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In 2005, a study published in the Annals of Internal Medicine found that cardiovascular effects of COX-2 inhibitors differ, depending on the drug. One patient withdrew from the study at 8 weeks and died of histoplasmosis 18 weeks later while not receiving maintenance. In general, the effects of 50 mcg were modest and shorter-lived, and only the 200 mcg dose had substantial effects on nocturnal secretion or on histamine- and meal-stimulated secretion. The risk or severity of adverse effects can be increased when Sufentanil is combined with Lamotrigine. Actions Archived 2014-08-10 at the Wayback Machine. Follow the manufacturer's directions carefully and ask your doctor or pharmacist if you have any questions about cleaning your inhaler or nebulizer.