Long-acting beta 2-adrenergic agonists, such as salmeterol, the active ingredient in salmeterol xinafoate inhalation powder, may increase the risk of asthma-related death. Therefore, when treating patients with asthma, salmeterol xinafoate should only be used as additional therapy for patients not adequately controlled on other asthma-controller medications (e.g., low- to medium-dose inhaled corticosteroids) or whose disease severity clearly warrants initiation of treatment with 2 maintenance therapies, including salmeterol xinafoate. Data from a large placebo-controlled US study that compared the safety of salmeterol or placebo added to usual asthma therapy showed an increase in asthma-related deaths in patients receiving salmeterol (13 deaths out of 13,176 patients treated for 28 weeks on salmeterol versus 3 deaths out of 13,179 patients on placebo) .
Long-acting beta(2)-adrenergic agonists may increase the risk of asthma-related deaths. Therefore, when treating patients with asthma, salmeterol should only be used for patients not adequately controlled on other asthma-controller medications or whose disease severity clearly warrants initiation of treatment with two maintenance therapies .
Commonly used brand name(s):
In the U.S.
Available Dosage Forms:
Therapeutic Class: Bronchodilator
Pharmacologic Class: Salmeterol
Salmeterol is used to help prevent the symptoms of asthma and improve breathing. It is used when a patient's asthma has not been controlled by using other asthma medicines, or when a patient's condition is so serious that more than one medicine is needed every day. salmeterol will not relieve an asthma attack that has already started.
Salmeterol is also used to treat air flow blockage and prevent the worsening of chronic obstructive pulmonary disease (COPD). This includes chronic bronchitis and emphysema. salmeterol is used to prevent exercise-induced bronchospasm.
Salmeterol is a long-acting bronchodilator. Bronchodilators are medicines that are breathed in through the mouth to open up the bronchial tubes (air passages) of the lungs. Salmeterol does not act quickly enough to relieve an asthma attack that has already started.
salmeterol must be used with a short-acting medicine (e.g. albuterol) for an asthma attack that has already started and needs attention right away.
salmeterol is available only with your doctor's prescription.
In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For salmeterol, the following should be considered:
Tell your doctor if you have ever had any unusual or allergic reaction to salmeterol or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.
Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of salmeterol in children above 4 years of age. Safety and efficacy have not been established in children younger than 4 years of age.
Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of salmeterol in the elderly. However, elderly patients with heart problems may require special caution when receiving salmeterol.
|All Trimesters||C||Animal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women.|
There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.
Using salmeterol with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Using salmeterol with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.
The presence of other medical problems may affect the use of salmeterol. Make sure you tell your doctor if you have any other medical problems, especially:
Inhaled salmeterol is used to prevent asthma attacks and to treat chronic obstructive pulmonary disease (COPD). It is not used to relieve an asthma attack that has already started. For relief of an asthma attack that has already started, you should use another medicine. If you do not have another medicine to use for an attack or if you have any questions about this, check with your doctor.
salmeterol comes with patient directions or a medication guide. Read the directions carefully before using salmeterol. If you do not understand the directions or you are not sure how to use the inhaler, ask your doctor or pharmacist to show you what to do.
Use salmeterol only as directed. Do not use more of it and do not use it more often than your doctor ordered. Also, do not stop taking salmeterol without telling your doctor. To do so may increase the chance of having breathing problems.
In order for salmeterol to help prevent asthma attacks, it must be used every day in regularly spaced doses, as ordered by your doctor.
To use the inhaler:
The dose of salmeterol will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of salmeterol. If your dose is different, do not change it unless your doctor tells you to do so.
The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.
If you miss a dose of salmeterol, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.
Keep the medicine in the foil pouch until you are ready to use it. Store at room temperature, away from heat and direct light. Do not freeze.
Keep out of the reach of children.
Do not keep outdated medicine or medicine no longer needed.
Ask your healthcare professional how you should dispose of any medicine you do not use.
It is very important that your doctor check your progress or your child's progress at regular visits. This will allow your doctor to see if the medicine is working properly and to check for any unwanted effects caused by the medicine.
Although salmeterol decreases the number of asthma attacks, it may increase the chance for a severe asthma attack when they do occur. Talk to your doctor about any questions or concerns you may have.
You should not use salmeterol if your asthma attack has already started. Your doctor will prescribe another medicine (e.g., a short-acting inhaler) for you to use in case of an acute asthma attack. Make sure you understand how to use the short-acting inhaler. Talk to your doctor if you need instructions.
Do not use any other asthma medicine or medicine for breathing problems without talking to your doctor. salmeterol should not be used with other inhalers that contain budesonide and formoterol combination (Symbicort®), fluticasone and salmeterol combination (e.g., Advair® Diskus®, Advair® HFA), formoterol (Foradil® Aerolizer®, Perforomist™), or arformoterol (Brovana™).
Talk to your doctor or get medical care right away if:
Do not change your dose or stop using your medicine without asking your doctor first.
Your doctor may want you to carry a medical identification (ID) card stating that you are using salmeterol. The card will say that you may need additional medicine during an emergency, a severe asthma attack or other illness, or unusual stress.
salmeterol may cause bronchospasm, which may be life-threatening. Check with your doctor right away if you are having a cough, difficulty with breathing, shortness of breath, or wheezing.
If you develop a skin rash, hives, or any allergic reaction to salmeterol, stop taking the medicine and check with your doctor as soon as possible.
Check with your doctor right away if you have chest pain, a fast heartbeat, nervousness, shaking of the hands or feet, noisy breathing, a feeling of choking, or tightness or irritation of the throat while using salmeterol.
salmeterol may affect blood sugar levels. If you are diabetic and notice a change in the results of your blood or urine sugar tests, check with your doctor.
Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:More common
Get emergency help immediately if any of the following symptoms of overdose occur:Symptoms of overdose
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:Less common
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
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