OTHER SHORT ACTING SYMPATHOMIMETIC AEROSOLS SHOLUD BE USED CAREFULLY,IF AT ALL AS IT POTENTIATES CARDIAC SIDE EFFECTS.BETABLOCKERS BLOCKS ITS EFFECT ON LUNGS BUT IF NECESSARY TO GIVE BLOCKERS AS IN HEART PATIENTS,THEN GIVE CARDIOSELECTIVE BETABLOCKERS ONLY.CONCOMMITANT USE OF NON-POT SPARING DIURETICS MAY CAUSE HYPOKALAEMIA AND ECG CHANGES.SERUM DIGOXIN LEVELS ARE DECREASED.
INTERACTIONS ARE SIMILAR TO SALBUTAMOL : CONCOMITANT ADMINISTRATION OF OTHER B-2 AGONISTS WITH CORTICOSTEROIDS, DIURETICS OR XANTHINES INCREASE THE RISK OF HYPOKALEMIA. TRICYCLIC ANTIDEPRESSANTS INCREASE THE PRESSOR EFFECT OF SYMPATHOMIMETICS. MUSCLE RELAXANTS. SALBUTAMOL GIVEN INTRAVENOUSLY HAS BEEN REPORTED TO ENHANCE THE NEUROMUSCULAR BLOCKADE PRODUCED BY PANCURONIUM AND BY VECURONIUM. SYMPATHOMIMETICS. PATIENTS RECEIVING SALMETEROL MAY REQUIRE SALBUTAMOL TO CONTROL AN ACUTE ATTACK OF BRONCHOSPASM.
ONE STUDY INDICATED THAT THE EFFECTS MIGHT BE ADDITIVE, BUT ANOTHER DEMONSTRATED THAT PATIENTS RECEIVING SALMETEROL HAD REDUCED SENSITIVITY TO SALBUTAMOL AND MIGHT NEED HIGHER DOSES OF THE LATTER FOR ACUTE RELIEF. SERUM DIGOXIN LEVELS ARE DECREASED BUT THERE MATY BE CHANCES OF DIGOXIN TOXICITY BECAUSE OF HYPOKALEMIA CAUSED BY SALBUTAMOL.