)." Rhone Poulenc Rorer (2001):
19. 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
20. 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
21. "Product Information. Alvesco (ciclesonide)." Nycomed USA (2008):
22. "Product Information. Omnaris (ciclesonide nasal)." Sepracor Inc (2008):
Cardiovascular Diseases
Moderate
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.
51 sources
1. Chazan R, Droszcz W, Maruchin JE "Pharmacodynamics of salbutamol in humans." Int J Clin Pharmacol Ther Toxicol 26 (1988): 385-7
2. 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
3. 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
4. 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
5. 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
6. Godfrey S "Worldwide experience with albuterol (salbutamol)." Ann Allergy 47 (1981): 423-6
7. Finch JS "Cardiovascular toxicity: clinical evaluation of albuterol, isoproterenol and placebo in rising dose tolerance trial." Ann Allergy 47 (1981): 402-4
8. Neville E, Corris PA, Vivian J, Nariman S, Gibson GJ "Nebulised salbutamol and angina." Br Med J (Clin Res Ed) 285 (1982): 796-7
Show all 51 sourcesShow fewer sources
1. Breeden CC, Safirstein BH "Albuterol and spacer-induced atrial fibrillation." Chest 98 (1990): 762-3
2. 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
3. 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
4. Shovlin CL, Tam FW "Salbutamol nebuliser and precipitation of critical cardiac ischaemia." Lancet 336 (1990): 1258
5. 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
6. Price AH, Clissold SP "Salbutamol in the 1980s. A reappraisal of its clinical efficacy." Drugs 38 (1989): 77-122
7. Richards DM, Brogden RN "Pirbuterol. A preliminary review of its pharmacological properties and therapeutic efficacy in reversible bronchospastic disease." Drugs 30 (1985): 6-21
8. 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
9. 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
10. Bengtsson B, Fagerstrom PO "Extrapulmonary effects of terbutaline during prolonged administration." Clin Pharmacol Ther 31 (1982): 726-32
11. "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
12. Wagner JM, Morton MJ, Johnson KA, O'Grady JP, Speroff L "Terbutaline and maternal cardiac function." JAMA 246 (1981): 2697-701
13. Kinney EL, Trautlein JJ, Harbaugh CV, Lambert D, Zelis RF "Ventricular tachycardia after terbutaline." JAMA 240 (1978): 2247
14. 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
15. Brogden RN, Speight TM, Avery GS "Terbutaline: a preliminary report of its pharmacological properties and therapeutic efficacy in asthma." Drugs 6 (1973): 324-32
16. 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
17. 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
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. 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
20. "Product Information. Proventil (albuterol)." Schering Corporation (2002):
21. "Product Information. Ventolin (albuterol)." Glaxo Wellcome (2002):
22. "Product Information. Brethaire (terbutaline)." Novartis Pharmaceuticals (2001):
23. Meyer JM, Wenzel CL, Kradjan WA "Salmeterol: a novel, long-acting beta 2-agonist." Ann Pharmacother 27 (1993): 1478-87
24. Maconochie JG, Forster JK "Dose-response study with high-dose inhaled salmeterol in healthy subjects." Br J Clin Pharmacol 33 (1992): 342-5
25. 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
26. 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
27. 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
28. "Product Information. Serevent (salmeterol)." Glaxo Wellcome
29. "Product Information. Maxair (pirbuterol)." 3M Pharmaceuticals (2001):
30. "Product Information. Alupent (metaproterenol)." Boehringer-Ingelheim (2001):
31. Hibbard JU "Chronic terbutaline therapy and peripartum cardiomyopathy: a case-control study." Hypertens Pregnancy 15 (1996): 183-91
32. Katz M, Robertson PA, Creasy RK "Cardiovascular complications associated with terbutaline treatment for preterm labor." Am J Obstet Gynecol 139 (1981): 605-8
33. Suissa S, Hemmelgarn B, Blais L, Ernst P "Bronchodilators and acute cardiac death." Am J Respir Crit Care Med 154 (1996): 1598-602
34. Tranfa CME, Pelaia G, Grembiale RD, Naty S, Durante S, Borrello G "Short-term cardiovascular effects of salmeterol." Chest 113 (1998): 1272-6
35. 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
36. Jenne JW "Can oral beta(2) agonists cause heart failure?" Lancet 352 (1998): 1081-2
37. "Product Information. Tornalate (bitolterol)." Apothecon Inc (2022):
38. 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
39. 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
40. 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
41. "Product Information. Xopenex (levalbuterol)." Sepracor Inc (2001):
42. 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
43. "Product Information. Striverdi Respimat (olodaterol)." Boehringer Ingelheim (2014):
Diabetes Mellitus
Moderate
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.
17 sources
1. Chazan R, Droszcz W, Maruchin JE "Pharmacodynamics of salbutamol in humans." Int J Clin Pharmacol Ther Toxicol 26 (1988): 385-7
2. Hastwell G, Lambert BE "The effect of oral salbutamol on serum potassium and blood sugar." Br J Obstet Gynaecol 85 (1978): 767-9
3. Price AH, Clissold SP "Salbutamol in the 1980s. A reappraisal of its clinical efficacy." Drugs 38 (1989): 77-122
4. Bengtsson B, Fagerstrom PO "Extrapulmonary effects of terbutaline during prolonged administration." Clin Pharmacol Ther 31 (1982): 726-32
5. "Product Information. Proventil (albuterol)." Schering Corporation (2002):
6. "Product Information. Ventolin (albuterol)." Glaxo Wellcome (2002):
7. "Product Information. Brethaire (terbutaline)." Novartis Pharmaceuticals (2001):
8. Meyer JM, Wenzel CL, Kradjan WA "Salmeterol: a novel, long-acting beta 2-agonist." Ann Pharmacother 27 (1993): 1478-87
Show all 17 sourcesShow fewer sources
1. Maconochie JG, Forster JK "Dose-response study with high-dose inhaled salmeterol in healthy subjects." Br J Clin Pharmacol 33 (1992): 342-5
2. "Product Information. Serevent (salmeterol)." Glaxo Wellcome
3. "Product Information. Maxair (pirbuterol)." 3M Pharmaceuticals (2001):
4. "Product Information. Alupent (metaproterenol)." Boehringer-Ingelheim (2001):
5. "Product Information. Tornalate (bitolterol)." Apothecon Inc (2022):
6. "Product Information. Xopenex (levalbuterol)." Sepracor Inc (2001):
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. Foradil (formoterol)." Novartis Pharmaceuticals (2001):
9. "Product Information. Striverdi Respimat (olodaterol)." Boehringer Ingelheim (2014):
Hepatic Insufficiency
Moderate
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.
4 sources
1. "Product Information. Flovent (fluticasone)." Glaxo Wellcome (2001):
2. "Product Information. Asmanex Twisthaler (mometasone)." Schering-Plough Corporation (2005):
3. "Product Information. Beconase AQ (beclomethasone nasal)." GlaxoSmithKline (2015):
4. "Product Information. Pulmicort Flexhaler (budesonide)." A-S Medication Solutions (2016):
Hypokalemia
Moderate
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.
30 sources
1. Whyte KF, Addis GJ, Whitesmith R, Reid JL "The mechanism of salbutamol-induced hypokalaemia." Br J Clin Pharmacol 23 (1987): 65-71
2. 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
3. Allon M, Dunlay R, Copkney C "Nebulized albuterol for acute hyperkalemia in patients on hemodialysis." Ann Intern Med 110 (1989): 426-9
4. Hastwell G, Lambert BE "The effect of oral salbutamol on serum potassium and blood sugar." Br J Obstet Gynaecol 85 (1978): 767-9
5. "Hypokalaemia due to salbutamol overdosage." Br Med J (Clin Res Ed) 283 (1981): 500-1
6. Kantola I, Tarssanen L "Hypokalemia from usual salbutamol dosage ." Chest 89 (1986): 619-20
7. 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
8. 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
Show all 30 sourcesShow fewer sources
1. Price AH, Clissold SP "Salbutamol in the 1980s. A reappraisal of its clinical efficacy." Drugs 38 (1989): 77-122
2. Gross TL, Sokol RJ "Severe hypokalemia and acidosis: a potential complication of beta- adrenergic treatment." Am J Obstet Gynecol 138 (1980): 1225-6
3. Hurlbert BJ, Edelman JD, David K "Serum potassium levels during and after terbutaline." Anesth Analg 60 (1981): 723-5
4. Bengtsson B, Fagerstrom PO "Extrapulmonary effects of terbutaline during prolonged administration." Clin Pharmacol Ther 31 (1982): 726-32
5. Gelmont DM, Balmes JR, Yee A "Hypokalemia induced by inhaled bronchodilators." Chest 94 (1988): 763-6
6. 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
7. "Product Information. Proventil (albuterol)." Schering Corporation (2002):
8. "Product Information. Ventolin (albuterol)." Glaxo Wellcome (2002):
9. "Product Information. Brethaire (terbutaline)." Novartis Pharmaceuticals (2001):
10. Meyer JM, Wenzel CL, Kradjan WA "Salmeterol: a novel, long-acting beta 2-agonist." Ann Pharmacother 27 (1993): 1478-87
11. Maconochie JG, Forster JK "Dose-response study with high-dose inhaled salmeterol in healthy subjects." Br J Clin Pharmacol 33 (1992): 342-5
12. 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
13. "Product Information. Serevent (salmeterol)." Glaxo Wellcome
14. "Product Information. Maxair (pirbuterol)." 3M Pharmaceuticals (2001):
15. 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
16. "Product Information. Alupent (metaproterenol)." Boehringer-Ingelheim (2001):
17. 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
18. 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
19. "Product Information. Tornalate (bitolterol)." Apothecon Inc (2022):
20. "Product Information. Xopenex (levalbuterol)." Sepracor Inc (2001):
21. 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
22. "Product Information. Striverdi Respimat (olodaterol)." Boehringer Ingelheim (2014):
Infections
Moderate
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.
31 sources
1. Horton DJ, Spector SL "Clinical pulmonary tuberculosis in an asthmatic patient using a steroid aerosol." Chest 71 (1977): 540-2
2. 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
3. Vogt FC "The incidence of oral candidiasis with use of inhaled corticosteroids." Ann Allergy 43 (1979): 205-10
4. Milne LJ, Crompton GK "Beclomethasone dipropionate and oropharyngeal candidiasis." Br Med J 3 (1974): 797-8
5. Toogood JH, Jennings B, Greenway RW, Chuang L "Candidiasis and dysphonia complicating beclomethasone treatment of asthma." J Allergy Clin Immunol 65 (1980): 145-53
6. Webb EL "Nasal candidiasis in a patient on long-term topical intranasal corticosteroid therapy." J Allergy Clin Immunol 91 (1993): 680-1
7. Shaikh WA "Pulmonary tuberculosis in patients treated with inhaled beclomethasone." Allergy 47 (1992): 327-30
8. Kesten S, Hyland RH, Pruzanski WR, Kortan PP "Esophageal candidiasis associated with beclomethasone dipropionate aerosol therapy." Drug Intell Clin Pharm 22 (1988): 568-9
Show all 31 sourcesShow fewer sources
1. 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
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. Executive Committee American Academy of Allergy and Immunology "Inhaled corticosteroids and severe viral infections." J Allergy Clin Immunol 92 (1993): 223-8
4. "Product Information. Beclovent (beclomethasone)." Glaxo Wellcome (2001):
5. "Product Information. Vancenase (beclomethasone)." Glaxo Wellcome (2001):
6. "Product Information. AeroBid (flunisolide)." Forest Pharmaceuticals (2022):
7. "Product Information. Nasalide (flunisolide)." Syntex Laboratories Inc (2001):
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. 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
10. "Product Information. Flonase (fluticasone)." Glaxo Wellcome (2001):
11. "Product Information. Rhinocort (budesonide)." Astra-Zeneca Pharmaceuticals (2001):
12. Howland WC "Fluticasone propionate: topical or systemic effects?" Clin Exp Allergy 26 ( Suppl (1996): 18-22
13. "Product Information. Flovent (fluticasone)." Glaxo Wellcome (2001):
14. 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
15. McEvoy CE, Niewoehner DE "Adverse effects of corticosteroid therapy for COPD - A critical review." Chest 111 (1997): 732-43
16. "Product Information. Nasonex (mometasone nasal)." Scherer Laboratories Inc
17. "Product Information. Pulmicort Turbuhaler (budesonide)." Astra-Zeneca Pharmaceuticals (2001):
18. "Product Information. Azmacort (triamcinolone)." Rhone Poulenc Rorer (2001):
19. "Product Information. Nasacort (triamcinolone nasal)." Rhone Poulenc Rorer (2001):
20. 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
21. 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
22. "Product Information. Alvesco (ciclesonide)." Nycomed USA (2008):
23. "Product Information. Omnaris (ciclesonide nasal)." Sepracor Inc (2008):
Keratitis, Herpetic
Moderate
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.
13 sources
1. "Product Information. Beclovent (beclomethasone)." Glaxo Wellcome (2001):
2. "Product Information. Vancenase (beclomethasone)." Glaxo Wellcome (2001):
3. "Product Information. AeroBid (flunisolide)." Forest Pharmaceuticals (2022):
4. "Product Information. Nasalide (flunisolide)." Syntex Laboratories Inc (2001):
5. "Product Information. Flonase (fluticasone)." Glaxo Wellcome (2001):
6. "Product Information. Rhinocort (budesonide)." Astra-Zeneca Pharmaceuticals (2001):
7. "Product Information. Flovent (fluticasone)." Glaxo Wellcome (2001):
8. "Product Information. Nasonex (mometasone nasal)." Scherer Laboratories Inc
Show all 13 sourcesShow fewer sources
1. "Product Information. Pulmicort Turbuhaler (budesonide)." Astra-Zeneca Pharmaceuticals (2001):
2. "Product Information. Azmacort (triamcinolone)." Rhone Poulenc Rorer (2001):
3. "Product Information. Nasacort (triamcinolone nasal)." Rhone Poulenc Rorer (2001):
4. "Product Information. Alvesco (ciclesonide)." Nycomed USA (2008):
5. "Product Information. Omnaris (ciclesonide nasal)." Sepracor Inc (2008):
Osteoporosis
Moderate
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.
24 sources
1. 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
2. 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
3. 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
4. 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
5. Kinberg KA, Hopp RJ, Biven RE, Gallagher JC "Bone mineral density in normal and asthmatic children." J Allergy Clin Immunol 94 (1994): 490-7
6. Barnes PJ "Drug therapy: inhaled glucocorticoids for asthma." N Engl J Med 332 (1995): 868-75
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. 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
Show all 24 sourcesShow fewer sources
1. 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
2. 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
3. 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
4. Ali NJ, Capewell S, Ward MJ "Bone turnover during high dose inhaled corticosteroid treatment." Thorax 46 (1991): 160-4
5. Howland WC "Fluticasone propionate: topical or systemic effects?" Clin Exp Allergy 26 ( Suppl (1996): 18-22
6. 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
7. 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
8. McEvoy CE, Niewoehner DE "Adverse effects of corticosteroid therapy for COPD - A critical review." Chest 111 (1997): 732-43
9. 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
10. 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
11. 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
12. 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
13. 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
14. 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
15. 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
16. 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
Seizures
Moderate
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.
12 sources
1. 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
2. Price AH, Clissold SP "Salbutamol in the 1980s. A reappraisal of its clinical efficacy." Drugs 38 (1989): 77-122
3. "Product Information. Proventil (albuterol)." Schering Corporation (2002):
4. "Product Information. Ventolin (albuterol)." Glaxo Wellcome (2002):
5. "Product Information. Brethaire (terbutaline)." Novartis Pharmaceuticals (2001):
6. "Product Information. Serevent (salmeterol)." Glaxo Wellcome
7. "Product Information. Maxair (pirbuterol)." 3M Pharmaceuticals (2001):
8. "Product Information. Alupent (metaproterenol)." Boehringer-Ingelheim (2001):
Show all 12 sourcesShow fewer sources
1. "Product Information. Tornalate (bitolterol)." Apothecon Inc (2022):
2. "Product Information. Xopenex (levalbuterol)." Sepracor Inc (2001):
3. "Product Information. Foradil (formoterol)." Novartis Pharmaceuticals (2001):
4. "Product Information. Striverdi Respimat (olodaterol)." Boehringer Ingelheim (2014):
Toxic Optic Neuropathy
Moderate
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.
32 sources
1. Fraunfelder FT, Meyer SM "Posterior subcapsular cataracts associated with nasal or inhalation corticosteroids." Am J Ophthalmol 109 (1990): 489-90
2. Karim AK, Thompson GM, Jacob TJ "Steroid aerosols and cataract formation." BMJ 299 (1989): 918
3. Allen MB, Ray SG, Leitch AG, Dhillon B, Cullen B "Steroid aerosols and cataract formation." BMJ 299 (1989): 432-3
4. Kewley GD "Possible association between beclomethasone diproprionate aerosol and cataracts." Aust Paediatr J 16 (1980): 117-8
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. Ghanchi F "Young patients on inhaled steroids and cataract." Lancet 342 (1993): 1306-7
7. Dreyer EB "Inhaled steroid use and glaucoma." N Engl J Med 329 (1993): 1822
8. "Product Information. Beclovent (beclomethasone)." Glaxo Wellcome (2001):
Show all 32 sourcesShow fewer sources
1. "Product Information. Vancenase (beclomethasone)." Glaxo Wellcome (2001):
2. "Product Information. AeroBid (flunisolide)." Forest Pharmaceuticals (2022):
3. "Product Information. Nasalide (flunisolide)." Syntex Laboratories Inc (2001):
4. 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
5. 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
6. 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
7. "Product Information. Flonase (fluticasone)." Glaxo Wellcome (2001):
8. Barnes PJ "Drug therapy: inhaled glucocorticoids for asthma." N Engl J Med 332 (1995): 868-75
9. "Product Information. Rhinocort (budesonide)." Astra-Zeneca Pharmaceuticals (2001):
10. Howland WC "Fluticasone propionate: topical or systemic effects?" Clin Exp Allergy 26 ( Suppl (1996): 18-22
11. 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
12. "Product Information. Flovent (fluticasone)." Glaxo Wellcome (2001):
13. 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
14. McEvoy CE, Niewoehner DE "Adverse effects of corticosteroid therapy for COPD - A critical review." Chest 111 (1997): 732-43
15. Cumming RG, Mitchell P, Leeder SR "Use of inhaled corticosteroids and the risk of cataracts." N Engl J Med 337 (1997): 8-14
16. "Product Information. Nasonex (mometasone nasal)." Scherer Laboratories Inc
17. "Product Information. Pulmicort Turbuhaler (budesonide)." Astra-Zeneca Pharmaceuticals (2001):
18. 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
19. "Product Information. Azmacort (triamcinolone)." Rhone Poulenc Rorer (2001):
20. "Product Information. Nasacort (triamcinolone nasal)." Rhone Poulenc Rorer (2001):
21. 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
22. 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
23. "Product Information. Alvesco (ciclesonide)." Nycomed USA (2008):
24. "Product Information. Omnaris (ciclesonide nasal)." Sepracor Inc (2008):

Therapeutic duplication

Drug classes that overlap with Fluticasone Propionate + Formoterol Fumarate, so taking both doubles up the same effect. This source publishes no per-row citations for duplication.

cortisones
The recommended maximum number of medicines in the 'cortisones' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'cortisones' category.
Example product in the source data (US market): Formoterol/mometasone
cortisones
The recommended maximum number of medicines in the 'cortisones' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'cortisones' category.
Example product in the source data (US market): Symbicort
cortisones
The recommended maximum number of medicines in the 'cortisones' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'cortisones' category.
Example product in the source data (US market): Budesonide/formoterol/glycopyrrolate
cortisones
The recommended maximum number of medicines in the 'cortisones' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'cortisones' category.
Example product in the source data (US market): Albuterol/budesonide
inhaled smooth muscle relaxants
The recommended maximum number of medicines in the 'inhaled smooth muscle relaxants' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'inhaled smooth muscle relaxants' category.
Example product in the source data (US market): Olodaterol/tiotropium
inhaled smooth muscle relaxants
The recommended maximum number of medicines in the 'inhaled smooth muscle relaxants' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'inhaled smooth muscle relaxants' category.
Example product in the source data (US market): Wixela inhub
inhaled smooth muscle relaxants
The recommended maximum number of medicines in the 'inhaled smooth muscle relaxants' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'inhaled smooth muscle relaxants' category.
Example product in the source data (US market): Glycopyrrolate/indacaterol
inhaled smooth muscle relaxants
The recommended maximum number of medicines in the 'inhaled smooth muscle relaxants' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'inhaled smooth muscle relaxants' category.
Example product in the source data (US market): Epinephrine/prilocaine
inhaled smooth muscle relaxants
The recommended maximum number of medicines in the 'inhaled smooth muscle relaxants' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'inhaled smooth muscle relaxants' category.
Example product in the source data (US market): Trelegy ellipta
inhaled smooth muscle relaxants
The recommended maximum number of medicines in the 'inhaled smooth muscle relaxants' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'inhaled smooth muscle relaxants' category.
Example product in the source data (US market): Orabloc
inhaled smooth muscle relaxants
The recommended maximum number of medicines in the 'inhaled smooth muscle relaxants' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'inhaled smooth muscle relaxants' category.
Example product in the source data (US market): Fluticasone/vilanterol
inhaled smooth muscle relaxants
The recommended maximum number of medicines in the 'inhaled smooth muscle relaxants' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'inhaled smooth muscle relaxants' category.
Example product in the source data (US market): Vivacaine
inhaled smooth muscle relaxants
The recommended maximum number of medicines in the 'inhaled smooth muscle relaxants' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'inhaled smooth muscle relaxants' category.
Example product in the source data (US market): Albuterol/ipratropium
inhaled smooth muscle relaxants
The recommended maximum number of medicines in the 'inhaled smooth muscle relaxants' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'inhaled smooth muscle relaxants' category.
Example product in the source data (US market): Anoro ellipta
inhaled smooth muscle relaxants
The recommended maximum number of medicines in the 'inhaled smooth muscle relaxants' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'inhaled smooth muscle relaxants' category.
Example product in the source data (US market): Albuterol/budesonide
inhaled smooth muscle relaxants
The recommended maximum number of medicines in the 'inhaled smooth muscle relaxants' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'inhaled smooth muscle relaxants' category.
Example product in the source data (US market): Epinephrine/lidocaine

Medicines

Conditions

Adrenocortical Hyperfunction

Cardiovascular Diseases

Diabetes Mellitus

Hepatic Insufficiency

Hypokalemia

Infections

Keratitis, Herpetic

Osteoporosis

Seizures

Toxic Optic Neuropathy

Therapeutic duplication

cortisones

cortisones

cortisones

cortisones

inhaled smooth muscle relaxants

inhaled smooth muscle relaxants

inhaled smooth muscle relaxants

inhaled smooth muscle relaxants

inhaled smooth muscle relaxants

inhaled smooth muscle relaxants

inhaled smooth muscle relaxants

inhaled smooth muscle relaxants

inhaled smooth muscle relaxants

inhaled smooth muscle relaxants

inhaled smooth muscle relaxants

inhaled smooth muscle relaxants