Bexitrol F 50/250 Maxhaler

✔️ Uses of Bexitrol F Maxhaler 50/250

• Asthma
• Chronic obstructive pulmonary disease (COPD)

✔️

Bexitrol F is prescribed for long-term asthma management, especially in cases where a combination of a long-acting β2-agonist (LABA) and an inhaled corticosteroid (ICS) is deemed suitable. The specific scenarios for its use include:

1. Patients inadequately controlled with inhaled corticosteroids alone combined with as-needed short-acting β2-agonists.
2. Patients already stabilized on a regimen involving an inhaled corticosteroid and a long-acting β2-agonist.

✔️ Dosage & Administration of Maxhaler

• A user-friendly device with pre-dispensed inhalation powder for asthma patients.
• Adults and Adolescents (12 years and older):
  • One inhalation twice daily (dosage options: 50/100 µg, 50/250 µg, or 50/500 µg).
• Children (4 years and older):
  • The maximum approved dose is 50/100 µg, administered as one inhalation twice daily.

✔️ Administration:

Using an inhaler correctly is vital for effective treatment. Improper use can reduce the amount of medicine reaching the lungs, diminishing its efficacy. Adherence to the following steps ensures correct use:

1. Remove the cap from the inhaler.
2. Shake the device vigorously (at least six times) before each use. If the inhaler is new or unused for over a week, release a test puff into the air to confirm functionality.
3. Exhale fully and comfortably, then position the inhaler upright between the teeth, sealing the lips tightly around the mouthpiece.
4. As you inhale deeply and slowly, press down firmly on the canister to release the medication.
5. Remove the inhaler and hold your breath for at least 10 seconds or as long as comfortably possible.
6. For multiple inhalations, wait one minute between puffs and repeat the above steps.
7. Replace the cap after use, and rinse your mouth thoroughly to prevent side effects like thrush or hoarseness.

✔️ Administration

Cleaning: Wash the plastic actuator and cap weekly with warm water, ensuring they are thoroughly dried before reinserting the metal canister. Avoid immersing the canister in water.

✔️ Overdose Management

• Salmeterol overdose: May cause tremors, palpitations, arrhythmias, and hypokalemia. Treatment includes discontinuation and careful administration of cardioselective beta-blockers if needed.
• Fluticasone overdose: Acute overdosing can suppress adrenal function temporarily, which typically recovers in a few days. Chronic overdose requires adrenal monitoring and dose adjustment.

✔️ Side Effects

• Salmeterol: Common side effects include tremors, palpitations, headaches, and transient muscle cramps. Cardiac arrhythmias and hypersensitivity reactions (e.g., rashes or swelling) are rare but possible.
• Fluticasone Propionate: May cause hoarseness or oral thrush. Rinsing the mouth post-use can mitigate these effects. Rarely, facial swelling or skin rashes may occur.

✔️ Drug Interactions

• Avoid the use of non-selective or selective β-blockers in asthma patients unless necessary.
• Co-administration with strong CYP3A4 inhibitors (e.g., ketoconazole or ritonavir) can increase systemic exposure to Fluticasone Propionate.

✔️ Bexitrol F should not be used in:

1. Patients are allergic to salmeterol, fluticasone, or any excipient in the formulation.
2. Acute or severe asthma episodes requiring immediate, intensive interventions.

✔️ Use During Pregnancy and Lactation

• Pregnancy: Should only be used if the potential benefits outweigh the risks to the fetus. Human data on safety during pregnancy are limited, although animal studies indicate possible effects at high doses.
• Lactation: Minimal amounts of salmeterol and fluticasone are expected to pass into breast milk, posing a low risk. Use is advised only when benefits to the mother justify potential risks to the infant.

✔️ Precautions

• Not suitable for acute symptom relief—patients should keep a fast-acting bronchodilator (e.g., salbutamol) for emergencies.
• Monitor for potential pneumonia in COPD patients, as symptoms can mimic exacerbations.
• Systemic corticosteroid effects (e.g., adrenal suppression, growth retardation in children) are rare but may occur with prolonged use at high doses.

✔️ Storage:

Store below 30°C and away from direct sunlight. Do not puncture, incinerate, or expose the pressurized canister to heat, even when empty. Keep out of reach of children.