It is recommended to gradually reduce the dose before stopping treatment is not recommended strongly to cancel treatment.
In case of insufficient efficacy or exceeding the maximum recommended necessary to reconsider the tactics of treatment. Sudden and progressive deterioration in control of the symptoms of asthma or primobolan cycle is potentially life-threatening condition and requires immediate medical intervention. In this situation, you should consider increasing the dose of glucocorticoids. The appointment course of oral corticosteroids, or antibiotic treatment in the event of the accession of infection
It should be noted, the patient’s attention to the need for regular maintenance dose of Symbicort reception turbuhaler in accordance with the chosen therapy, even in the absence of symptoms. Inhalation Symbicort turbuhaler cupping should be performed only when symptoms occur, but are not shown for regular prophylactic use, ie before exercise. In such cases, shows the use of a separate short-acting bronchodilator.
If asthma symptoms are manageable, you can gradually reduce turbuhaler, it is important to continuously monitor the patient’s condition. It is necessary to assign the lowest effective dose of turbuhaler (see; “Dosage and Administration” section).
Treatment should not be initiated during an exacerbation or significant worsening of asthma.
During turbuhaler can celebrate exacerbation and development of serious adverse events associated with asthma. Patients should continue treatment but to seek medical care in the absence of control over the symptoms of asthma, or in the case of deterioration after initiation of therapy.
As with any other inhalation therapy, paradoxical bronchospasm may occur with an immediate intensification of wheezing after taking the dose. In this connection, primobolan cycle discontinue therapy treatment policy review and, if necessary, to assign an alternative therapy.
Systemic action may occur at any reception inhaled glucocorticosteroids, especially when high doses of drugs over a long period of time. The manifestation of systemic effects are less likely during inhalation therapy than with oral corticosteroids. Possible systemic effects include adrenal suppression, growth retardation in children and adolescents, decrease in bone mineral density, cataract and glaucoma.
It is recommended to regularly monitor the growth of children receiving long-term glucocorticoid therapy in inhalable form. In the case of established growth retardation, therapy should be reviewed with the aim of reducing the dose of inhaled glucocorticosteroid. It should be carefully weighed against the benefits of glucocorticosteroid therapy to a possible risk of growth retardation. When selecting therapy is recommended to apply to the children’s lung specialist.
Based on the limited research data on the chronic administration of corticosteroids, one can assume that the majority of children and adolescents receiving therapy with inhaled budesonide ultimately achieve normal adult growth rates. However reported slight momentary delay in growth mainly during the first year of treatment. Because of the potential actions of inhaled corticosteroids on bone mineral density should pay particular attention to patients taking high doses over a long period with the presence of risk factors for osteoporosis. Studies have long-term use of inhaled budesonide in children at mean daily doses of 400 micrograms (metered dose) or adults in a daily dose of 800 micrograms (metered dose) have not shown significant effects on bone mineral density. No data on the effect of high doses of Symbicort turbuhaler on bone mineral density. If there is reason to believe that against the background of previous systemic therapy primobolan cycle corticosteroids adrenal function has been compromised, you should take precautions when transferring patients to treatment Symbicort.
The benefits of inhalation therapy with budesonide, as a rule, minimize the need for acceptance of oral corticosteroids, but in patients discontinuing therapy oral corticosteroids for a long time can be maintained insufficient function of the adrenal glands. Patients who are in urgent need of past reception of high doses of corticosteroids or receiving long-term treatment with inhaled corticosteroids at high doses, may also be in this risk. It is necessary to provide for the appointment of additional corticosteroids during times of stress or surgery.
It is recommended to instruct the patient about the need to rinse your mouth with water after maintenance doses of inhaled to prevent the risk of candidiasis of the mucous membranes of the mouth and pharynx. It is also necessary to rinse your mouth with water after inhalation for the relief of symptoms in the case of candidiasis of the mucous membranes of the mouth and throat.
Observe the precautions in the treatment of patients with prolonged QTc-interval. Acceptance of formoterol may cause lengthening of the QTc-interval. It is necessary to reconsider the need for, and dose of inhaled glucocorticosteroid in patients with active or inactive forms of pulmonary tuberculosis, fungal, viral or bacterial infections of the respiratory system.
The joint appointment β 2 -adrenomimetikov with drugs that can cause or exacerbate hypokalemic effect, for example, xanthine derivatives, steroids or diuretics may increase gipokaliemicheskogo effect of β2 -adrenomimetikov. It is necessary to take special precautions in patients with unstable asthma who use short-acting bronchodilators, for the removal of heavy attacks during exacerbation of asthma, since the risk of hypokalemia increased by hypoxia and in other conditions when the increased probability of developing gipokaliemicheskogo effect. In such cases it is advisable to control the content of potassium in serum.
Reception primobolan cycle of patients with acute bronchial obstruction formoterol in a dose of 90 mg for 3 hours safe. The treatment should monitor the concentration of blood glucose in patients with diabetes.
Generally, such amount does not cause problems in patients with lactose intolerance.