Salmeterol, Inhalation sal-MEE-teh-rol

What are other names for this medicine?

Type of medicine: bronchodilator

Generic and brand names: salmeterol, inhalation; Serevent Diskus

What is this medicine used for?

This long-acting medicine is inhaled to:

• prevent asthma attacks (It does not stop asthma attacks that have already started.)
• prevent wheezing caused by exercise in people who have lung problems
• treat chronic obstructive pulmonary (lung) disease such as chronic bronchitis or emphysema.

This medicine is usually used with other medicines to improve breathing.

What should my healthcare provider know before I take this medicine?

Before taking this medicine, tell your healthcare provider if you have ever had:

• an allergic reaction to any medicine, lactose, or milk protein
• an irregular or fast heartbeat
• an overactive thyroid gland
• diabetes
• glaucoma
• heart disease
• high blood pressure
• liver disease
• seizures

Do not take this medicine if you have taken an MAO inhibitor within the last 14 days. A dangerous interaction can occur that can cause very serious side effects.

Females of childbearing age: Talk with your healthcare provider if you are pregnant or plan to become pregnant. It is not known whether this medicine will harm an unborn baby. Do not breast-feed while taking this medicine without your healthcare provider's approval.

How do I use it?

Check the label on the medicine for directions about your specific dose. Use this medicine exactly as your healthcare provider prescribes. Try to use it the same times each day.

Do not use this medicine more often than prescribed. Using too much can cause serious side effects. Do not stop taking this medicine without your healthcare provider's approval. Suddenly stopping this medicine may be life-threatening.

If you are using this medicine to prevent exercise-induced asthma, use this medicine 30 minutes before you exercise. Do not use this medicine again for 12 hours. Do not use extra medicine before exercise if you are already taking this medicine twice a day.

Read carefully the instructions that come in the medicine package. If you do not understand how to use your medicine or how to get the exact dosage, ask your healthcare provider or pharmacist to explain.

1. 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. Hold the Diskus in a level, straight 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 inhale. This is shown by a decrease in numbers on the dose counter. Do not close the device. Do not play with the lever. Do not advance the lever more than once.)
3. Holding the Diskus level and away from your mouth. Before inhaling your dose of Diskus, breathe out as far as is comfortable. (Never breathe out into the Diskus mouthpiece.)
4. Put the mouthpiece to your lips. Breathe in quickly and deeply through the Diskus, not through your nose.
5. Remove the Diskus from your mouth. Hold your breath for 5 to 10 seconds, or for as long as is comfortable. Breathe out slowly.
6. When you are finished taking a dose, close the Diskus. Put your thumb on the thumbgrip and slide the thumbgrip back towards you as far as it will go. The Diskus will click shut.

• Never exhale into the Diskus.
• Never attempt to take the Diskus apart.
• Always activate and use the Diskus in a level, horizontal position.
• Never wash the mouthpiece or any part of the Diskus. Keep it dry.
• Always keep the Diskus in a dry place.
• Do not use the Diskus with a spacer.

If your healthcare provider has prescribed other medicines to be inhaled, ask him or her how long you should wait between inhalations.

What if I miss a dose?

If you miss a dose, use it as soon as you remember unless it is almost time for the next scheduled dose. In that case, skip the missed dose and use the next one as directed. Do not use double doses. If you are not sure of what to do if you miss a dose, or if you miss more than one dose, contact your healthcare provider.

What if I overdose?

If you or anyone else has intentionally taken too much of this medicine, call 911 or go to the emergency room right away. If you pass out, have seizures, weakness or confusion, or have trouble breathing, call 911. If you think that you or anyone else may have taken too much of this medicine, call the poison control center. Do this even if there are no signs of discomfort or poisoning. The poison control center number is 800-222-1222.

Symptoms of an acute overdose may include: muscle cramps or weakness, tremors, chest pain, fast or irregular heartbeat, lightheadedness, fainting, seizures.

What should I watch out for?

This medicine must not be the only medicine you use to treat asthma. You must also use another asthma control medicine.

In people with asthma, long-acting beta2-adrenergic agonists increase the risk of asthma-related death. Talk with your healthcare provider about this. If you have any of these signs of worsening asthma, call your healthcare provider right away:

• You need to use more puffs than usual of your short-acting inhaler or use it more often.
• You have severe breathing trouble that does not improve, such as persistent wheezing, coughing, or shortness of breath.
• You have a bluish color in your lips or fingernails or cannot speak.
• You have any asthma symptoms that are getting worse.

Do not use this medicine for sudden breathing problems. Your healthcare provider may also prescribe a short-acting inhaled medicine to use when you have a sudden breathing problem. Use all medicines as directed by your healthcare provider.

You may need to have lung function tests or other tests to see how the medicine affects you. Keep all appointments for these tests.

If you need emergency care, surgery, or dental work, tell the healthcare provider or dentist you are using this medicine.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away. If you cannot reach your healthcare provider right away, get emergency medical care or call 911 for help): Allergic reaction (hives; itching; rash; tightness in your chest; swelling of your lips, tongue, and throat); choking; trouble swallowing; persistent wheezing, coughing, or shortness of breath; bluish color in the lips or fingernails; being unable to speak.

Serious (contact your healthcare provider right away): Chest pain, fast or irregular heartbeat, itching over the whole body, fever.

Other: Sinus headache, joint or muscle pain, mild rash, runny or stuffy nose, shakiness, dizziness, diarrhea, nausea, throat irritation, dry mouth, upset stomach, nervousness, trouble sleeping.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

• antibiotics such as clarithromycin (Biaxin), erythromycin (Erythrocin, EryPed), isoniazid, and telithromycin (Ketek)
• antifungal medicine such as itraconazole (Sporanox) and ketoconazole (Nizoral)
• anti-HIV medicines such as atazanavir (Reyataz), delavirdine (Rescriptor), indinavir (Crixivan), nelfinavir (Viracept), nevirapine (Viramune), ritonavir (Norvir), and saquinavir (Invirase)
• atomoxetine (Strattera)
• beta blockers such as acebutolol (Sectral), atenolol (Tenormin), carvedilol (Coreg), labetalol (Trandate), metoprolol (Lopressor, Toprol XL), nadolol (Corgard), pindolol, propranolol (Inderal LA), and sotalol (Betapace)
• diuretics (water pills) such as bumetanide, furosemide (Lasix), hydrochlorothiazide (Diuril), and torsemide (Demadex)
• imatinib (Gleevec)
• MAO inhibitors such as isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl, Emsam), and tranylcypromine (Parnate) (Do not take this medicine and an MAO inhibitor within 14 days of each other.)
• nefazodone
• other asthma medicines you are taking by mouth, inhalation, or shots
• telaprevir (Incivek)
• tricyclic antidepressants such as amitriptyline, desipramine (Norpramin), doxepin, imipramine (Tofranil), and nortriptyline (Pamelor)

The effects of this medicine may be increased if you take it with grapefruit juice. Talk with your healthcare provider about this.

If you are not sure if your medicines might interact, ask your pharmacist or healthcare provider. Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

How should I store this medicine?

MDI: Store the container of this medicine at room temperature and away from bright light, keeping the nozzle end down. Protect the medicine from freezing and heat. If the container gets cold, warm it by holding it in your hand before you use the spray. Keep the spray away from your eyes. Throw out the container after using all the medicine in the package.

Diskus: Store at room temperature in a dry place away from direct heat or sunlight. The Diskus should be discarded in 6 weeks after removal from moisture-protective foil overwrap pouch, or after all blisters have been used, whichever comes first. The Diskus is not reusable.

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This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Ask your pharmacist for the best way to dispose of outdated medicine or medicine you have not used. Do not throw medicine in the trash.

Keep all medicines out of the reach of children.

Do not share medicines with other people.

Developed by RelayHealth.
Medication Advisor 2012.1 published by RelayHealth.
Last modified: 2011-10-03
Last reviewed: 2011-10-03
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
© 2012 RelayHealth and/or its affiliates. All rights reserved.