Wixela Inhub Dosing Recommendations

Standard Dosing for Adults and Adolescents

The American College of Cardiology is not mentioned, however, the standard dosing for mild to moderate asthma is to initiate Wixela Inhub at the 100 mcg fluticasone/50 mcg salmeterol strength, which provides 200 mcg/day total fluticasone and falls within low-dose inhaled corticosteroid therapy, for adults and adolescents ≥12 years 1

For mild persistent asthma, the recommended dose is 100/50 mcg strength, one inhalation twice daily 1
For moderate persistent asthma, the recommended dose is 250/50 mcg strength, one inhalation twice daily 1, 2
For severe persistent asthma, the recommended dose is 500/50 mcg strength, one inhalation twice daily 1

Administer Wixela Inhub twice daily, approximately 12 hours apart, to maintain steady therapeutic levels, as recommended by medical guidelines 1
Consistency in timing is critical for maintaining therapeutic drug concentrations 1

Show 1-3 months of stability before reducing the inhaled steroid dose, then decrease by 25-50% at each step when stepping down, as per standard medical practice 1
Reassess asthma control every 2-6 weeks initially, according to medical guidelines 2
If symptoms are not controlled on twice daily dosing at standard doses, increase to the next strength rather than increasing frequency, as recommended by the BMJ 3
The goal is to find the minimum effective dose that maintains asthma control, as stated in medical guidelines 2

Long-acting beta-agonists (LABAs) like salmeterol should never be used alone for asthma and must always be combined with inhaled corticosteroids, as warned by medical guidelines 1
Monotherapy with LABAs increases risk of severe exacerbations and asthma-related deaths, according to medical guidelines 1
Common salmeterol-related side effects include tremor, tachycardia, hypokalemia, headache, and muscle cramps, as reported in medical guidelines 1
Fluticasone-related side effects include oral candidiasis, dysphonia, and cough, as stated in medical guidelines 1
Rinse mouth after each use to prevent oral thrush, as recommended by medical guidelines 2

Wixela Inhub 100/50 mcg is approved for children 4-11 years, with one inhalation twice daily, as approved by the FDA and recommended by medical guidelines 1
Most children ≥4 years can generate sufficient inspiratory flow (≥30 L/min) for the Diskus-type device, according to medical guidelines 1
Always use a large volume spacer device with MDI formulations in young children, though Wixela Inhub is a dry powder inhaler that does not require a spacer, as recommended by medical guidelines 2

No dose adjustment is required based on age alone for elderly patients, as stated in medical guidelines 1
Monitor closely for tremor from salmeterol and systemic corticosteroid effects in elderly patients, as recommended by medical guidelines 1