Discontinue and consider alternative therapy Anaphylaxis and other hypersensitivity reactions (eg, angioedema, urticaria or rash) have been reported.If paradoxical bronchospasm occurs, discontinue BREZTRI immediately and institute alternative therapy.Adverse effects related to increased systemic exposure to budesonide may occur Caution should be exercised when considering the coadministration of BREZTRI with long-term ketoconazole and other known strong CYP3A4 Inhibitors.If such changes occur, consider appropriate therapy Hypercorticism and adrenal suppression may occur with regular or very high dosage in susceptible individuals.Taper patients slowly from systemic corticosteroids if transferring to BREZTRI Particular care is needed for patients transferred from systemic corticosteroids to ICS because deaths due to adrenal insufficiency have occurred in patients during and after transfer.A more serious or fatal course of chickenpox or measles can occur in susceptible patients Due to possible immunosuppression, potential worsening of infections could occur. Physicians should remain vigilant for the possible development of pneumonia in patients with COPD as the clinical features of pneumonia and exacerbations frequently overlap Lower respiratory tract infections, including pneumonia, have been reported following ICS. Advise patients to rinse their mouths with water without swallowing after inhalation
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