Salmeterol

Sounds like 'sal-MET-er-all'

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

Type of medicine Also called
  • Bronchodilator (opens the air passages to the lungs)
  • Serevent Accuhaler®
  • Serevent Inhaler®
  • Meterol®

What is salmeterol?

Salmeterol is used to improve breathing problems caused by asthma and COPD and to prevent them from recurring. It eases symptoms such as wheezing, coughing and shortness of breath. Salmeterol works by opening air passages in the lungs to make breathing easier.

  • Salmeterol must be used every day. It is a long-acting bronchodilator, which means that it works throughout the day. It reduces your symptoms over the long term. 
  • For asthma, salmeterol should be used together with other medicines called corticosteroids or preventers such as beclomethasone, budesonide or fluticasone

In New Zealand salmeterol is available in different brands and inhaler devices:

  • metered dose inhaler (MDI or puffer): Serevent and Meterol 
  • accuhaler (a dry powder inhaler): Serevent.

Using an inhaler device enables the medicine to go straight into your airways when you breathe in. This means that your airways and lungs are treated, but very little of the medicine gets into the rest of your body. Both the MDI and accuhaler are effective. The choice of device is personal preference. Read more about the different inhaler devices and deciding on the right inhaler for you.

Salmeterol does not give immediate relief from an asthma attack 
If you need quick relief from asthma symptoms, use your ‘reliever’ medicine such as salbutamol or terbutaline.

Dose

  • The dose of salmeterol will be different for different people depending on the severity of your symptoms and the strength of your inhaler or accuhaler.
  • The usual dose of salmeterol is 1 or 2 inhalations twice daily.
  • Always use your salmeterol exactly as your doctor has told you. The pharmacy label on your medicine will tell you how much to use, how often to use it and any special instructions.

Tips

  • Keep using your inhaler every day. Do not stop using it, even if you feel better. Since asthma and COPD are long-term conditions, prevention with salmeterol is ongoing and it will need to be used every day for months or years.
  • Try to use your inhaler at the same time each day, to help you to remember to use it regularly.
  • If you miss a dose, you can take it as soon as you remember. But if it is nearly time for your next dose, just take your next dose at the right time.

How to use your MDI (puffer)

To get the most benefit, it is important to use the correct technique. Ask your doctor, pharmacist or nurse to explain how to use your inhaler. Even if you have been shown before, ask them to show you again how to use your inhaler if you still have any questions. Here is some guidance.

 How to use your MDI (puffer)
Take off the cap and hold the inhaler upright.
Shake the inhaler to mix the medication.
  Sit upright, tilt your head back slightly (as if you are sniffing) and breathe out gently.
Hold the device upright, insert the inhaler into your mouth, ensuring that your lips firmly seal the mouthpiece.
At the beginning of a slow, deep breath, breathe in through the mouthpiece as you press the inhaler to release one dose or 'puff'.
Breathe in fully, remove the inhaler from your mouth and hold your breath for 10 seconds or as long as is comfortable.
Breathe out gently through your nose.

Learn more about metered dose inhalers.

Using a spacer with your MDI

A spacer is an attachment to use with your MDI. Using a spacer with your MDI makes it easier to use the inhaler and helps to get the medicine into your lungs, where it’s needed (with less medicine ending up in your mouth and throat). Spacers improve how well your medicine works. Read more about spacers.

How to use your accuhaler

To get the most benefit, it is important to use the correct technique. Ask your doctor, pharmacist, or nurse to explain how to use your accuhaler. Here is some guidance:

(NHS UK, 2016)

Using your accuhaler

  • Open: hold the accuhaler in one hand, and with the thumb of the other hand push the thumb grip away from you until you hear a click. This reveals the mouth piece.
  • Load the dose: hold the inhaler in a horizontal position. Slide the lever away from you until you hear a click.
  • Breath out: breathe out, away from the accuhaler. Do not blow directly into your device.
  • Inhale your dose: place the mouth piece in your mouth and form a seal with your lips. Breathe in deeply and forcefully through your mouth. Remove the accuhaler and hold your breath for up to 10 seconds. If you need another dose, wait for 30 seconds and then repeat the process.
  • Close: the inhaler by sliding the thumb grip towards you.

Cleaning and storing your accuhaler: wipe the mouthpiece with a clean dry tissue. Do not wash the mouthpiece or allow it to get wet when cleaning. Close the device when not in use. 

When to start a new accuhaler: there is a window on the side of the accuhaler called a dose counter. When it turns red it is time to get a new accuhaler.

Precautions – before using salmeterol

  • Do you have heart disease?
  • Do you have an overactive thyroid (hyperthyroid)?
  • Do you have high blood pressure (hypertension)?
  • Do you have diabetes?
  • Do you have lactose intolerance?
  • Are you pregnant or breastfeeding?
  • Do you have an irregular heartbeat or rhythm, including a very fast pulse?
  • Do you play competitive or professional sport?

If so, it’s important that you tell your doctor or pharmacist before you start using salmeterol. Sometimes a medicine isn’t suitable for a person with certain conditions, or it can only be used with extra care.

Possible side effects

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

Side effects What should I do?
  • A different taste in your mouth
  • Dry mouth
  • Nausea (feeling sick)
  • Headache
  • Cough
  • These are quite common when you first start using salmeterol, and usually go away with time.
  • Tell your doctor if troublesome.
  • Fast heart rate
  • Feeling nervous, restless, agitated
  • Trembling or shakiness
  • Problems sleeping
  • Tell your doctor if troublesome.
  • Sudden worsening of breathing problems 
  • Tell your doctor immediately or phone HealthLine on 0800 611 116.

Learn more

Serevent accuhaler Medsafe Consumer Information
Serevent inhaler Medsafe Consumer Information
Salmeterol New Zealand Formulary Patient Information

References

  1. Salmeterol New Zealand Formulary
Credits: Sandra Ponen, Pharmacist. Reviewed By: Angela Lambie, Pharmacist, Auckland Last reviewed: 28 Oct 2017