Seretide (Fluticasone and Salmeterol 250mcg/25mcg) Inhaler

Seretide general information

What is Seretide used for?

Seretide Inhaler 25/250 is a combination medication used for the regular long-term treatment and management of reversible obstructive airways disease, such as asthma, where a combination medication is considered appropriate.  This includes patients already using a combination medication, or using an inhaled preventer medication but are not adequately controlled and are still having symptoms, or patients using a reliever medication as needed, to treat symptoms of asthma, but are not adequately controlled.  Seretide 250 Inhaler should not be used for severe asthma or as a “reliever” for asthma attack.  Seretide Inhaler 25/250 is also used for treatment of moderate to severe chronic obstructive pulmonary disease (COPD), which is a non-reversible obstructive airways disease.  The combination of medications in Seretide 250 Inhaler work together to provide better control of asthma to protect against symptoms, prevent exacerbations of asthma or COPD and improve lung function.

How does Seretide work?

Seretide Inhaler 25/250 contains a combination of two medications that work by different mechanisms of action to control obstructive airways disease in asthma and chronic obstructive pulmonary disease (COPD).  Fluticasone in Seretide 250 Inhaler is a corticosteroid and anti-inflammatory medication that blocks Inflammation, one of the underlying causes of asthma.  This is a preventer medication and works by inhibiting the production of inflammatory chemicals released in the airways in response to asthma trigger, such as allergens or irritants in the air, reducing inflammation and swelling of the airways.  Salmeterol is a long-acting beta₂-agonist and bronchodilator that relaxes the muscles of the small airways of the lungs (bronchioles) to widen the airways.  This reduces bronchospasm (constriction or the airways) relieving symptoms of asthma such as tightness of the chest, wheezing and shortness of breath and provides relief for up to 12 hours.  Fluticasone and salmeterol in Seretide Inhaler 25/250 are delivered in an aerosol directly into the bronchioles of the lung and work together to improve lung function, and to reduce symptoms and exacerbations of asthma.

What does Seretide contain?

Seretide Inhaler 25/250 is a metered dose inhaler (MDI) that contains the active ingredients salmeterol xinafoate a bronchodilator (25mcg), and fluticasone propionate (250mcg), a corticosteroid used in combination to treat asthma and COPD.  Each dose contains 25mcg salmeterol xinafoate and 250mcg fluticasone propionate.  It also contains the non-CFC propellant norflurane (also known as HFA 134a or 1,1,1,2-tetrafluoroethane), which delivers 25mcg salmeterol and 250mcg fluticasone as an aerosol into your lungs each time your actuate (press down) your inhaler.  Each inhaler contains 120 actuations (doses).  

Treating asthma with Seretide

Seretide Inhaler 25/250 contains a combination of fluticasone, a corticosteroid and anti-inflammatory medication that blocks Inflammation, one of the underlying causes of asthma; and salmeterol, a long-acting bronchodilator that relieves bronchospasm (constriction or narrowing of the bronchioles or small airways) and widens the airways to allow air to flow more easily into the lungs.  Seretide 250 Inhaler is used as an asthma prevention medication and the two medication works together to improve lung function, and to reduce exacerbations of asthma and symptoms like tightness of the chest, wheezing and shortness of breath.  Seretide Inhaler 25/250 should not be used as a “reliever” or “rescue” medication if you are having an asthma attack.

Treating chronic obstructive pulmonary disease (COPD) with Seretide

Seretide Inhaler 25/250 contains a combination of fluticasone, a corticosteroid and anti-inflammatory medication that blocks Inflammation, one of the underlying causes of COPD; and salmeterol, a long-acting bronchodilator that relieves bronchospasm (constriction or narrowing of the bronchioles or small airways) and widens the airways to allow air to flow more easily into the lungs.  Chronic obstructive pulmonary disease (COPD) is a progressive obstructive airways disease that usually gets worse with time, with symptoms similar to asthma caused by bronchospasm, including tightness of the chest, wheezing and shortness of breath, as well as chronic cough with sputum production because the lung tissues have become damaged.  Seretide Inhaler 25/250 improves lung function, reduces frequency of exacerbations and improves exercise tolerance and health-related quality of life, but does not cure COPD.    

Should you use Seretide with other asthma inhalers?

Seretide Inhaler 25/250 is used as a long-term “preventer” medication to reduce inflammation and swelling of the airways of the lung and reduce bronchospasm (constriction or narrowing of the bronchioles or small airways) as part of an asthma management plan to reduce symptoms and exacerbations of asthma, and to improve lung function.  You may also be prescribed a short-acting bronchodilator for relief of bronchospasm during an asthma attack, to be used as needed.  Both are intended to be taken together, only if recommended by your doctor. 

What are the side effects of Seretide?

The most commonly reported side effects when taking Seretide Inhaler 25/250 are due to the fluticasone component and include, a sore throat or tongue, which may be due to candida infection (thrush), hoarseness or throat irritation and contusion in the skin (bruising).  Side effects due to the salmeterol component include headache, tachycardia (rapid heartbeat), tremor (shaky or tense feeling), palpitations, mouth or throat irritation and muscle cramps.  Pneumonia was reported in studies of patients with COPD.

When should Seretide not be used?

You should not use Seretide Inhaler 25/250 if you:

• are allergic to salmeterol or fluticasone or any ingredients in Seretide
• are pregnant or are breastfeeding, without discussion with your doctor
• are a diabetic, without discussion with your doctor, as the fluticasone in Seretide Inhaler 25/250 may increase your glucose levels
• have tuberculosis of the lung or other long term lung infection
• have pre-existing cardiovascular disease, heart rhythm abnormality or thyrotoxicosis (high levels of thyroid hormone), without discussion with your doctor
• are taking other medications that may interact with Seretide, like ritonavir for HIV infection, ketoconazole for fungal infection, or the β-blocker propranolol

What are the health risks of Seretide?

Long term use of Seretide Inhaler 25/250 may cause the adrenal glands, which produce endogenous (naturally occurring) corticosteroids, to stop working efficiently.  This may slow down the growth rate in children and will need regular monitoring.  Seretide Inhaler 25/250 may also cause decreased bone mineral density if used for long periods.

What is paradoxical bronchospasm?

All inhaled asthma medications can cause paradoxical bronchospasm, which is when the inhaled medication taken to relieve or prevent bronchospasm actually makes it worse, causing wheezing, shortness of breath and tightness of the chest.  If this happens you should inform your doctor and take their advice.

How should Seretide be used?

You should use your Seretide Inhaler 25/250 by using two puffs (inhalations) twice a day, morning and evening.  The dose you use and how often you use it depends on the severity of your asthma and your age and should be as recommended by your doctor.  Seretide 250 Inhaler does not work immediately but is intended as a long-term medication which may take up to a week to start to work and it may take several weeks before you feel maximum benefit.  Follow the instructions provided when using your Seretide 250 Inhaler.  You should continue to use your Seretide 250 Inhaler as long as is recommended by your doctor and you should not stop using your Seretide Inhaler 25/250, even if you feel better. 

How to use your Seretide inhaler

Follow the instructions provided with your Seretide 250 Inhaler.  

1. Remove the mouthpiece cover and shake the inhaler.
2. Breathe out as far as is comfortable and then place the mouthpiece in your mouth. 
3. Start to inhale and press down on the top of the inhaler to release a dose of fluticasone and salmeterol while still breathing in through your mouth until your lungs are full, and then hold your breath for a few seconds.
4. Remove the inhaler and breathe normally. 
5. Replace the mouthpiece cover. 
6. Rinse your mouth after use.

Note:  You can use a spacer device to help you inhale correctly.

How long should you use Seretide?

You should continue to use your Seretide Inhaler 25/250 as long as is recommended by your doctor and you should not stop using your Seretide 250 Inhaler, even if you feel better.

Missed dose of Seretide

If you miss a dose of Seretide Inhaler 25/250 use it as soon as you remember, unless it is time to use the next dose, then skip the missed dose.  Do not use a double dose.

How should Seretide be stored?

You should store your Seretide below 30°C in a cool dry place, protect from direct sun and do not freeze.