Talk:Fluticasone/salmeterol
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My Advair dispenser is not a "Diskus", but a "puffer" - the usual cannister under pressure (CFC-free.) It contains 120 metered doses - 25mcg salmeterol, and 125 mcg fluticasone per metered dose. 70.69.211.197 00:15, 11 April 2006 (UTC)
[edit] metaanalysis study
How in the world can you say that the following is spamming?
Three common asthma inhalers containing the drugs salmeterol or formoterol may be causing four out of five U.S. asthma-related deaths per year and should be taken off the market, researchers from Cornell and Stanford universities have concluded after a search of medical literature.[1]
The link is the reference to a valid study by respected scientists and physicians.
Doing a search on google for salmeterol or formoterol may be causing four out of five U.S. asthma-related deaths I found that there are 11,400 references to the article. I don't think this is a spamming effort..
- The effect being suggested is from the salmeterol rather than the fluticasone (which on its own has, like all steroids, been previously shown to reduce death rates). Would info not be better placed on salmeterol, with this and the other combination-product articles then linking there?
- Also are you aware if the current comment in salmeterol article re the FDA’s November 2005 warning to much the same effect, was due to forewarning by these researchers (date of meta-analysis can be well before final publication dates) or from a separate source ?
- Finally even if the risk is confirmed by other researchers and accepted by the consensus of medical opinion, does this necessarily mean that they will be banned ? I suspect not for this ignores the huge symptom relieve given to very large numbers of patients (so small mortality against very large morbidity effects) - I'm not saying one is right or wrong, but I have seen lives previously ruined by poorly controlled asthma (frequent GP visits or time off work affecting job security, earning potential etc) transformed as LABA were introduced. One might compare to the well recognised situation of strong analgesics being associated with increased falls in the elderly (with risks hip fractures, morbidity & mortality), yet there would be outrage if such analgesics were withdrawn from the thousands of patients incapacitated by unbearable arthritic pain (with I am sure some renewed calls for legalising euthanasia). Stronger warnings and a change in use might minimise the problem (so LABA fine for routine control of symptoms, but if any exacerbation then immediate discontinuation and use of just normal short-acting bronchodilator with high-dose steroid inhaler ? I've no idea if that would have the desired effect, but it is the type of shift in management/usage that I can more realistically see occurring. David Ruben Talk 23:48, 19 July 2006 (UTC)
[edit] meta analysis
I don't know why I am getting such resistance to posting the article (11,400 references to it on google). I had posted it on salmeterol and other places as well only to be removed. I do have a concern about the safety and efficacy of salmeterol based on the article written (as well as other references). These were written by other physicians/researchers not connected financially to the manufacturer. One can not keep this information back in the bottle despite the forces that wish to ("the fourth bestselling drug in the world with $5.6 billion in annual sales"). The general public has a right to know if 4 out of 5 people are dying from this drug -- salmeterol or maybe any long-acting beta-agonists ... ("These agents can improve symptoms through bronchodilation at the same time as increasing underlying inflammation and bronchial hyper-responsiveness, thus worsening asthma control without any warning of increased symptoms," said Shelley Salpeter.").
I'm sure further research will probably confirm this if given a chance and an open airing of the information at hand.
Looking at the Salmeterol article, I appreciate you adding in the references to the study David.
--Ian.desouza 02:35, 24 July 2006 (UTC)
[edit] Information, if needed
I've got the box and information leaflet from an Advair 100 diskus, if anyone who watches this page thinks that the information may be useful. I could scan/photograph either if it doesn't infringe on any copyrights, but only if it is requested. BigNate37T·C 06:56, 29 July 2006 (UTC)
