Indications: Regular treatment of asthma where use of combination product (long-acting β2 agonist and inhaled corticosteroid) is appropriate: patients not adequately controlled with inhaled corticosteroids and ‘as needed’ inhaled short-acting β2 agonist or patients already adequately controlled on both inhaled corticosteroid and long-acting β2 agonist Available strengths: 25μg/50μg; 25μg/125μg & 25μg/250μg salmeterol/fluticasone per metered dose pressurised inhalation, suspension. Dosage and method of use: Inhalation use. Adults and adolescents 12 years and older: two inhalations twice daily. Children 4 years and older: two inhalations 25 μg/50 μg twice daily. Titrate to lowest dose at which effective control of symptoms is maintained and if long-term control maintained at lowest dose, consider testing inhaled corticosteroid alone or combination once daily. Combisal 25 μg /50 μg not appropriate for adults and children with severe asthma. Maximum licensed dose of fluticasone propionate in children is 100 μg twice daily. No data in children under 4 years. AeroChamber Plus® spacer device can be used. This may increase drug delivery to lungs with increase in risk of systemic adverse effects. Advise patients to rinse mouth out with water and spit out, and/or brush teeth after each dose of medicine to minimize risk of oropharyngeal candidiasis and hoarseness. Contraindications: Hypersensitivity to active substance or excipients. Special warnings and precautions for use: Do not use to treat acute asthma for which fast- and short-acting bronchodilator required or initiate Combisal during an exacerbation, or if asthma is significantly worsening or acutely deteriorating. Use with caution in patients with active or quiescent pulmonary tuberculosis and fungal, viral or other infections of the airway; severe cardiovascular disorders or heart rhythm abnormalities, diabetes mellitus, thyrotoxicosis, uncorrected hypokalaemia or predisposed to low levels of serum potassium. Discontinue if paradoxical bronchospasm occurs. Prolonged use of high doses of ICS may result in adrenal suppression and acute adrenal crisis. Consider additional systemic corticosteroid cover during periods of stress or elective surgery. Monitor patients transferring from oral steroids for impaired adrenal reserve. Safety and efficacy in COPD not established. Visual disturbance reported with steroid use – if blurred vision or other visual disturbances, consider referral to ophthalmologist for evaluation of possible causes e.g. cataract, glaucoma, central serous chorioretinopathy.