Bexitrol F 50/500mcg Bexicap Inhalation Capsule 1 Strip

✔️ Adverse Effects

Salmeterol-related:

• Tremor, palpitations, headache
• Cardiac arrhythmias (rare)
• Muscle cramps, throat irritation

Fluticasone-related:

• Oral candidiasis (thrush)
• Hoarseness
• Skin reactions, rare facial swelling

Rinsing the mouth after use reduces local side effects.

✔️ Dosage & Administration

Inhaler (Asthma)

• Adults & adolescents (≥12 years):
  • 2 puffs twice daily of:
    • 25/50 µg, or
    • 25/125 µg, or
    • 25/250 µg
• Children (4–12 years):
  • 2 puffs of 25/50 µg twice daily

Inhalation Capsule (Asthma)

• ≥12 years:
  • 50/100 µg or 50/250 µg twice daily
  • Maximum: 50/500 µg twice daily
• Children (4–11 years):
  • 50/100 µg twice daily

Inhalation Capsule (COPD)

• 50/250 µg twice daily

Maxhaler Device

• Adults & adolescents: One inhalation twice daily (50/100, 50/250, or 50/500 µg)
• Children (≥4 years): One inhalation twice daily (max fluticasone 100 µg twice daily)

No dose adjustment is required for elderly or renal impairment patients.

Administration Instructions

Proper inhaler technique is essential:

• Shake well before use
• Exhale fully before inhalation
• Inhale deeply while pressing the canister
• Hold breath for ~10 seconds after inhalation
• Wait 1 minute between puffs if multiple doses are prescribed
• Rinse mouth after use to prevent infection

Clean the inhaler weekly using warm water (excluding the metal canister).

✔️ Drug Interactions

• Avoid β-blockers unless necessary
• Strong CYP3A4 inhibitors (e.g., ketoconazole, ritonavir) may increase steroid exposure
• Clinically significant interactions are unlikely due to low systemic absorption

✔️ Pregnancy & Lactation

• Use only if benefits outweigh risks
• Limited human data available
• Drug levels in breast milk are expected to be low

✔️ Contraindications

• Hypersensitivity to salmeterol, fluticasone, or formulation components
• Not suitable for acute asthma attacks or status asthmaticus

✔️ Precautions & Warnings

• Not for relief of acute asthma symptoms
• Always keep a rescue inhaler (e.g., salbutamol) available
• Monitor for worsening asthma or exacerbations
• May cause paradoxical bronchospasm—discontinue if it occurs
• Increased pneumonia risk in COPD patients
• Long-term corticosteroid use may cause:
  • Adrenal suppression
  • Reduced bone density
  • Cataracts or glaucoma
  • Growth retardation in children

✔️ Storage:

• Store below 30°C, away from heat and sunlight
• Do not puncture or burn the canister
• Keep away from children and eyes