Inaladuo (Fluticasone Propionate, Salmeterol)

• Inaladuo, an inhaled corticosteroid/long‑acting β2‑agonist combination, is used for chronic respiratory diseases that require maintenance therapy.
• Asthma: provides long‑term control of symptoms and reduces the frequency of exacerbations.
• COPD: improves lung function and helps prevent worsening of disease.
• Chronic respiratory disease: serves as a maintenance option to stabilize airway tone and inflammation.

• Fluticasone propionate binds to glucocorticoid receptors in airway cells, suppressing inflammatory gene expression and reducing mucosal edema. Salmeterol selectively activates β2‑adrenergic receptors, stimulating adenylate cyclase and increasing cyclic AMP, which leads to prolonged bronchodilation. The combined actions provide both anti‑inflammatory and bronchodilatory effects, improving airway patency over time.

Inaladuo may cause a range of adverse reactions, from mild to serious.

Common Side Effects

• Oral candidiasis (thrush): fungal infection of the mouth.
• Hoarseness or voice changes.
• Throat irritation or soreness.
• Cough.
• Headache.
• Tremor.

Serious or Rare Side Effects

• Paradoxical bronchospasm: sudden worsening of breathing.
• Adrenal suppression: reduced endogenous cortisol production.
• Cardiac arrhythmias: irregular heart rhythm.
• Severe hypersensitivity reactions: rash, swelling, or anaphylaxis.

• Before prescribing Inaladuo, clinicians should consider several safety measures.
• Assess infection risk: evaluate for active respiratory infections before initiating therapy.
• Monitor lung function: regularly review spirometry or peak flow results.
• Use a spacer device: helps reduce oropharyngeal deposition and side effects.
• Avoid abrupt discontinuation: tapering may be needed to prevent adrenal insufficiency.
• Review concomitant medications: consider potential additive effects with other bronchodilators.
• Store at ambient temperature: keep in original packaging, protect from moisture and direct sunlight.

Inaladuo can interact with other medicines, requiring attention to avoid adverse outcomes.

Major Interactions (Avoid)

• Beta‑blockers: may diminish bronchodilator effect and precipitate bronchospasm.
• Strong CYP3A4 inhibitors (e.g., ketoconazole, itraconazole): increase systemic exposure to fluticasone.
• Concurrent inhaled corticosteroids: raise risk of systemic corticosteroid effects.

Moderate Interactions (Monitor Closely)

• Diuretics: may exacerbate hypokalemia when combined with salmeterol.
• Theophylline: salmeterol can increase theophylline plasma levels.
• Anticholinergic bronchodilators: additive bronchodilation may require dose adjustment.