125 micrograms/dose inhalation spray, suspension
fluticasone propionate

1. What Fluticasone Cipla is and what it is used for

This medicine contains the active substance fluticasone propionate which belongs to the group of corticosteroids. Fluticasone Cipla works by reducing inflammation in the lungs. This helps prevent asthma attacks in people who need regular treatment. It takes 4-7 days before the medicine has a full effect and you must use it regularly.

Fluticasone Cipla does not help with acute asthma attacks as you feel short of breath. Another drug is used to treat acute attacks.

Fluticasone propionate contained in Fluticasone Cipla may also be approved for the treatment of other conditions not mentioned in this leaflet. Ask your doctor, pharmacist, or another healthcare professional if you have any further questions, and always follow their instructions.

What you need to know before using Fluticasone Cipla

Do not use Fluticasone Cipla

– if you are allergic to fluticasone propionate or any of the other ingredients of this medicine (listed in section 6).

Warnings and cautions

Discontinue treatment with Fluticasone Cipla immediately

– if you experience difficulty breathing with wheezing that worsens immediately after taking a dose of this medicine

Talk to your doctor, pharmacist, or nurse before using Fluticasone Cipla

– if you have ever been treated for tuberculosis (TB)

– if you have or have had diabetes mellitus (because fluticasone may raise your blood sugar)

– if you have used high doses of this medicine for long periods and noticed any of the following:

  • weight gain and a rounded face (full moon face) (Cushing’s syndrome)
  • vague symptoms such as abdominal pain, vomiting, diarrhea, headache, or dizziness (adrenal suppression, acute adrenal crisis). This is more likely during an infection such as a viral infection or in case of stomach upset.
  • reduced bone density
  • eye problems ( cataracts and glaucoma )
  • delayed growth (occurs mainly in children and adolescents)

If you are not sure if any of the above applies to you, talk to your doctor, nurse, or pharmacist before using Fluticasone Cipla.

Contact a doctor if you experience blurred vision or other visual disturbances.

Other medicines and Fluticasone Cipla

Tell your doctor or pharmacist if you are taking, have recently taken, or might take any other medicines, including medicines obtained without a prescription. You must tell your doctor or pharmacist if you are taking any of the following:

– medicines for different types of infection, e.g. ketoconazole, clarithromycin, telithromycin, ritonavir, cobicistat, atazanavir, indinavir, nelfinavir, or saquinavir. These medicines may increase the effects of Fluticasone Cipla and your doctor may want to monitor you closely if you are taking these medicines.

– steroid tablets together with your Fluticasone Cipla inhaler or if you have just stopped taking steroid tablets. You should carry a special card with you stating that you are using steroids as there is a risk of impaired adrenal function, especially in stressful situations such as a serious accident or before surgery. Your doctor may then decide to give you an extra supplement of steroids during this time.

If you are not sure if any of the above applies to you, talk to your doctor or pharmacist before using Fluticasone Cipla.

Pregnancy, breastfeeding, and fertility

If you are pregnant or breast-feeding, think you may be pregnant, or are planning to have a baby, ask your doctor or pharmacist for advice before taking this medicine.

Driving and using machines

Fluticasone Cipla is unlikely to affect your ability to drive or use tools or machines.

You are responsible for assessing whether you are fit to drive a motor vehicle or perform work that requires increased attention. One of the factors that can affect your ability in these respects

is the use of drugs due to their effects and/or side effects. Descriptions of these effects and side effects can be found in other sections. Read all the information in this leaflet for guidance. If you are not sure, talk to your doctor or pharmacist.

3. How to use Fluticasone Cipla

Fluticasone Cipla is available in two different strengths for use in oral inhalation only. Your doctor will decide what strength you need. Always take Fluticasone Cipla exactly as your doctor has told you. If you are not sure, talk to your doctor, nurse, or pharmacist.

How to use the medicine

– Fluticasone Cipla can be used with Volumatic respirators by patients who find it difficult to spray a dose by pressing the trigger just as they begin to inhale.

– The starting dose must be adapted to the severity of the disease. Your doctor will work with you to reduce the dose to one of the lowest doses that provide effective asthma control.

Adults and young people over 16 years

The recommended dose is 50-500 micrograms twice daily.

Use for children

Fluticasone Cipla is not recommended for children under 16 years of age.

If you use high doses of inhaled steroids for long periods of time, you may sometimes need an extra supplement of steroids, for example in stressful situations such as a traffic accident or before an operation.

Your doctor may then decide to give you an extra supplement of steroids during this time.

Instructions for use

Your doctor, nurse, or pharmacist should instruct you on how to use your inhaler. From time to time, they should also check how you use it. Improper use of Fluticasone Cipla or use that is not as prescribed may result in the medicine not having the intended effect on your asthma.

This medicine is contained in a pressure vessel in a plastic housing with a nozzle. To prevent the inhaler from clogging, it is important to clean it at least once a week.

How to check the inhaler

  1. When using the inhaler for the first time, test sprays to check that it works. Remove the nozzle by tapping both sides of it with your thumb and forefinger and pulling it apart.
  2. To check that the inhaler works, shake it well, direct the nozzle away from you, push the container down and spray into the air. If you have not used the inhaler for a week or more, spray two puffs in the air.

How to use the inhaler

It is important to breathe as slowly as possible just before using the inhaler.

  1. You should either stand up or sit upright when using the inhaler.
  2. Remove the cover on the nozzle. Check that the nozzle is clean and free from foreign objects. objects both inside and outside (picture A).
  3. Shake the inhaler 4 or 5 times so that any loose objects are removed and the contents of the inhaler are mixed well (Figure B).
  4. Hold the inhaler upright with your thumb on the bottom, under the mouthpiece. Exhale as far as you feel comfortable (picture C). Do not inhale again.
  5. Place the mouthpiece in your mouth between your teeth. Close your lips around the nozzle. Do not bite (picture D).
  6. Inhale through the mouth. Just as you begin to inhale, press down on the top of the container to spray a dose. Continue to breathe calmly and deeply (picture D).
  7. Hold your breath, remove the inhaler from your mouth and release your finger from the top of the inhaler. Continue to hold your breath for a few seconds or as long as it feels comfortable (picture E).
  8. If your doctor has told you to take two doses, wait about half a minute before repeating treatment from point 3 to 7.
  9. Rinse mouth afterward with water and spit out to avoid side effects in mouth and throat. You can also brush your teeth.
  10. Always replace the protective cover to protect against dust after using the inhaler. A snap is heard when the protective hood is pressed into place.

Practice in front of a mirror the first few times. If it snorts from the top of the inhaler or out through the sides of your mouth, start again. Older children or people with weak hands may find it easier to hold the inhaler with both

hands. Place both index fingers on top of the inhaler and both thumbs under the mouthpiece. If you are not sure, talk to your doctor, nurse, or pharmacist.

How to clean the inhaler

To prevent the inhaler from clogging, it is important to clean it at least once a week.

To clean the inhaler:

– Remove the protective cap on the nozzle.

– Do not remove the metal container from the plastic cover.

Wipe the inside and outside of the nozzle and the plastic cover with a dry towel or

paper napkin.

– Put the protective cap back on the nozzle.

Do not place the metal container in water.

If you use more Fluticasone Cipla then you should  

If you have used too much, talk to a doctor as soon as possible.

You must take a dose according to the label on the package or according to your doctor’s prescription. Do not increase or decrease the dose without consulting a doctor.

If you have ingested too much medicine or if e.g. If a child has inadvertently ingested the medicine, contact a doctor, hospital, or the Poison Information Center for risk assessment and advice.

If you forget to use Fluticasone Cipla

– Take the next dose at the usual time.

– Do not take a double dose to make up for a forgotten dose .

If you stop using Fluticasone Cipla

Do not stop the treatment even if you feel better other than on the doctor’s prescription . Patients treated with high dose of your steroid you for a long time should not stop taking their medication suddenly without first talking to your doctor, as this can worsen asthma symptoms. Abrupt discontinuation of treatment may also make you feel unwell and may cause symptoms such as vomiting, drowsiness, nausea, headache, fatigue, loss of appetite, low blood sugar and seizures (convulsions).

If you have any further questions on the use of this product, ask your doctor, nurse or pharmacist.

4. Possible side effects

Like all medicines, this medicine can cause side effects , although not everybody gets them. If you notice any of the following serious side effects , stop using this medicine and contact a doctor immediately. You may need urgent medical attention.

– allergic reaction (may affect up to 1 in 100 people) or severe allergic reaction (may affect up to 1 in 10,000 people). Signs include rash, redness , itching or swelling of the skin such as hives or hives and swelling of the face, lips, mouth, tongue or throat which may cause difficulty breathing, itching , fainting, dizziness and intoxication and collapse.

– your breathing or hissing worsens immediately after using the inhaler.

Other side effects include:

Very common (affects more than 1 in 10 people)

fungal infection of the mouth and throat

Common (affects less than 1 in 10 people)

– hoarseness

– bruises

– pneumonia in COPD patients

Tell your doctor if you have any of the following symptoms while taking Fluticasone Cipla as they may be symptoms of pneumonia:

• fever or chills

• increased mucus production, changed color of the mucus

• increased cough or increased difficulty breathing

Rare (may affect up to 1 in 1,000 people)

– fungal infection (cod) in the esophagus

Very rare (affects less than 1 user in 10,000)

– sewing difficulties or anxiety, overactivity and irritability (seen mainly in children)

joint pain

– indigestion

– elevated blood sugar (blood glucose)

– use of high dose Fluticasone Cipla for long periods may cause:

adrenal insufficiency, acute adrenal crisis, Cushing’s syndrome (overproduction of

adrenal cortex hormones), decreased bone density, eye problems (such as cataracts and glaucoma , which means high pressure in the eye) and delayed growth in children and adolescents (see section 2 Warnings and precautions). To prevent this, your doctor will make sure that you use the lowest dose of a steroid that provides symptom control.

Has been reported (occurs in an unknown number of users)

• depression

• restlessness or nervousness (seen mainly in children)

• nosebleeds

• dimsyn

Reporting of side effects ar

If you get any side effects , talk to your doctor, pharmacist or nurse. This also applies to any side effects not mentioned in this information. You can also report side effects directly (see details below). By reporting side effects, you can help increase drug safety information.

The Medical Products Agency

Box 26

751 03 Uppsala

5. How to store Fluticasone Cipla

Keep this medicine out of the sight and reach of children.

Clean the inhaler every week and if it has become clogged as described under “How to clean the inhaler”.

Do not use this medicine after the expiry date which is stated on the label and carton after EXP. The expiration date is the last day of the specified month.

The container contains a liquid under pressure. Do not expose to temperatures above 50 ° C. The container must not be punctured. Store in a cold place. Do not freeze. Protected against frost and direct sunlight.

If the inhaler has cooled down, remove the metal container from the plastic cover and heat it between your hands for a few minutes. Never use anything else to heat the inhaler.

The contents of the metal container are under pressure. It must not be punctured, broken or burned, even if the container appears to be empty.

Medicines should not be disposed of via wastewater or household waste. Ask your pharmacist how to dispose of medicines no longer required. These measures will help to protect the environment.

If you are told to stop taking this medicine, return the inhaler to your pharmacist, who will dispose of it appropriately.

6. Contents of the packaging and other information

Content declaration

– The active substance is fluticasone propionate. A measured dose ( dose leaving the valve)

contains 125 and 250 micrograms fluticasone propionate, respectively. This corresponds to a given dose

( dose leaving the inhaler) of 110 and 227 micrograms fluticasone propionate, respectively.

– The other ingredients are norflurane (HFA 134a).

What the medicine looks like and the contents of the pack

Fluticasone Cipla is a white suspension in a metal container closed with a metering valve, trigger and protective cap.

Each container contains 120 doses of either 125 or 250 micrograms fluticasone propionate.

Pack sizes:

Single pack – Each single pack contains a container with 120 doses .

Multipack – bundle pack of 2 or 3 single packs.

Hospital packaging – bundle packaging of 10 single packages.

Not all pack sizes may be marketed.

Marketing Authorization Holder and Manufacturer

Marketing Authorisation Holder

Cipla Europe NV

The Keyserlei 58-60

Box-19, 2018 Antwerp

Belgium

Manufacturer

S&D Pharma CZ, spol. s ro

Theodor 28

273 08 Archery

Czech

Cipla (EU) Limited,

Dixcart House, Addlestone Road,

Bourne Business Park, Addlestone,

Surrey, KT15 2LE,

UK

Cipla Europe NV

De Keyserlei 58-60,

Box-19, 2018 Antwerp,

Belgium

Kern Pharma, SL

Venus, 72 – Pol. Ind. Colon II

08228 Terrace – Barcelona

Spain

Orion Corporation Orion Pharma

Orionintie 1

FI-02200 Espoo

Finland

Orion Corporation Orion Pharma

Joensuunkatu 7

FI-24100 Salo

Finland

For any information about this medicine, please contact the local representative of the Marketing Authorization Holder:

Orion Pharma AB

medinfo@orionpharma.com

This leaflet is available in a large size on request.

This medicinal product is authorized under the European Economic Area under the names:

Finland Fluticason Orion 125 micrograms / annos inhalaatiosumute, suspensionFluticason Orion 250 micrograms / annos inhaleatiosumute, suspension
Germany Fluticason Cipla 125 Micrograms / Injection Pressure Gas Inhalation, SuspensionFluticason Cipla 250 Micrograms / Injection Pressure Gas Inhalation, Suspension
Hungary Flutikazon Cipla 125 micrograms / adag túlnyomásos inhalációs szuszpenzióFlutikazon Cipla 250 micrograms / adag túlnyomásos inhalációs szuszpenzió
Italy Fluticasone Cipla 125 micrograms for erosion, suspension pressurized for inhalationFluticasone Cipla 250 micrograms for erosion, suspension pressurized for inhalation
Norway Fluticasone Cipla 125 micrograms / dose inhalation aerosol suspensionFluticasone Cipla 250 micrograms / dose inhalation aerosol suspension
Spain Fluticasona Kern Pharma 125 micrograms / suspension suspension for pressure inhalationFluticasona Kern Pharma 250 micrograms / suspension suspension for pressure inhalation

Muhammad Nadeem

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