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Maintenance treatment of asthma where combination therapy (ICS + LABA) is appropriate; maintenance treatment of COPD (chronic bronchitis/emphysema) to reduce symptoms and exacerbations.

Fluticasone is an inhaled corticosteroid that reduces airway inflammation, swelling and mucus production. Salmeterol is a long-acting beta2-agonist that relaxes airway smooth muscle for prolonged bronchodilation, improving breathing and preventing symptoms.

For inhalation use only via the prescribed DPI device. Use regularly at the same time each day as directed by the doctor; not for sudden asthma attacks. Rinse mouth and gargle with water after each use and spit out to reduce risk of oral thrush.

Throat irritation, hoarseness/voice change, cough, headache, oral thrush (candidiasis), upper respiratory tract infection, tremor, palpitations

Not a rescue inhaler—use a quick-relief bronchodilator for acute attacks. Use with caution in heart disease, arrhythmias, hypertension, hyperthyroidism, diabetes, glaucoma, and in patients prone to hypokalemia. Inhaled steroids may cause oral candidiasis; rinse mouth after use. Do not stop abruptly; taper only on medical advice. Monitor for paradoxical bronchospasm, worsening breathing, and signs of pneumonia in COPD. Long-term/high-dose ICS may affect bone density, eyes (cataract/glaucoma) and growth in children.

Strong CYP3A4 inhibitors (ritonavir, cobicistat, ketoconazole, itraconazole, clarithromycin) may increase fluticasone/salmeterol exposure; beta-blockers may reduce bronchodilator effect; other sympathomimetics may increase side effects; diuretics/xanthines/corticosteroids may increase risk of hypokalemia; MAO inhibitors/tricyclic antidepressants may enhance cardiovascular effects.

Store in a cool, dry place below 25°C. Protect from moisture and direct sunlight. Keep inhaler/device tightly closed and out of reach of children.

Seroflo 250 Rotacaps, Foracort 200 Rotacaps, Duolin/Levolin not equivalent (rescue only), Budamate 200 Rotacaps, Symbicort 160 Turbuhaler