Major research findings

Fluticasone and salmeterol inhalers are often recommended for the treatment of asthma and COPD, often in combination with long-acting beta2-agonists (LABA), depending on the severity of the disease and/or on the specific phenotype. 3 , 2 These medications have been shown to be effective in improving asthma control, lung function, and preventing exacerbations of disease. 3 The addition of long-acting beta-agonist (LABA) therapy with ICS increases the efficacy of ICS effects in moderate-to-severe asthma. 3 For example, a 800 mug daily dose of the ICS budesonide reduced severe exacerbation rates by 49% compared to a low dose of 200 mug daily, and addition of the LABA formoterol to budesonide (800 mug) led to a 63% reduction. 3 The effects of ICS are less prominent in COPD but there are beneficial effects on the decline in FEV(1) and the rate of exacerbations. 3 In COPD, the effects of ICS are less prominent but there are beneficial effects on the decline in FEV(1) and the rate of exacerbations. 3

Reasons for side effects

Side effects of fluticasone and salmeterol inhalers are due to the direct action of the medication on the airways. These medications work on airway cells to suppress airway inflammation. This action can cause side effects.

General side effects

Oral candidiasis

The most common side effect of fluticasone and salmeterol inhalers is oral candidiasis. 3 This side effect occurs when the medication adheres to the oral cavity. Oral candidiasis is characterized by white spots or white membrane-like formations in the oral cavity.

Hoarseness

Fluticasone and salmeterol inhalers can cause hoarseness. 3 This side effect occurs when the medication acts on the vocal cords.

Easy bruising

Fluticasone and salmeterol inhalers can cause easy bruising. 3 This side effect occurs when the medication acts on the body.

Reduced growth velocity

Fluticasone and salmeterol inhalers can cause reduced growth velocity. 3 This side effect occurs when the medication acts on the body. However, this side effect is only likely to occur if the medication is taken in doses exceeding the maximum recommended dose.

Reduced bone mineral density

Fluticasone and salmeterol inhalers can cause reduced bone mineral density. 3 This side effect occurs when the medication acts on the body. However, this side effect is only likely to occur if the medication is taken in doses exceeding the maximum recommended dose.

Pneumonia

Fluticasone and salmeterol inhalers may increase the risk of pneumonia. 2 In particular, medications containing fluticasone may have a higher risk of pneumonia compared to other inhaled steroids. 2

Measures against side effects

Oral candidiasis

Rinsing your mouth after inhalation is effective in preventing oral candidiasis. 3 You can also consult your doctor for a prescription for oral candidiasis medication.

Hoarseness

Hoarseness occurs when the medication adheres to the vocal cords during inhalation. To prevent hoarseness, it is important to inhale slowly and carefully during inhalation to prevent the medication from adhering to the vocal cords. You can also consult your doctor for a prescription for hoarseness medication.

Easy bruising

Easy bruising occurs when the medication acts on the body. To prevent easy bruising, it is important to take the medication according to your doctor's instructions.

Reduced growth velocity

To prevent reduced growth velocity, it is important to take the medication according to your doctor's instructions. It is also important to consult your doctor regularly to monitor growth velocity.

Reduced bone mineral density

To prevent reduced bone mineral density, it is important to take the medication according to your doctor's instructions. It is also important to consult your doctor regularly to monitor bone mineral density.

Pneumonia

To reduce the risk of pneumonia, it is important to take the medication according to your doctor's instructions. If you experience symptoms of pneumonia (fever, cough, phlegm), it is important to consult your doctor immediately.

Comparison between studies

Common points of studies

Multiple studies have shown that fluticasone and salmeterol inhalers are effective in treating asthma and COPD. 3 , 4 , 6 Also, these studies reported oral candidiasis, hoarseness, and easy bruising as side effects of fluticasone and salmeterol inhalers. 3 , 2

Differences between studies

The association between fluticasone use and the risk of pneumonia is not consistent across studies. One study suggests that medications containing fluticasone have a higher risk of pneumonia compared to other inhaled steroids. 2 On the other hand, other studies have found no association between fluticasone and the risk of pneumonia. 4 Further research is needed to evaluate the risk of pneumonia.

Precautions for application to real life

It is important to take fluticasone and salmeterol inhalers according to your doctor's instructions. The dosage, frequency, and timing of the medication will be determined by your doctor based on your individual condition. Also, when using fluticasone and salmeterol inhalers, you need to understand that there is a possibility of side effects such as oral candidiasis and hoarseness. If you experience any of these side effects, consult your doctor.

Limitations of current research

There is still not enough research on fluticasone and salmeterol inhalers. In particular, research on long-term use is lacking. Therefore, further research is needed to evaluate the long-term safety of these medications.

Future research directions

Long-term use studies are needed to evaluate the long-term safety of fluticasone and salmeterol inhalers. Further research is also needed to evaluate the risk of pneumonia.

Conclusion

Fluticasone and salmeterol inhalers are effective medications for treating chronic airway diseases such as asthma and COPD. These medications work by suppressing airway inflammation and improving airway patency, improving respiratory function and preventing exacerbations of disease. However, fluticasone and salmeterol inhalers can cause side effects such as oral candidiasis and hoarseness. When using these medications, take them according to your doctor's instructions, and consult your doctor immediately if you experience any side effects.