Azmasol Plus HFA Inhaler | (90mcg+80mcg/puff)

✔️ Dosage & Administration

• Recommended dose: Salbutamol 180 µg + Budesonide 160 µg (equivalent to 2 inhalations) as needed
• Maximum: Do not exceed 6 doses (12 inhalations) within 24 hours

Priming instructions:

• Before first use: Spray 4 times into the air (away from face), shaking well before each spray
• Re-prime with 2 sprays if:
  • Not used for more than 7 days
  • Dropped
  • Cleaned

✔️ Side Effects:

Serious adverse reactions may include:

• Worsening of asthma
• Paradoxical bronchospasm
• Cardiovascular effects (e.g., increased heart rate, blood pressure changes)
• Hypersensitivity reactions including anaphylaxis
• Hypokalemia
• Increased risk of infections due to immunosuppression
• Oral candidiasis
• Adrenal suppression and hypercorticism
• Decreased bone mineral density
• Eye disorders such as glaucoma and cataracts
• Growth suppression in pediatric patients (not indicated in this population)

✔️ Interaction

• Strong CYP3A4 inhibitors (e.g., ritonavir) may increase systemic corticosteroid effects
• Beta-blockers may reduce effectiveness and provoke bronchospasm
• Diuretics may increase risk of hypokalemia and ECG changes
• Digoxin levels may decrease
• Use caution with MAO inhibitors and tricyclic antidepressants

✔️ Overdose Effects

• Salbutamol: May cause symptoms of excessive β-adrenergic stimulation such as tachycardia, arrhythmias, tremors, hypertension or hypotension, nervousness, and hypokalemia
• Budesonide: Prolonged excessive use may lead to systemic corticosteroid effects (e.g., hypercorticism)

✔️ Pregnancy & Lactation

• Pregnancy: Limited data; use only if benefits outweigh potential risks
• Lactation: Insufficient data on excretion into breast milk or effects on infants

✔️ Precautions & Warnings

• Asthma may worsen acutely or gradually; increased use may indicate poor disease control
• May cause paradoxical bronchospasm—discontinue immediately if it occurs
• Excessive use may lead to serious cardiovascular complications
• Use cautiously in patients with:
  • Cardiovascular disorders
  • Hyperthyroidism
  • Diabetes mellitus
  • Seizure disorders
• Monitor potassium levels due to risk of hypokalemia
• Increased susceptibility to infections with corticosteroid use
• Long-term use may reduce bone density—monitor high-risk patients
• Risk of glaucoma, cataracts, and increased intraocular pressure with prolonged use
• Avoid exposure to infections like chickenpox and measles in immunocompromised patients

✔️ Storage:

• Store below 30°C in a dry place, protected from light
• Avoid heat and direct sunlight
• Do not puncture or incinerate the pressurized canister
• Clean inhaler regularly as instructed
• Use within 6 months after removing from foil pouch
• Keep out of reach of children and away from eyes