1. What Aliflus is and what it is used for

Aliflus contains two medicines, salmeterol and fluticasone propionate:

•    Salmeterol is a long-acting bronchodilator. Bronchodilators help the airways in the lungs to stay open. This makes it easier for air to get in and out. The effects last for at least 12 hours.

•    Fluticasone propionate is a corticosteroid which reduces swelling and irritation in the lungs.

The doctor has prescribed this medicine to help prevent breathing

problems such as:

•    Asthma

•    Chronic Obstructive Pulmonary Disease (COPD). Aliflus Accuhaler, at a dose of 50/500 micrograms, reduces the number of flare ups of COPD symptoms.

If you are using Aliflus for asthma, your doctor will want to regularly check your symptoms.

If your asthma or breathing gets worse tell your doctor straight away. You may find that you feel more wheezy, your chest feels tight more often or you may need to use more of your fast-acting 'reliever' medicine. If any of these happen, you should continue to take Aliflus but do not increase the number of puffs you take. Your chest condition may be getting worse and you could become seriously ill. See your doctor as you may need additional treatment.

You must use Aliflus every day as directed by your doctor. This will make sure that it works properly in controlling your asthma or COPD.

Aliflus helps to stop breathlessness and wheeziness coming on. However Aliflus should not be used to relieve a sudden attack of breathlessness or wheezing. If this happens you need to use a fast -acting ‘reliever' (‘rescue') inhaler, such as salbutamol. You should always have your fast-acting ‘rescue' inhaler with you.

Instructions for use

•    Your doctor, nurse or pharmacist should show you how to use your inhaler. They should check how you use it from time to time. Not using the Aliflus Accuhaler properly or as prescribed may mean that it will not help your asthma or COPD as it should.

•    The Accuhaler device holds blisters containing Aliflus as a powder.

•    There is a counter on top of the Accuhaler which tells you how many doses are left. It counts down to 0. The numbers 5 to 0 will appear in red to warn you when there are only a few doses left. Once the counter shows 0, your inhaler is empty.

2. What you need to know before you use Aliflus

Do not take Aliflus if:

You are allergic (hypersensitive) to salmeterol, fluticasone propionate or to the other ingredient lactose monohydrate.

Warnings and precautions

Your doctor will supervise your treatment more closely if you have medical conditions such as:

•    Heart disease, including an irregular or fast heart beat

•    Overactive thyroid gland

•    High blood pressure

•    Diabetes mellitus (Aliflus may increase your blood sugar)

•    Low potassium in your blood

•    Tuberculosis (TB) now or in the past, or other lung infections

If you have ever had any of these conditions, tell your doctor before you use Aliflus.

Other medicines and Aliflus

Tell your doctor or pharmacist if you are taking or have recently taken any other medicines. This includes medicines for asthma or any medicines obtained without a prescription. This is because Aliflus may not be suitable to be taken with some other medicines.

Tell your doctor if you are taking the following medicines, before starting to use Aliflus:

•    p blockers (such as atenolol, propranolol and sotalol). p blockers are mostly used for high blood pressure or other heart conditions.

•    Medicines to treat infections (such as ritonavir, ketoconazole, itraconazole and erythromycin). Some of these medicines may increase the amount of fluticasone propionate or salmeterol in your body. This can increase your risk of experiencing side effects with Aliflus, including irregular heart beats, or may make side effects worse.

•    Corticosteroids (by mouth or by injection). If you have had these medicines recently, this might increase the risk of this medicine affecting your adrenal gland.

•    Diuretics, also known as 'water tablets' used to treat high blood pressure.

•    Other bronchodilators (such as salbutamol).

•    Xanthine medicines. These are often used to treat asthma.

Using your inhaler

1. To open your Accuhaler, hold the outer case in one hand and put the thumb of your other hand on the thumbgrip. Push your thumb away from you as far as it will go. You will hear a click. This will open a small hole in the mouthpiece.

2. Hold your Accuhaler with the mouthpiece towards you. You can hold it in either your right or left hand. Slide the lever away from you as far as it will go. You will hear a click. This places a dose of your medicine in the mouthpiece.

Every time the lever is pulled back a blister is opened inside and the powder made ready for you to inhale. Do not play with the lever as this opens the blisters and wastes medicine.

3.    Hold the Accuhaler away from your mouth, breathe out as far as is comfortable. Do not breathe into your Accuhaler.

4.    Put the mouthpiece to your lips; breathe in steadily and deeply through the Accuhaler, not through your nose.

Remove the Accuhaler from your mouth.

Hold your breath for about 10 seconds or for as long as is comfortable.

Breathe out slowly.

5.    Afterwards, rinse your mouth with water and spit it out, and/or brush your teeth.

This may help to stop you getting thrush and becoming hoarse.

6.    To close the Accuhaler, slide the thumbgrip back towards you, as far as it will go. You will hear a click.

The lever will return to its original position

and is reset.

Your Accuhaler is now ready for you to use again.