<p>The safety and efficacy of this inhaler in patients with asthma have not been established. this inhaler is not indicated for the treatment of asthma. This inhaler has not been studied in patients with acutely deteriorating COPD. The use of this inhaler in this setting is not appropriate. This inhaler should not be used for the relief of acute symptoms, i.e., as rescue therapy for the treatment of acute episodes of bronchospasm. This inhaler has not been studied in the relief of acute symptoms and extra doses should not be used for that purpose. Acute symptoms should be treated with an inhaled short-acting beta2-agonist. When beginning treatment with this inhaler, patients who have been taking inhaled, short-acting beta2-agonists on a regular basis (e.g., four times a day) should be instructed to discontinue the regular use of these drugs and use them only for symptomatic relief of acute respiratory symptoms. When prescribing this inhaler, the healthcare provider should also prescribe an inhaled, short acting beta 2-agonist and instruct the patient on how it should be used. Increasing inhaled beta 2-agonist use is a signal of deteriorating disease for which prompt medical attention is indicated.<br />
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The daily dosage of this inhaler should not be increased beyond the recommended dose. As with other inhaled drugs containing beta2-adrenergic agents, this inhaler should not be used more often than recommended, at higher doses than recommended, or in conjunction with other medications containing LABA, as an overdose may result. Clinically significant cardiovascular effects and fatalities have been reported in association with excessive use of inhaled sympathomimetic drugs.</p>