Posology : מינונים

4.2     Posology and method of administration

Posology
Asthma

Adults:
Two actuations of 25 micrograms salmeterol twice daily.
In asthma patients with more severe airways obstruction up to four inhalations of 25 micrograms of salmeterol twice daily may be of benefit.

Children aged 4 years and older:
Two actuations of 25 micrograms salmeterol twice daily.

Children below 4 years of age:
Serevent Inhaler CFC Free is not recommended for use in children below four years of age due to insufficient data on safety and efficacy.

COPD

Adults:
Two actuations of 25 micrograms salmeterol twice daily.
Paediatric population
There is no relevant indication for use of Serevent Inhaler CFC Free in the paediatric population in the indication for COPD.

Special populations
There is no need to adjust the dose in elderly patients or in those with renal impairment. There are no data available on the use of Serevent Inhaler CFC Free in patients with hepatic impairment.

Method of administration
Serevent Inhaler CFC Free is for inhalation use only.

Serevent Inhaler CFC Free should be used regularly. The full benefits of treatment will be apparent after several doses of the medicinal product. As there may be adverse reactions associated with excessive dosing with this class of medicinal product, the dosage or frequency of administration should only be increased on medical advice.


Instructions for use:
Patients should be carefully instructed in the proper use of their inhaler (see Patient Information Leaflet).

1. Patients should remove the mouthpiece cover by gently squeezing the sides of the cover.

2. Patients should check inside and outside of the inhaler including the mouthpiece for the presence of loose objects.
3. Patients should shake the inhaler well to ensure that any loose objects are removed and that the contents of the inhaler are evenly mixed. Before using for the first time or if the inhaler has not been used for a week patients should release two puffs into the air to make sure that it works.

4. Patients should hold the inhaler upright between fingers and thumb with their thumb on the base, below the mouthpiece.

5. Patients should breathe out as far as is comfortable and then place the mouthpiece in their mouth between their teeth and close their lips around it. Patients should be instructed not to bite the mouthpiece.

6. Just after starting to breathe in through their mouth patients should press down on the top of the inhaler to release salmeterol while still breathing in steadily and deeply.

7. While holding their breath, patients should take the inhaler from their mouth and take their finger from the top of the inhaler. They should continue holding their breath for as long as is comfortable.

8. If patients are going to take a further puff, they should keep the inhaler upright and wait about half a minute before repeating steps 3 to7.

9. After use patients should always replace the mouthpiece cover to keep out dust and fluff.

10. Patients should replace the mouthpiece cover by firmly pushing and snapping the cap into position.
Important:
Patients should not rush stages 5, 6 and 7. It is important that they start to breathe in as slowly as possible just before operating their inhaler.

Patients should practise in front of a mirror for the first few times. If they see "mist" coming from the top of their inhaler or the sides of their mouth they should start again from stage 2.

Serevent Inhaler CFC Free should be used with a Volumatic spacer device by patients who find it difficult to synchronise aerosol actuation with inspiration of breath which is often the case for children and the elderly.

Cleaning:

The inhaler should be cleaned at least once a week by:
1.      Removing the mouthpiece cover.

2.      Wiping the inside and outside of the mouthpiece and the plastic casing with a dry cloth or tissue.

3.      Replacing the mouthpiece cover.
The canister must not be removed from the plastic casing when cleaning the inhaler.

Patients must not put the metal canister into water.