and Product :
25 mcg/acutation 120
doses: Aerosol Inhaler
Salmeterol is a
bronchodilator which is similar to albuterol (Proventil® or
Ventolin®) and other "shorter-acting" medications such as
bitolterol (Tornalate®), pirbuterol (Maxair®) and terbutaline
(Brethaire®). Salmeterol differs from these medications in that
it does not begin working immediately and has a longer duration
of action. This allows for twice daily dosing rather than the
usual four times daily or every 4-6 hours dosing.
Recently, there has been concern over the potential for a
greater risk of dying of acute asthma attacks in persons treated
with salmeterol. This has received much attention in newspapers
and magazines. While the association between salmeterol and
deaths due to asthma remains unclear, proper use of this
medication can minimize any risks.
Salmeterol, with its slow onset of action and long duration
of action, is not intended for use as a "rescue" medication.
Therefore it should not be used for relief of acute symptoms
such as coughing, wheezing, chest tightness or shortness of
breath. Salmeterol's longer onset of action, the time it takes
to begin working, means that you may not feel immediate relief
after taking a treatment. Thus, you should continue to use your
shorter-acting agent for relief of symptoms, especially those
that occur suddenly. Because salmeterol is a long-acting
bronchodilator, you may feel relief for a longer period of time
and may require fewer treatments of your shorter-acting
Why is this drug prescribed?
Serevent relaxes the muscles in the walls of the bronchial
tubes, allowing the passageways to expand and carry more air.
Taken regularly (twice a day), the drug helps prevent wheezing
and other symptoms of asthma, as well as exercise-induced
asthma. A relatively long-acting medication, it is recommended
for people who need shorter-acting bronchodilators such as
Alupent and Ventolin on a frequent, regular basis.
Serevent is available in an aerosol inhaler and as Serevent
Diskus (Acculhaler) inhalation powder. The aerosol inhaler is
also used to treat the airway constriction that marks such
chronic lung diseases as emphysema and chronic bronchitis. Both
forms of Serevent can be used with or without inhaled or oral
Most important fact about this drug
Serevent is intended only for long-term prevention of
symptoms, and should not be used more than twice a day. Do not
use it to treat acute asthma attacks, and do not attempt to
relieve worsening asthma by increasing the frequency of your
doses. (Your doctor will prescribe a short-acting bronchodilator
to relieve acute attacks.)
Seriously worsening asthma is a dangerous-even
life-threatening-condition that needs immediate medical
attention. Alert your doctor if your short-acting bronchodilator
is becoming less effective or you need more inhalations than
usual. Also consider it a warning sign if you need 4 or more
inhalations daily for 2 days or more in a row, or find that you
are finishing a 200-dose canister in less than 8 weeks.
How should you take this medication?
Use no more than the prescribed dose and follow package
directions closely. Space your two daily doses approximately 12
hours apart, in the morning and evening. To be effective, the
drug must be used regularly every day.
Serevent aerosol inhaler must be shaken thoroughly before
each use. Test-spray the inhaler 4 times before the first use
and whenever 4 weeks have passed since the last use. Avoid
spraying in the eyes.
Serevent Diskus should never be used with a spacer. Always
activate the Diskus device in a level, horizontal position.
Never exhale into the Diskus device, and always keep it dry. Do
not wash the mouthpiece or any other part of the device.
—If you miss a dose…
Take it as soon as you remember. If it is almost time for
your next dose, skip the one you missed and go back to your
regular schedule. Never double your dose.
Store the Serevent aerosol inhaler and Serevent Diskus at
room temperature away from direct sunlight and freezing
temperatures. Leave the aerosol inhaler canister with the nozzle
end down. Throw away the Diskus inhalation device after every
blister has been used (when the dose indicator reads "0") or 2
months after the blisters have been removed from their foil
What side effects may occur?
Side effects cannot be anticipated. If any develop or change
in intensity, inform your doctor as soon as possible. Only your
doctor can determine if it is safe for you to continue using
- More common side effects may include:
Asthma, back pain, bronchitis, chest congestion, cough,
diarrhoea, headache, nasal inflammation, pallor, respiratory
tract infection, sinus headache, sinus infection, sinus
problems, sore throat, stomach ache, tremor
- Less common side effects may include:
Abdominal pain, arm pain, chest discomfort, constipation,
dental pain, difficulty breathing, dry mouth, earache, eczema,
fatigue, feeling of illness, fever, heartburn, hives,
indigestion, insomnia, irritation of the mouth and throat,
joint pain, laryngitis, leg cramps, mouth infection, mouth
problems, muscle aches or cramps, nasal congestion, nausea,
neck pain, nervousness, nosebleed, painful menstruation,
pneumonia, rapid heartbeat, rash, shortness of breath,
shoulder pain, skin tingling, sneezing, stomach pain, urinary
tract infection, vomiting, wheezing
Why should this drug not be prescribed?
If Serevent gives you an allergic reaction, you cannot
continue using it.
Special warnings about this medication
Serevent is not for the treatment of seriously worsening
asthma, and should not be started if your asthma is
If you are taking inhaled or oral steroid medications for
your asthma, continue using them along with Serevent. This drug
does not replace them.
If you develop an allergic reaction (throat irritation,
choking, hives, face and throat swelling, rash, and wheezing)
after using Serevent, call your doctor immediately. Likewise, if
symptoms of asthma or chronic lung disease get worse after
inhaling Serevent, stop using it and check with your doctor at
Although such effects are rare, Serevent can cause an
increase in blood pressure and heart rate. Use this medication
carefully if you have high blood pressure, heart disease, or an
irregular heartbeat. Caution is also advised if you have a
seizure disorder or an overactive thyroid.
Serevent aerosol inhaler can be given to children 12 years of
age and older. The Diskus inhalation powder can be given to
children 4 and older.
Possible food and drug interactions when
taking this medication
If Serevent is taken with certain other drugs, the effects of
either drug could be increased, decreased, or altered. It is
especially important to check with your doctor before combining
Serevent with the following:
Airway-opening medications such as Alupent, Proventil, and
Blood pressure medications known as beta blockers, including
Inderal, Lopressor, and Tenormin
MAO inhibitors such as the antidepressants Marplan, Nardil, and
Tricyclic antidepressants such as Elavil and Tofranil
Water pills (diuretics) such as furosemide (Lasix) and
Special information if you are pregnant or breastfeeding
Serevent has not been adequately tested in pregnant women.
Check with your doctor immediately if you are pregnant or are
planning a pregnancy. Serevent's effects during breastfeeding
are also unknown. You and your doctor should decide whether to
discontinue nursing or give up Serevent.
SEREVENT AEROSOL INHALER
Asthma and chronic lung disease
The usual dose is 2 inhalations (42 micrograms) twice a day
(morning and evening) 12 hours apart.
Prevention of exercise-induced asthma
Take 2 inhalations at least 30 to 60 minutes before exercise.
Do not take another dose for 12 hours. (If you are on a twice
daily dosage schedule, do NOT take additional Serevent before
SEREVENT DISKUS INHALATION POWDER
The usual dose is 1 inhalation (50 micrograms) twice a day
(morning and evening).
Prevention of exercise-induced asthma
Take 1 inhalation at least 30 minutes before exercise. Do not
take another dose for 12 hours. (If you are on a twice daily
dosage schedule, do NOT take additional Serevent before
Any medication taken in excess can have serious consequences.
If you suspect an overdose, seek medical attention immediately.
- Symptoms of Serevent overdose may include:
Angina (chest pain), dizziness, dry mouth, fatigue, flu-like
symptoms, headache, heart irregularities, high or low blood
pressure, high blood sugar, insomnia, muscle cramps, nausea,
nervousness, rapid heartbeat, seizures, tremor