How does this medication work? What will it do for me?

Salmeterol belongs to the class of medications called long-acting bronchodilators. It is used for the treatment of asthma. It works by opening the airways and making breathing easier. It is used for people 4 years of age and older who are also using inhaled corticosteroids to treat their asthma. These people still experience breakthrough asthma symptoms (coughing, wheezing, tightening of the airways) and require regular use of a short-acting bronchodilator such as salbutamol, terbutaline, or fenoterol.

Salmeterol may also be used for the treatment of chronic obstructive pulmonary disease (COPD).

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. As well, some forms of this medication may not be used for all of the conditions discussed here. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

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What form(s) does this medication come in?

Diskhaler Disks

Each circular, double-foil blister pack contains 4 regularly distributed blisters, each containing a dry powder blend of microfine salmeterol. Each blister contains 50 µg of salmeterol. Nonmedicinal ingredient: lactose.

Diskus

Each dose of dry powder of microfine salmeterol for inhalation contains 50 µg of salmeterol. Nonmedicinal ingredient: lactose.

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How should I use this medication?

The recommended dose for people four years of age and older is 1 blister (50 µg) used with the Diskhaler or Diskus twice daily. This medication must not be used to treat acute symptoms of asthma. For "rescue" purposes, use short-acting medications that start to work quickly such as salbutamol, terbutaline, or fenoterol. Ask your pharmacist to demonstrate the proper administration of the medication for the particular device you are using.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones given here, do not change the way that you are taking the medication without consulting your doctor.

It is very important to take this medication on a regular schedule as prescribed by the doctor. Do not stop taking any of your regularly inhaled medications unless instructed to do so by your doctor. If you miss a dose of this medication, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature, protect it from light and moisture, and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Who should NOT take this medication?

Do not use this medication if you:

  • are allergic to salmeterol or any ingredients of this medication
  • are allergic to lactose or milk protein
  • are not using an inhaled corticosteroid (e.g., budesonide)
  • have abnormal heart rhythms associated with fast heart rates
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What side effects are possible with this medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

  • coughing or other bronchial irritation
  • dizziness or lightheadedness
  • dryness or irritation of mouth or throat
  • fast heartbeat
  • headache
  • irritation of throat or mouth
  • muscle cramps or twitching
  • nausea or vomiting
  • nervousness
  • palpitations
  • restlessness
  • trembling
  • trouble sleeping

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor immediately if any of the following side effects occur:

  • difficulty breathing
  • feeling of choking, irritation, or swelling in throat
  • flushing or redness of skin
  • hives
  • increased shortness of breath, tightness in chest, or wheezing
  • severe dizziness
  • skin rash
  • swelling of face, lips, or eyelids
  • tightness in chest or wheezing

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

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Are there any other precautions or warnings for this medication?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Asthma flare-ups: Talk to your doctor and make sure you know what to do if you have an asthma flare-up. This is sometimes referred to as an "asthma action plan." Knowing how to adjust your medication in response to an acute worsening of asthma is an important safety measure.

Medical conditions: If you have high blood pressure, heart problems, diabetes, thyroid problems, or epilepsy (seizures), discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Monitoring asthma: Talk to your doctor about ways for you to monitor your asthma at home, such as a peak flow meter. Peak flow metres measure the amount of air you can expel in a short time and can help you identify when your asthma might be flaring up even before you begin to experience symptoms.

Prevention only: Salmeterol should not be used to treat acute symptoms (as a "rescue" medication). It is meant for prevention purposes only. Salmeterol should be taken along with other medications called inhaled corticosteroids. Short-acting medications such as salbutamol, terbutaline, or fenoterol are required for relief of breathing symptoms as instructed by your doctor and should be available at all times.

Worsening symptoms: If you find you need to use your short-acting ("rescue") inhaler more often or if your condition seems to worsen, call your doctor. If you have not been given instructions beforehand, contact your doctor immediately about what to do if any of the following situations occur (they may be signs of seriously worsening asthma):

  • decreased effectiveness of short-acting, inhaled bronchodilators such as salbutamol, terbutaline, or fenoterol (less than 4 hours of relief)
  • need for more inhalations than usual of short-acting, inhaled bronchodilators
  • peak flow meter showing results in the below-normal range

Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: It is not known if salmeterol passes into breast milk. If you are a breast-feeding mother and are taking this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using salmeterol have not been established for children younger than 4 years of age.

What other drugs could interact with this medication?

There may be an interaction between salmeterol and any of the following:

  • atomoxetine
  • beta-blockers (e.g., metoprolol, propranolol)
  • digoxin
  • diuretics (e.g., hydrochlorothiazide, furosemide)
  • ketoconazole
  • MAO inhibitors (e.g., phenelzine, tranylcypromine)
  • ritonavir
  • sympathomimetic medications (e.g., caffeine, ephedrine, pseudoephedrine)
  • tricyclic antidepressants (e.g., amitriptyline, desipramine)

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

  • stop taking one of the medications,
  • change one of the medications to another,
  • change how you are taking one or both of the medications, or
  • leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.