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salmeterol (inhalation)

Pronunciation

Generic Name: salmeterol (inhalation) (sal MEE ter all)
Brand Name: Serevent Diskus, Serevent

What is salmeterol inhalation?

Salmeterol is a bronchodilator. It works by relaxing muscles in the airways to improve breathing.

Salmeterol inhalation is used to prevent asthma attacks or exercise-induced bronchospasm.

Salmeterol inhalation is also used to treat chronic obstructive pulmonary disease (COPD) including emphysema and chronic bronchitis.

Salmeterol inhalation may also be used for purposes not listed in this medication guide.

What is the most important information I should know about salmeterol inhalation?

Do not use salmeterol inhalation to treat an asthma attack that has already begun.

Salmeterol may increase the risk of asthma-related death. Use only the prescribed dose of this medication, and do not use it for longer than your doctor recommends. Follow all patient instructions for safe use. Talk with your doctor about your individual risks and benefits of using salmeterol inhalation.

If you use salmeterol inhalation for asthma, you must use it together with another long-term asthma control medication. Seek medical attention if you think any of your asthma medications are not working as well as usual.

What should I discuss with my healthcare provider before using salmeterol inhalation?

You should not use this medication if you are allergic to salmeterol or to milk proteins.

To make sure salmeterol inhalation is safe for you, tell your doctor if you have:

  • a food or drug allergy;

  • heart disease or high blood pressure;

  • epilepsy or other seizure disorder;

  • diabetes;

  • a thyroid disorder; or

  • liver disease.

FDA pregnancy category C. It is not known whether salmeterol inhalation will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication.

It is not known whether salmeterol inhalation passes into breast milk or if it could harm a nursing baby. You should not breast-feed while using this medicine.

Salmeterol can increase the risk of asthma-related hospitalization in children and teenagers. It is very important that children using salmeterol inhalation for asthma use it together with another long-term asthma control medication.

Do not give this medication to a child younger than 4 years old.

How should I use salmeterol inhalation?

Salmeterol may increase the risk of asthma-related death. Use only the prescribed dose of this medication, and do not use it for longer than your doctor recommends. Follow all patient instructions for safe use. Tell your doctor if your symptoms do not improve after 1 week of treatment.

Do not use salmeterol inhalation to treat an asthma attack that has already begun. It will not work fast enough. Use only a fast-acting inhalation medication.

Asthma is often treated with a combination of different drugs. If you use salmeterol inhalation to treat asthma, you must use it together with another asthma control medication. Use all of your medications as directed by your doctor. Talk with your doctor if your medications do not seem to work as well in treating or preventing attacks. Do not change your doses or medication schedule without advice from your doctor.

Serevent Diskus is a powder form of salmeterol inhalation that comes with a special inhaler device preloaded with blister packs containing measured doses of the medicine. The device opens and loads a blister each time you use the inhaler. This device is not to be used with a spacer.

Use salmeterol inhalation regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely.

Do not stop using salmeterol inhalation without first talking to your doctor. Your asthma symptoms may get worse after you stop using the medication.

If you also use a steroid medication, do not stop using the steroid suddenly or you may have unpleasant withdrawal symptoms. Talk with your doctor about taking less and less of the steroid before stopping completely.

Seek medical attention if you think any of your asthma medications are not working as well as usual. An increased need for medication could be an early sign of a serious asthma attack. If you use a peak flow meter at home, call your doctor if your numbers are lower than normal.

Store at room temperature away from moisture, heat, and sunlight.

Do not try to clean or take apart the Diskus device. Throw it away 6 weeks after you have taken it out of the foil pouch, or if the dose indicator shows a zero, whichever comes first. Each Diskus device contains 60 doses.

What happens if I miss a dose?

Use the medication as soon as you remember, then wait 12 hours before using the medication again. Skip the missed dose if it is almost time for your next scheduled dose. Do not use extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while using salmeterol inhalation?

Do not use a second form of salmeterol (such as Advair) or use a similar inhaled bronchodilator such as formoterol or arformoterol (Foradil, Perforomist, Symbicort, or Brovana) unless your doctor has told you to.

Do not exhale or blow into the Diskus device. Do not take the device apart or allow it to get wet.

Salmeterol inhalation side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

  • worsening asthma symptoms, or other breathing problems after using this medication;

  • muscle cramps, sleep problems (insomnia), tremors;

  • chest pain, fast or irregular heartbeats, feeling light-headed, fainting, or seizure (convulsions);

  • low potassium (confusion, uneven heart rate, extreme thirst, increased urination, leg discomfort, muscle weakness or limp feeling); or

  • high blood sugar (increased thirst, increased urination, hunger, dry mouth, fruity breath odor, drowsiness, dry skin, blurred vision, weight loss).

Common side effects may include:

  • headache;

  • flu symptoms;

  • joint or muscle pain;

  • throat irritation, cough; or

  • stuffy or runny nose.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Salmeterol dosing information

Usual Adult Dose for Asthma -- Maintenance:

50 mcg (1 inhalation) orally twice a day, approximately 12 hours apart.

Comments:
-Reevaluate the therapeutic regimen if a previously effective dosage fails to provide the usual response, as this is often a sign of destabilization of asthma.
-If symptoms arise in the period between doses, an inhaled, short-acting beta2-­agonist should be taken for immediate relief.

Uses:
-Treatment of asthma and prevention of bronchospasm only as concomitant therapy with a long-term asthma control medication, such as an inhaled corticosteroid, in patients with reversible obstructive airway disease, including patients with symptoms of nocturnal asthma.

Usual Adult Dose for Bronchospasm Prophylaxis:

Prevention of Exercise Induced Bronchospasm (EIB):
-50 mcg (1 inhalation) orally at least 30 minutes before exercise

Comments:
-Protection may last up to 9 hours when used intermittently as needed for prevention.
-Additional doses should not be taken for 12 hours.
-Patients receiving twice daily doses for the treatment of asthma should not use additional doses for the prevention of EIB.

Uses:
-For the prevention of EIB, as a single agent, in patients with no persistent asthma.
-In patients with persistent asthma use of this drug for the prevention of EIB may be clinically indicated, but the treatment of asthma should include a long-term asthma control medication, such as an inhaled corticosteroid.

Usual Adult Dose for Chronic Obstructive Pulmonary Disease -- Maintenance:

50 mcg (1 inhalation) orally twice daily, approximately 12 hours apart

Use: Long-term maintenance treatment of bronchospasm associated with chronic obstructive pulmonary disease (COPD), including emphysema and chronic bronchitis

Usual Pediatric Dose for Asthma -- Maintenance:

Less than 4 years: Not approved.

4 years or older: 50 mcg (1 inhalation) orally twice a day, approximately 12 hours apart

Comments:
-For patients with asthma less than 18 years of age requiring addition of a LABA to an inhaled corticosteroid, a fixed-dose combination product containing both an inhaled corticosteroid and LABA should be used to ensure adherence with both drugs.
-If the use of a separate long-term asthma control medication (e.g., inhaled corticosteroid) and LABA is clinically indicated, take appropriate steps to ensure adherence with both treatment components. If adherence cannot be assured, a fixed-dose combination product containing both an inhaled corticosteroid and LABA is recommended.

Uses:
-Treatment of asthma and prevention of bronchospasm only as concomitant therapy with a long-term asthma control medication, such as an inhaled corticosteroid with reversible obstructive airway disease, including patients with symptoms of nocturnal asthma.

Usual Pediatric Dose for Bronchospasm Prophylaxis:

Prevention of Exercise Induced Bronchospasm:
-Less than 4 years: Not approved.
-4 years or older: 50 mcg (1 inhalation) orally at least 30 minutes before exercise

Comments:
-Protection may last up to 9 hours in adolescents and up to 12 hours in pediatrics aged 4 to 11 years, when used intermittently as needed for prevention.
-Additional doses should not be used for 12 hours.
-Patients receiving twice daily doses for the treatment of asthma should not use additional doses for the prevention of EIB.

Uses:
-For the prevention of EIB, as a single agent in patients with no persistent asthma
-In patients with persistent asthma use of this drug for the prevention of EIB may be clinically indicated, but the treatment of asthma should include a long-term asthma control medication, such as an inhaled corticosteroid.

What other drugs will affect salmeterol inhalation?

Tell your doctor about all medicines you use, and those you start or stop using during your treatment with salmeterol inhalation, especially:

  • an antidepressant--nefazodone;

  • an antibiotic--clarithromycin, telithromycin; antifungal medication--itraconazole, ketoconazole, voriconazole; a beta blocker--carvedilol, labetalol, nadolol, metoprolol, penbutolol, pindolol, propranolol, sotalol, timolol;

  • hepatitis C medications--boceprevir, telaprevir; HIV/AIDS medication--atazanavir, cobicistat, darunavir, delavirdine, fosamprenavir, indinavir, nelfinavir, ritonavir, saquinavir.

This list is not complete. Other drugs may interact with salmeterol, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Where can I get more information?

  • Your pharmacist can provide more information about salmeterol inhalation.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 13.04.

Date modified: November 30, 2016
Last reviewed: July 15, 2013

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