40 mcg inhaled twice daily, approximately 12 hours apart, is the recommended starting dose. For patients who do not respond adequately to 40 mcg after 2 weeks of therapy, increasing the dosage to 80 mcg twice daily may provide additional asthma control. The maximum recommended dosage is 80 mcg twice daily. The starting dosage is based on the severity of asthma, including consideration of the patients’ current control of asthma symptoms and risk of future exacerbation. Improvement in asthma symptoms can occur within 24 hours of the beginning of treatment and should be expected within the first or second week, but maximum benefit should not be expected until 3 to 4 weeks of therapy. Improvement in pulmonary function is usually apparent within 1 to 4 weeks after the start of therapy. The National Asthma Education and Prevention Program Expert Panel defines low dose therapy as 80 to 160 mcg/day, medium dose as 161 to 320 mcg/day, and high dose therapy as more than 320 mcg/day for children ages 5 to 11 years. The Global Initiative for Asthma (GINA) guidelines define low dose therapy as 100 mcg/day in this age group. Titrate to the lowest effective dose once asthma stability is achieved.
Important Safety Information for VECTICAL ® (calcitriol) Ointment
Indication: VECTICAL ® Ointment is indicated for the topical treatment of mild to moderate plaque psoriasis in adults 18 years and older. Adverse Events: In controlled clinical studies, the most commonly reported adverse reactions (≥ 3%) were lab test abnormality, urine abnormality, psoriasis, hypercalciuria, pruritus, and skin discomfort. Warnings/Precautions: The maximum weekly dose should not exceed 200 g. Avoid contact with eyes, lips and face. VECTICAL ® Ointment should be used with caution in patients receiving medications known to increase the serum calcium level, such as thiazide diuretics and in patients receiving calcium supplements or high doses of Vitamin D. If aberrations in parameters of calcium metabolism are noted discontinue VECTICAL ® Ointment until these normalize. Avoid excessive exposure of VECTICAL ® Ointment treated areas to either natural or artificial sunlight.
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