Fluticasone and salmeterol

Fluticasone sounds like (flu-tic-a-sone) and salmeterol sounds like (sal-Me-ter-ol)

Easy-to-read medicine information about fluticasone + salmeterol – what it is, how to use fluticasone + salmeterol safely and possible side effects.

Type of medicine Also called
  • This is a combination medicine. It contains a corticosteroid (fluticasone)
    plus
    a bronchodilator (salmeterol) 
    • Seretide® MDI
    • Seretide® Accuhaler

Seretide is available in two devices either as an inhaler (puffer or MDI) or a dry powder for inhaler, an accuhaler. Both devices work just as well (are equally effective). The choice of device is personal preference.

What is fluticasone + salmeterol?

  • Fluticasone and salmeterol are mixed together in an inhaler (puffer) or an accuhaler.
  • The combination is used to treat the symptoms of asthma and to prevent them from recurring.
  • Fluticasone works by preventing the swelling and irritation in the walls of the small air passages in the lungs. It belongs to a group of medicines known as inhaled corticosteroids. It is also called a preventer (because when used every day it prevents asthma attacks).
  • Salmeterol works by relaxing and opening up the air passages and in that way makes breathing easier. It belongs to a group of medicines known as long-acting bronchodilators.

Dose

  • The dose of fluticasone + salmeterol varies depending on the type of inhaler:
    • Seretide MDI - the usual dose is 2 puffs twice daily.
    • Seretide Accuhaler - the usual dose is 1 inhalation once or twice daily.
  • If your symptoms improve, your doctor may decide to reduce your dose to once a day. The dose may change to:
    • once at night - if you have night-time symptoms
    • once in the morning - if you have daytime symptoms.
  • Since asthma is a long-term condition, prevention with fluticasone + salmeterol is ongoing and it will need to be used every day for months to years.

How to use fluticasone + salmeterol inhaler/puffer (Serevent MDI)

  • To get the most benefit from the medication, it is important to use the correct technique when using an inhaler.
  • Even if you have been shown before, ask your doctor, pharmacist, or nurse to explain how to use your inhaler if you still have any questions.
  • The following steps are a guide:
    • Remove the protective cap at the plastic bottom part of the puffer.
    • Put your mouth over the plastic bottom part of the puffer AND push down on the top metal part as you breathe in.
    • Inhale the medicine that comes out.
    • Hold breath for 10 seconds. Breathe out slowly.
    • Wait for 1 minute before repeating the steps for the next puff.
    • Rinse your mouth with water and spit out after using fluticasone + salmeterol inhaler.

NOTE:

  • Your fluticasone + salmeterol has a counter, a little window in the back of the puffer, which shows how many puffs are left.
  • If your inhaler is new, it will need to be primed, by spraying 2 puffs into the atmosphere.
  • If you have not used your inhaler for 3 days, you will need to re-prime by spraying one puff into the atmosphere.
  • If you find difficulty in using an inhaler, ask your doctor, nurse or pharmacist about a spacer device, which can be attached to your inhaler. It may make using your inhaler easier.

How to use fluticasone + salmeterol accuhaler (Serevent Accuhaler)

  • To get the most benefit from the medication, it is important to use the correct technique when using an accuhaler.
  • The accuhaler device is breath activated, which means that it releases a dose of the powder, when you breath in
  • Even if you have been shown before, ask your doctor, pharmacist, or nurse to explain how to use your accuhaler if you still have any questions.
  • The following steps are a guide:
    • Open the accuhaler to expose the mouthpiece.
    • Slide the lever away from you. The number in the dose counter will be reduced by one.
    • Put the mouthpiece to your lips and breath in steadily through the accuhaler.
    • Remove the accuhaler and hold your breath for 10 seconds.
    • Breathe out slowly.
    • Rinse your mouth with water after using your accuhaler.

NOTE:

  • The accuhaler has a dose counter that tells you how many doses are left. Numbers 5 to 1 will appear in RED, to warn you when there are only a few doses left

What else do I need to know?

  • Use fluticasone + salmeterol every day. Do not stop using fluticasone + salmeterol, even if you feel better.
  • Try to use it at the same time each day, to help you to remember to use it regularly.
  • It is not harmful if you miss a dose of fluticasone + salmeterol. If you miss a dose, you can take it as soon as you remember, or if it is nearly time for your next dose, just take your next dose at the right time.

Possible side effects

Like all medicines fluticasone + salmeterol can cause unwanted side effects, although not everyone gets them. Often unwanted effects improve as your body adjusts to the new medicine.

  
Side effects What should I do?
  • A different taste in your mouth
  • Nausea (feeling sick)
  • Fast heart rate
  • Feeling nervous, restless, agitated
  • Muscle cramps
  • These are common symptoms  that will likely go away with time.
  • If the side effects are severe or do not go away contact your health professional. 
  • Signs of oral thrush (a fungal infection in the mouth) such as a very sore tongue or mouth, with white sores on the tongue, or in the mouth
  • Tell your doctor or pharmacist
  • Allergic reaction such as skin rashes, itching, swelling of the face, lips or mouth.
  • Tell your doctor immediately  or ring Healthline on 0800 611 116

Learn More

Asthma Foundation: learn more about inhalers

Medsafe Consumer Information Sheets: Seretide

New Zealand Formulary Patient Information: Fluticasone and salmeterol

Credits: Sandra Ponen, Pharmacist. Reviewed By: Dr J Bycroft. Health Navigator NZ