Salmeterol

Canisters (13g with 120 inhalations and 6.5g with 60 inhalations).

Salmeterol should be stored from 36 F to 86 F (2.2 C to 30 C). The canister should be kept away from heat or flame and not punctured; it should not be frozen or placed in direct sunlight .

Salmeterol may be found in some form under the following brand names:

• Serevent

• Serevent Diskus

Tell your healthcare provider if you are breastfeeding. It is not known if salmeterol passes into your milk and if it can harm your baby.

See the step-by-step instructions for using the salmeterol in the leaflet that comes with this medication. Do not use salmeterol unless your healthcare provider has taught you and you understand everything. Ask your healthcare provider or pharmacist if you have any questions.

• Children should use salmeterol with an adult’s help, as instructed by the child’s healthcare provider.
• Use salmeterol exactly as prescribed. Do not use salmeterol more often than prescribed.
• For asthma and COPD, the usual dose is 1 inhalation 2 times each day (morning and evening). The 2 doses should be about 12 hours apart.
• For preventing exercise-induced bronchospasm, take 1 inhalation at least 30 minutes before exercise. Do not use salmeterol more often than every 12 hours. Do not use extra salmeterol before exercise if you already use it 2 times each day.
• If you miss a dose of salmeterol, just skip that dose. Take your next dose at your usual time. Do not take 2 doses at one time.
• Do not use a spacer device with salmeterol.
• Do not breathe into salmeterol.
• While you are using salmeterol 2 times each day, do not use other medicines that contain a long-acting beta2-agonist or LABA for any reason. Ask your healthcare provider or pharmacist for a list of these medicines.
• Do not stop using salmeterol or any of your asthma medicines unless told to do so by your healthcare provider because your symptoms might get worse. Your healthcare provider will change your medicines as needed.
• Salmeterol does not relieve sudden symptoms. Always have a rescue inhaler medicine with you to treat sudden symptoms. If you do not have an inhaled, short-acting bronchodilator, contact your healthcare provider to have one prescribed for you.

• your breathing problems worsen with salmeterol
• you need to use your rescue inhaler medicine more often than usual
• your rescue inhaler medicine does not work as well for you at relieving symptoms
• you need to use 4 or more inhalations of your rescue inhaler medicine for 2 or more days in a row
• you use 1 whole canister of your rescue inhaler medicine in 8 weeks’ time
• your peak flow meter results decrease. Your healthcare provider will tell you the numbers that are right for you.
• you have asthma and your symptoms do not improve after using salmeterol regularly for 1 week.
• after a change in your asthma medicines you have any worsening of your asthma symptoms or an increase in the need for your rescue inhaler medicine. 

Instructions for Using Salmeterol:

Follow the instructions below for using your salmeterol. You will breathe in (inhale) the medicine from the Diskus. If you have any questions, ask your healthcare provider or pharmacist.

Take the salmeterol out of the box and foil pouch. Write the “Pouch opened” and “Use by” dates on the label on top of the Diskus. The “Use by” date is 6 weeks from date of opening the pouch.

• The Diskus will be in the closed position when the pouch is opened.
• The dose indicator on the top of the Diskus tells you how many doses are left. The dose indicator number will decrease each time you use the Diskus. After you have used 55 doses from the Diskus, the numbers 5 to 0 will appear in red to warn you that there are only a few doses left.

Taking a dose from the Diskus requires the following 3 simple steps: Open, Click, Inhale.

1. OPEN - Hold the Diskus in one hand and put the thumb of your other hand on the thumbgrip. Push your thumb away from you as far as it will go until the mouthpiece appears and snaps into position.

2. CLICK - Hold the Diskus in a level, flat position with the mouthpiece towards you. Slide the lever away from you as far as it will go until it clicks. The Diskus is now ready to use.

Every time the lever is pushed back, a dose is ready to be inhaled. This is shown by a decrease in numbers on the dose counter. To avoid releasing or wasting doses once the Diskus is ready:

3. INHALE - Before inhaling your dose from the Diskus, breathe out (exhale) fully while holding the Diskus level and away from your mouth. Remember, never breathe out into the Diskus mouthpiece.

Put the mouthpiece to your lips. Breathe in quickly and deeply through the Diskus. Do not breathe in through your nose.

Remove the Diskus from your mouth. Hold your breath for about 10 seconds, or for as long as is comfortable. Breathe out slowly.

The Diskus delivers your dose of medicine as a very fine powder. Most patients can taste or feel the powder. Do not use another dose from the Diskus if you do not feel or taste the medicine.

4. Close the Diskus when you are finished taking a dose so that the Diskus will be ready for you to take your next dose. Put your thumb on the thumbgrip and slide the thumbgrip back towards you as far as it will go. The Diskus will click shut. The lever will automatically return to its original position. The Diskus is now ready for you to take your next scheduled dose, due in about 12 hours.

Remember:

• Never breathe into the Diskus.
• Never take the Diskus apart.
• Always ready and use the Diskus in a level, flat position.
• Do not use the Diskus with a spacer device.
• Never wash the mouthpiece or any part of the Diskus. Keep it dry.
• Always keep the Diskus in a dry place.
• Never take an extra dose, even if you did not taste or feel the medicine.

Asthma:

The usual dosage for adults and children aged 4 years and older is 1 inhalation (50 mcg) twice daily (morning and evening, approximately 12 hours apart).

COPD:

For maintenance treatment of bronchospasm associated with COPD, the dosage for adults is 1 inhalation (50 mcg) twice daily (morning and evening, approximately 12 hours apart).

Excercise-induced bronchospasm:

 One inhalation of salmeterol at least 30 minutes before exercise has been shown to protect patients against EIB.

Additional doses of salmeterol should not be used for 12 hours after the first dose of this drug.

• Salmeterol Xinafoate

Asthma/Bronchospasm: Treatment of asthma and the prevention of bronchospasm (only as concomitant therapy with a long-term asthma control medication, such as an inhaled corticosteroid), in patients 4 years and older with reversible obstructive airway disease, including patients with symptoms of nocturnal asthma.

Chronic obstructive pulmonary disease: Maintenance treatment of bronchospasm associated with chronic obstructive pulmonary disease (COPD) (including emphysema and chronic bronchitis).

Exercise-induced bronchospasm: Prevention of exercise-induced bronchospasm (EIB) in patients 4 years and older (monotherapy may be indicated in patients without persistent asthma).

Limitations of use: Salmeterol is not indicated for the relief of acute bronchospasm.

Some products may contain lactose; very rare anaphylactic reactions have been reported in patients with severe milk protein allergy.

Store at 20°C and 25°C (68°F and 77°F); excursions are permitted between 15°C and 30°C (59°F and 86°F). Protect from direct heat or sunlight. Store Diskus in the unopened foil pouch and only open when ready for use; stable for 6 weeks after removal from foil pouch.

FEV1, peak flow, and/or other pulmonary function tests; blood pressure, heart rate; CNS stimulation; serum glucose, serum potassium. Monitor for increased use of short-acting beta2-agonist inhalers; may be marker of a deteriorating asthma condition.