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Introduction About DIGIHALER SF 250MCG INHALER

DIGIHALER SF 250MCG INHALER is a combination of Fluticasone and Salmeterol which belongs to the group of medicines called Corticosteroids and Bronchodilators respectively. It is used to manage asthma and chronic obstructive pulmonary disease (COPD). It also helps in reducing the flare-ups of COPD symptoms.

Asthma is a long-term respiratory disease in which your airways become inflamed, swollen and narrowed. It also causes excessive mucous secretion in the airways which makes it difficult for the air to pass through, leading to unpleasant symptoms like wheezing, difficulty in breathing, chest pain and/or cough.

COPD is a lung disease characterized by chronic lung inflammation and obstructed air flow within the airways. It causes wheezing, breathing difficulties, cough with mucus production and chest pain.

Use DIGIHALER SF 250MCG INHALER every day until your doctor tells you to stop. It is meant for inhalation use only, and therefore do not the swallow the medicine. Do not stop using this medicine once your symptoms subside without consulting your doctor. It is suitable for use both in adults and in adolescents (aged 12 years or above).

DIGIHALER SF 250MCG INHALER should not be used to relieve a sudden asthma attack (such as sudden breathing problems). Instead contact your doctor or use a fast-acting ‘rescue’ inhaler containing salbutamol to subside the symptoms.

Before using DIGIHALER SF 250MCG INHALER inform your doctor if you have any lung infections, liver problems or heart problems. You must also inform your doctor if you have diabetes, hypertension, fits, overactive thyroid functions, osteoporosis, adrenal gland problems or a weak immune system as a precaution.

DIGIHALER SF 250MCG INHALER should be used in pregnant and breastfeeding women only if it is considered necessary by the physician. The most common side effects of using DIGIHALER SF 250MCG INHALER are headache, cold, oral thrush or oral sores, throat irritation, hoarse voice, muscle pain and joint pain. Contact your doctor if any of these side effect worsens.

Uses Of DIGIHALER SF 250MCG INHALER

It is used to manage, manage the symptoms of:

Asthma
Chronic Obstructive Pulmonary Disease (COPD)

How DIGIHALER SF 250MCG INHALER Works

DIGIHALER SF 250MCG INHALER is a combination of two medicines namely, fluticasone and salbutamol. Fluticasone is an inhalation corticosteroid. It blocks the release of certain chemical messengers in the airways (such as prostaglandins, leukotrienes) that cause inflammation and swelling.

Salmeterol is a bronchodilator. It relaxes the smooth muscles of the airways and widens them. Collectively, they reduce airway inflammation, allows the air to pass through more freely and makes breathing easier.

How to use DIGIHALER SF 250MCG INHALER

Use DIGIHALER SF 250MCG INHALER medicine every day until your doctor tells you to stop. It is meant for inhalation only. Inhale the medicine only through your mouth into the lungs and not via nose.

Follow the instruction given in the enclosed leaflet.

prime the device by releasing two puffs of the medicine into the air
place the mouthpiece in your mouth between your teeth and ensure completely closure
breathe in slowly and deeply using your mouth through the mouthpiece while simultaneously pressing the top of the canister firmly to release a puff of medicine
remove the device from your mouth and hold your breath for about 10 seconds or for as long as is comfortable
wait about 30 seconds between taking each puff of medicine
after inhalation, wipe the mouthpiece with a dry tissue and close the device after use
once inhalation is over, rinse your mouth with water and spit it out or brush your teeth

Your doctor will decide the correct dose, duration and number of puffs for you depending upon your age, body weight and disease condition.

Do not start using this medicine unless your doctor or health care provider has taught you how to use and you understand how to use it correctly. If you find it difficult to use this device, your doctor may recommend you a suitable spacer device.

Do not stop taking this medicine abruptly or reduce the dose without consulting your doctor, as it could make your breathing even worse.

Side Effects Of DIGIHALER SF 250MCG INHALER

Common

headache
common cold
thrush in the mouth or throat (a yeast infection that causes sore, creamy-yellow, raised patches)
sore tongue, hoarse voice, throat irritation
muscle pain or cramps
joint pain and swelling
bruising and fractures
inflammation of sinuses
signs of low levels of potassium in blood (such as an uneven heartbeat, muscle weakness or cramps)

Uncommon

diabetes (increased blood sugar levels)
cataract (cloudy eyes)
unusually fast or uneven heartbeat, tremor (feeling shaky)
chest pain
feeling worried, disturbance in sleep
allergic skin rash

Rare

slowing of growth in adolescents, bone thinning, glaucoma, weight gain
Cushing’s Syndrome (a disorder caused due to release of high levels of cortisol)
changes in behavior (such as being unusually active and irritable)
fungal infection in the esophagus which causes difficulties in swallowing

Stop using DIGIHALER SF 250MCG INHALER and contact your doctor immediately if you experience any of the following side effects:

severe allergic reactions (such as sudden wheezing, cough, shortness of breath, skin rash, itching, swelling of the face, lips, tongue, or throat, breathing difficulties, sudden fast heartbeat which can cause fainting, light-headedness, collapse or even loss of consciousness)
sign of pneumonia (a lung infection accompanied with fever, chills, increased cough production, increased breathing difficulties, excessive mucus production and change in mucus color)

How To Manage Side Effects

Headache:

Rest and relax. Drink plenty of fluids such as water or electrolytes. Apply a pain-relieving balm on the head if required. Do not consume too much of alcohol. Consult your doctor if the symptom did not improve.

Throat irritation:

Gargle your throat with salt water twice a day. Always try to drink warm water. Avoid chilled, cooled, or sweetened food items or beverages. Drinking turmeric milk or ginger tea mixed with honey and pepper powder can ease the soreness. Consult your doctor if the symptom did not improve.

Muscle pain or cramps:

Rub a pain-relieving balm or place a heat pack on the affected area for some time, as it could ease the pain. Do not move the affected area frequently. Try to do some simple movements every day which would improve blood circulation and reduce further incidence of muscle pain. Try to eat a well-balanced protein rich diet, so that it can help to repair and rebuild the damaged muscle. Consult your doctor if the symptom did not improve.

Joint pain:

Rub a pain-relieving balm or place a heat pack on the affected area for some time, as it could ease the pain. Do not move the affected area frequently. Consume calcium and vitamin supplements regularly, particularly if you are elderly. Consult your doctor if the symptom did not improve.

Allergic skin rash:

Avoid hot showers because hot water can irritate your skin further. Do not scratch the affected area. Use protective clothing when going outdoors. Regularly moisturize your skin. Consult your doctor if the symptom did not improve.

Warning & Precautions

Pregnancy

DIGIHALER SF 250MCG INHALER should be used in pregnant women only if it is considered necessary by the doctor. Your doctor may prescribe this medicine after outweighing the risk and benefits to you and your baby. Therefore, inform your doctor before using it.

Breastfeeding

DIGIHALER SF 250MCG INHALER should be used in breastfeeding women only if it is considered necessary by the doctor. Therefore, consult your doctor for advice before using it.

Driving and Using Machines

Do not drive or operate any heavy tools or machines if your ability is affected by DIGIHALER SF 250MCG INHALER.

Liver

DIGIHALER SF 250MCG INHALER should be taken with caution in patients with liver diseases. Therefore, consult your doctor before using it.

Allergy

Do not use DIGIHALER SF 250MCG INHALER if you are allergic to Salmeterol or Fluticasone.

Lungs

DIGIHALER SF 250MCG INHALER should be taken with caution among patients who have or previously had any Tuberculosis or any other lung infections. Therefore, consult your doctor before using it.

Heart Disease

DIGIHALER SF 250MCG INHALER should be taken with caution in patients with heart diseases (such as irregular or fast heartbeat). Therefore, consult your doctor before using it.

Others

DIGIHALER SF 250MCG INHALER is not recommended for use in patients having:

status asthmaticus (respiratory failure)
acute asthma attacks

Before using DIGIHALER SF 250MCG INHALER, inform your physician if you:

have an over-active thyroid gland
have diabetes
have high blood pressure
have hypokalemia (low levels of potassium in blood)
have fits (seizure)
have osteoporosis (weak bones)
have a weak immune system
have or had eye problems (such as glaucoma, increased pressure in the eyes, cataracts)
have viral, bacterial or fungal infections (Ex. measles, chickenpox)
have glucose intolerance
have problems in adrenal gland (Ex. adrenal insufficiency)
met with any major trauma (accidents) or undergone a surgery

Use in pediatrics:

DIGIHALER SF 250MCG INHALER is not recommended for use in children younger than 12 years of age. Kindly consult your doctor before using it.

Use in geriatrics:

DIGIHALER SF 250MCG INHALER should be taken with caution in elderly patients (aged 65 years or above). Therefore, consult your doctor before using it. Proper dose adjustments and careful monitoring are required in such patients.

Interactions

A. Drug-Drug interactions:

Before using DIGIHALER SF 250MCG INHALER, inform your physician if you are taking any of the following medicines such as:

other beta-blockers (used to manage high blood pressure or other heart conditions) Ex. atenolol, propranolol and sotalol
medicines used to manage fungal infection (such as ketoconazole and itraconazole)
medicines used to manage HIV infection (Ex. ritonavir, atazanavir, indinavir, nelfinavir, saquinavir or cobicistat)
clarithromycin, erythromycin (used to manage bacterial infections)
other corticosteroids (taken orally or via injections to manage pain or inflammation) Ex. dexamethasone
potassium-sparging diuretics (used to manage high blood pressure by increasing urine output) Ex. spironolactone, acetazolamide
other medicines that can cause bronchodilation (such as salbutamol, formoterol)
xanthine medicines (used to manage asthma) Ex. theophylline and aminophylline
nefazodone (used to manage depression)
medicines used to manage depression such as (rasagiline, selegiline, phenelzine, amitriptyline, nortriptyline, doxepin, imipramine, desipramine)

Overdosage:

If you or anyone else accidentally inhaled excessive amount of this medicine, contact your doctor immediately or go to the hospital straight away. Symptoms of overdosage might include shortness of breath, chest pain, fast heartbeat, feeling shaky, dizziness, headache, muscle weakness and joint pain.

Synopsis

Drug	:	Fluticasone, Salmeterol
Pharmacological Category	:	Corticosteroids, Beta-1 receptor agonists
Therapeutic Indication	:	Asthma, COPD
Dosage Forms	:	Autohaler, Blisters, Capsule, Inhalation capsule, Octacaps, Respicaps, Rotacaps, Trans caps, Nexcaps, Accuhaler, Inhaler, Ciphaler, Multihaler

More Information

Keep DIGIHALER SF 250MCG INHALER out of reach of children
Store DIGIHALER SF 250MCG INHALER at room temperature

FAQs About DIGIHALER SF 250MCG INHALER

What is the use of DIGIHALER SF 250MCG INHALER?

DIGIHALER SF 250MCG INHALER is used to manage asthma and chronic obstructive pulmonary disease (COPD). It also helps in reducing flare-ups of COPD symptoms.

How DIGIHALER SF 250MCG INHALER works in my body?

DIGIHALER SF 250MCG INHALER relaxes the smooth muscles of the airways and widens them. It also reduces the inflammation of airway tract. Therefore, it allows the air to pass through more freely and makes breathing easier.

Can DIGIHALER SF 250MCG INHALER be used on an asthma attack?

DIGIHALER SF 250MCG INHALER is only used to manage or manage the symptoms of asthma and COPD (such as breathlessness or wheezing). If your asthma or breathing gets worse suddenly, contact your doctor immediately or go to the straight away to avoid further exacerbation of the attack. Meanwhile use a fast-acting rescue inhaler containing salbutamol along with this medicine.

Is DIGIHALER SF 250MCG INHALER safe?

DIGIHALER SF 250MCG INHALER is considered safe at doses prescribed by the physician.

What are the side effects of using DIGIHALER SF 250MCG INHALER?

The most common side effects of using DIGIHALER SF 250MCG INHALER are headache, cold, oral thrush or oral sores, throat irritation, hoarse voice, muscle pain and joint pain. Contact your doctor if any of these side effect worsens.

Can I stop using DIGIHALER SF 250MCG INHALER once my symptoms subside?

No. Use DIGIHALER SF 250MCG INHALER every day until your doctor tells you to stop. Do not stop taking this medicine abruptly or reduce the dose without consulting your doctor, as it could make your breathing even worse. Your doctor will access your disease condition regularly and will increase or decrease the dose accordingly.

Will DIGIHALER SF 250MCG INHALER more effective if taken at higher doses?

Always consume the dose prescribed for you by your physician. Your doctor will decide the correct dose and duration of therapy for you depending upon your age, body weight and severity of the disease. Do not take a higher dose of this medicine without consulting your doctor as it could lead to unwanted side effects. It your symptoms are not relieved by the prescribed dose, consult your doctor so that he might adjust the dose according to your health condition or can suggest an alternative therapy.

I’m pregnant. Can I use DIGIHALER SF 250MCG INHALER?

DIGIHALER SF 250MCG INHALER should be used in pregnant women only if it is considered necessary by the physician. Your doctor will prescribe you with DIGIHALER SF 250MCG INHALER after evaluating the risks and benefits of the therapy.

Can DIGIHALER SF 250MCG INHALER be used in children?

DIGIHALER SF 250MCG INHALER is considered safe for use in children and adolescents aged 12 years or above. However, it is not recommended for use in children younger than 12 years due to lack of safety data. Kindly consult your doctor before taking.

How long will it take for DIGIHALER SF 250MCG INHALER to relieve the symptoms and how long the effects can last?

Generally, DIGIHALER SF 250MCG INHALER takes about 10-15 minutes to relieve the symptoms of asthma or COPD. However, the onset of action slightly differs from person to person based upon their disease condition. The effects of DIGIHALER SF 250MCG INHALER can last for 12-18 hours, because salmeterol present in this medicine is considered as a longer-acting beta-1 adrenergic agonist.

Can DIGIHALER SF 250MCG INHALER cause infection in the mouth?

Yes. DIGIHALER SF 250MCG INHALER may cause fungal infections of the mouth (oral thrush). To avoid this, make sure to rinse your mouth with water after inhaling the medicine. However, if an infection develops, consult your doctor.

What happens when you forget to use DIGIHALER SF 250MCG INHALER?

If you forget to use DIGIHALER SF 250MCG INHALER, use it as soon as you remember. However, if it's time for the next dose, skip the missed dose and take the next dose. Do not use a double dose to compensate the missed dose.

Can DIGIHALER SF 250MCG INHALER be used if you have an infection?

Inform your doctor if you have any bacterial, fungal, or viral infection before using DIGIHALER SF 250MCG INHALER. Your doctor will evaluate your existing health condition and advise changes in management accordingly. Also, inform your doctor if have exposure to an infectious environment or with a person with infectious diseases, as DIGIHALER SF 250MCG INHALER may mask your symptoms of the infection.

References

1. KD. Tripathi. Drugs for Cough and Bronchial Asthma. Essentials of medical pharmacology. Seventh edition. 2013. Page – 221-224 & 230-233

2. Jinming Gao and Roy A Pleasants. Role of the fixed combination of fluticasone and salmeterol in adult Chinese patients with asthma and COPD. NCBI; PMC US National Library of Medicine, National Institute of Health. April 2015. [Accessed 10th January 2022] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4403740/

3. Cipla Ltd. SEROFLO Inhaler (Salmeterol + Fluticasone propionate). Ciplamed.com. [Revised in March 2020] [Accessed 10th January 2022] https://www.ciplamed.com/content/seroflo-inhaler

4. Cipla (EU) limited. Electronic Medicines Compendium (EMC). [Revised in February 2019] [Accessed 10th January 2022] https://www.medicines.org.uk/emc/files/pil.10146.pdf

5. Glaxo Wellcome Production. Health Products Regulatory Authority (HPRA). [Revised in March 2018] [Accessed 10th January 2022] https://www.hpra.ie/img/uploaded/swedocuments/PIL-2206316-02052018155014-636608730177031250.pdf

6. Orion Corporation. Electronic Medicines Compendium (EMC). [Revised in March 2018] [Accessed 10th January 2022] https://www.medicines.org.uk/emc/files/pil.9224.pdf

7. Cipla Ltd. SEROFLO Inhaler (Salmeterol + Fluticasone propionate). Ciplamed.com. [Revised in March 2020]. [Accessed on 16th November 2022] https://www.ciplamed.com/content/seroflo-inhaler

8. Central Drugs Standard Control Organization. Fluticasone Propionate 50mcg/125mcg/250mcg + Salmeterol xinafoate 25mcg/25mcg/25mcg Powder for inhalation. Salmeterol xinafoate + fluticasone propionate. [Accessed on 16th November 2022] https://cdscoonline.gov.in/CDSCO/Drugs

Useful Diagnostic Tests

Absolute eosinophil count
Complete blood count

Author Details

Written By Srilekha. R - B.Pharm

Reviewed For Accuracy By Dr. Rajnikant - MBBS, MD (Physiology)

Last updated on 18 Nov 2022 | 05:33 PM(IST)

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