**Indications**
Lutisone Nebuliser Suspension is indicated for use in:
- **Adults and adolescents over 16 years of age**: This medication is recommended for the prophylactic management of severe asthma, particularly for patients who require high doses of inhaled or oral corticosteroid therapy.
- **Children and adolescents aged 4 to 16 years**: It is indicated for the treatment of mild to moderate acute exacerbations of asthma.
*Always consult a registered physician before taking medication.*
**Pharmacology**
While the exact mechanisms of glucocorticoid action in asthma remain unclear, inflammation is a recognized key factor in the pathogenesis of this condition. Glucocorticoids effectively inhibit various cell types, including mast cells, eosinophils, basophils, lymphocytes, macrophages, and neutrophils, as well as the production or secretion of mediators such as histamine, eicosanoids, leukotrienes, and cytokines that contribute to the asthmatic response. These anti-inflammatory properties are believed to enhance the efficacy of glucocorticoids in managing asthma.
Although glucocorticoids are highly effective in treating asthma, they do not provide immediate relief from symptoms. However, improvement can be observed within 24 hours of initiating treatment with inhaled fluticasone propionate, although maximum benefits may take 1 to 2 weeks or longer to manifest. Upon discontinuation of glucocorticoids, asthma stability may be maintained for several days or longer.
**Dosage & Administration**
- **Adults and adolescents over 16 years (for prophylactic management in severe asthma)**: The recommended dosage is 0.5-2 mg twice daily, with an initial suggested dose of 2 mg twice daily. Adjustments should be made based on individual response until control is achieved or the minimum effective dose is determined.
- **Children and adolescents aged 4 to 16 years (for treatment of acute exacerbations of asthma)**: The recommended dosage is 1 mg twice daily.
*Always consult a registered physician before taking medication.*
**Interaction**
Clinically significant drug interactions involving Lutisone are unlikely.
**Contraindications**
Fluticasone Propionate Nebuliser Suspension is contraindicated in individuals with a known hypersensitivity to any of its components.
**Side Effects**
Commonly reported side effects include candidiasis of the mouth and throat, as well as hoarseness. Patients may find it beneficial to rinse their mouths with water after inhalation. Rarely, paradoxical bronchospasm may occur, leading to an immediate increase in wheezing following administration. Other infrequent adverse reactions may include hypersensitivity reactions such as angioedema, bronchospasm, and in very rare cases, anaphylactic reactions. Additional potential rare adverse events include decreased plasma cortisol levels in adult patients on higher doses, bone density reduction, growth retardation, cataracts, and glaucoma.
**Pregnancy & Lactation**
Lutisone is classified as Pregnancy Category B3. There is insufficient evidence regarding the safety of Fluticasone Propionate in human pregnancies. As with other medications, the use of Fluticasone Propionate during pregnancy should only be considered if the anticipated benefits to the mother outweigh any potential risks to the fetus. The excretion of Fluticasone Propionate into human breast milk has not been adequately studied.
**Precautions & Warnings**
Lutisone Nebuliser Suspension should not be utilized for the treatment of severe acute exacerbations of asthma in children and adolescents, as its efficacy in this context has not been established. Patients using nebulized Lutisone must be informed that if their condition worsens or if a dose does not provide the expected relief, they should not increase the dosage or frequency of administration but should seek medical advice promptly. Prolonged use of inhaled Lutisone Nebuliser Suspension should be tapered gradually and not stopped abruptly, with medical supervision recommended.
**Overdose Effects**
Acute inhalation of Lutisone above the recommended doses may lead to temporary adrenal function suppression. This does not necessitate emergency intervention, as adrenal function typically recovers within a few days, which can be verified through plasma cortisol measurements. However, continued use of higher-than-recommended doses over extended periods could result in adrenal suppression. Monitoring of adrenal reserve may be required. In cases of Lutisone overdose, therapy can continue at an appropriate dosage for effective symptom control.
**Therapeutic Class**
Fluocinolone & Combined Preparations, Respiratory corticosteroids.
**Storage Conditions**
Store below 30°C. Protect from frost and light. Do not freeze. Store upright. After removal from their packaging, ampoules should be shielded from light and used within 28 days. Opened ampoules should be refrigerated and utilized within 12 hours of opening.
*Always consult a registered physician before taking medication.*
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