Salmeterol

Brand Name:erevent, Serevent Diskus, Advair (in combination with fluticasone)

Prescription needed: Yes

What is this drug used for?

Salmeterol is a long-acting medicine that is used to treat and prevent breathing problems associated with asthma, chronic bronchitis, and emphysema. It works by relaxing the muscles in the airways of the lungs. It is not prescribed to relieve acute symptoms. Other shorter-acting bronchodilators are available for this purpose.

Is there any reason not to take this drug?

You should not take this drug if you are allergic to salmeterol, lecithin, soya or soybean-related products. Tell your doctor if you have or have ever had:

  • diabetes
  • heart problems
  • high blood pressure
  • hyperthyroidism (overactive thyroid gland) that is not well controlled
  • low amounts of potassium in the body
  • sensitivity to inhaled lactose (this is different from [lactose intolerance])

What about possible side effects?

The following side effects are related to salmeterol only. If you have the combination product Advair, please see fluticasone to get information on other possible side effects.

This medication is usually well tolerated but you should be aware of some potential side effects. The following list of more common side effects can be quite bothersome, but unless they are severe, you should continue taking salmeterol as prescribed. Contact your doctor or pharmacist to get advice on how to manage these side effects

  • muscle tremors, particularly in the hands
  • nervousness
  • heart palpitation
  • headache

Other less common side effects include:

  • difficulty sleeping
  • muscle cramps
  • joint pain
  • increase in blood sugar (important for diabetics – when you start to use salmeterol, test your blood sugar more often)
  • decrease in blood potassium

Other less common but potentially serious side effects include:

  • severe skin rash, difficulty breathing or swallowing, hives all over the body or near the face and throat – signs of an allergic reaction - stop taking salmeterol and get emergency medical help immediately
  • increased difficulty breathing – consult with your doctor as soon as possible

This is not a complete list of side effects. If you are concerned about these or other unusual symptoms while taking this medication, ask your doctor and/or pharmacist for more information and advice.

What if I am taking other drugs?

Always provide your doctor with a list of all other drugs you are taking (including over-the-counter medications and herbal/natural products) as they may interact with and/or may change the safety or effectiveness of either drug. Tell your doctor specifically if you are taking any of these drugs as he/she may need to make changes or monitor you more closely:

  • Medications in the classes of amphetamines, epinephrine, phenylephrine, or [pseudoephedrine] - may increase the risk of side effects . Many nonprescription products contain these medications (e.g., diet pills and medications for colds). Talk to your doctor or pharmacist
  • Beta blockers (e.g. metoprolol, timolol, propranolol, labetalol, carvedilol, nadolol, pindolol, sotalol) - may reduce the effects of salmeterol.
  • Theophylline, prednisone, methylprednisolone, dexamethasone, furosemide, hydrochlorothiazide – may increase risk of having low blood potassium
  • formoterol – similar to salmeterol - drug duplication resulting in increased risk of side effects
  • short-acting drugs that help with breathing (e.g. Salbutamol or Ventolin, terbutaline, fenoterol) – regular use of these drugs while using salmeterol increases risks of side effects such as tremor, anxiety, heart palpitations
  • Ma huang, ephedra, certain types of ginseng, caffeine – may increase risks of having tremors, difficulty sleeping, racing heart
  • amiodarone, quinidine, disopyramide, sotalol, propafenone, procainamide, thioridazine, haloperidol - may increase your chances of having heart rhythm problems
  • Monoamine oxidase inhibitors (MAOIs) e.g. phenelzine (brand name Nardil), tranylcypromine (brand name Parnate), moclobemide (brand name Manerix, generics available) isocarboxazid (available in the U.S.A. under the brand name Marplan) – risk of a serious rise in blood pressure – be aware of this while taking an MAOI or until 14 days after stopping an MAOI

Other information:

Special Instructions

Salmeterol-only products (Serevent, Serevent Diskus) are often prescribed to use together with other drugs called inhaled corticosteroids such as beclomethasone (e.g. Qvar), budesonide (e.g. Pulmicort) or fluticasone (e.g. Flovent) and are not meant to replace treatment with these drugs. You must continue treatment with these drugs as prescribed.

If you find that salmeterol is not helping your breathing condition as well as it did before, you should see your doctor as soon as possible. Salmeterol is not meant to work as a rescue medication – there are other inhalers for that purpose.

Salmeterol may not work for you if you are not using the puffer device properly. Check with your pharmacist to see if you are using the puffer correctly.

It is important to inform your doctor or dentist that you are using salmeterol if you have any planned surgery that requires use of anesthetics.

Children: Not recommended for those under the age of 4 years. .

Seniors: May be more sensitive to effects. More likely to have a heart condition and/or diabetes.

Pregnancy: Safely used in normal doses.

Women who are nursing: Passes into breast milk. Safely used in normal doses. .

People who drive or operate machinery: Should not do so until they know how this drug affects them personally. May cause your hands to be unsteady.

Alcohol: If you drink, always drink in moderation.

Overdose: An excessive dose of salmeterol may cause significant heart problems. If you have taken a large overdose and/or notice any unusual symptoms, see a doctor.

Stopping the drug: This medication is used to prevent and treat breathing problems. Do not stop taking it without talking to your doctor as your symptoms may return.

If you miss a dose: Take as soon as you remember, then continue taking as directed on your prescription label. Do not take a double dose to make up for a missed dose.

Storage conditions: Closed container; cool, dry location away from excess moisture (not in the bathroom) and light; always out of reach of children. Follow safety recommendations on the container.

Dietary precautions: No specific recommendations.