Use of QVAR with a spacer device in children less than 5 years of age is not recommended. In vitro dose characterization studies were performed with QVAR 40 mcg/actuation with the OptiChamber and AeroChamber Plus ® spacer utilizing inspiratory flows representative of children under 5 years old. These studies indicated that the amount of medication delivered through the spacing device decreased rapidly with increasing wait times of 5 to 10 seconds as shown in Table 2. If QVAR is used with a spacer device, it is important to inhale immediately.
While most of the medicine inhaled acts locally on the airways, a small amount (10-40%) comes into contact with blood vessels in your lungs and can get into your circulatory system. A small amount of medicine impacts into your oral cavity and may be swallowed. In either case, it is broken down by the liver and may potentially cause some systemic side effects. Such side effects are generally considered negligible, and may include bruising, stunted growth (children), osteoporosis (adults), cataracts, and sometimes pneumonia. 1-3 The most common side effects are from the medicine impacting in your oral cavity, and include thrush and dysphonia (hoarse voice).
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