Salmeterol is a type of drug known as a long-acting beta2 agonist that works by activating beta2 adrenoceptors in the body and leading to relaxation of the bronchial tubes in the airways. This makes it easier for you to breathe and helps to reduce the symptoms of asthma and chronic obstructive respiratory disease (COPD.)
It has a long duration of action and can continue to have an effect on your body for up to 12 hours after taking a dose, which makes it useful for preventative treatment.
Brand Names and Doses
Salmeterol is the generic name of the drug, which is the name of the active ingredient in the medication that has an effect on your body. However, you may know it better by its brand name Serevent Accuhaler, which is the name given by the pharmaceutical company that produces it. Serevent Accuhaler is available in a dose of 50 mcg/dose.
It is also available in combination with fluticasone, which another type of drug to help prevent asthma and COPD symptoms. This combination is useful because it means that a lower dose of salmeterol can be used, which is thought to be safer. The brand name of the eformeterol-fluticasone combination medication is known as Seretide Accuhaler and is available in several different doses, as follows:
· 25 mcg salmeterol + 50 mcg fluticasone
· 25 mcg salmeterol + 125 mcg fluticasone
· 25 mcg salmeterol + 250 mcg fluticasone
· 50 mcg salmeterol + 100 mcg fluticasone
· 50 mcg salmeterol + 250 mcg fluticasone
· 50 mcg salmeterol + 500 mcg fluticasone
What type of drug is it?
Salmeterol is a type of drug known as a beta2 agonist. This is a group of drugs that act in a similar way to activate the beta2 adrenoceptors and cause the muscles surrounding airways to relax so that the air can pass through more easily.
Specifically, it is a long-acting beta2 agonist because it works for a longer period of time in your body. Other long-acting beta2 agonists include indacaterol and eformeterol.
Short-acting beta2 agonists that also work in a similar way but for a shorter period of time include salbutamol and terbutaline.
How does Salmeterol work?
Salmeterol works by stimulating certain receptors in the body, called beta2 adrenoceptors. When these adrenoceptors are activated, the smooth muscles surrounding the bronchial tubes relaxes so that the airways can expand and allow the air to pass through more easily. This is useful in the management of respiratory conditions such as asthma and COPD.
Salmeterol has a longer duration of action than other types of beta2 agonists, which is what makes it a good choice for ongoing preventative treatment. It is also quick to have an effect, which means that it can help to relieve acute symptoms.
What is it used for?
Salmeterol is usually used in the management of respiratory conditions such as asthma and COPD. It can take up to half an hour to have an effect on your body and it can last for up to 12 hours.
As it has an extended duration of action, it can be useful for the ongoing management of asthma and COPD symptoms to help prevent them from worsening.
As it is a preventative medication, it is important to take it regularly as your doctor recommended, even if you feel better and don’t have any symptoms. This is because it may be helping to prevent asthma or COPD symptoms in the background and you may begin to experience symptoms once again if you stop taking it.
How is Salmeterol administered?
There are two main ways that salmeterol can be taken, depending on which pharmaceutical product containing the medication that you are using.
Serevent Accuhaler is administered with a device called an accuhaler or dry powder inhaler (DPI), which delivers a powder that contains salmeterol into the airways. The device is breath-activated and you can inhale the powder as you breathe in.
Seretide can be taken with an accuhaler, similar to Serevent, or with a metered dose inhaler (MDI). This device delivers the salmeterol to the airways in propellant gas as you breathe in and press the button of the inhaler at the same time.
Side Effects
Some people who take Salmeterol may experience some side effects, particularly if they take high doses. Side effects may include:
- Tremor in the hands
- Heart palpitations
- Fast heart rate (tachycardia)
- Headache
- Hyperglycemia
- Muscle cramps
- Agitation
Drug Interactions
Salmeterol can interact with some other drugs that you may be taking, and it is important for you to be aware of these interactions so that you can double check that the combination is okay.
Sympathomimetic amines (e.g. ephedrine, phenylephrine, pseudoephedrine): increased risk of side effects such as tremor, tachycardia and headache.
Beta-blockers: have an opposite effect on the beta2 adrenoceptors in the body, so they are not usually used together.
Theophylline: increased risk of low potassium levels in the blood (hypokalemia) so you will need to monitor your potassium levels more closely than usual.
Precautions
There are some people who may be more likely to experience side effects when taking Salmeterol.
If you have hypertension, ischemic heart disease, heart failure or arrhythmias you may be more likely to experience side effects related to the heart (e.g. palpitations, fast heart rate.) You are also more likely to experience these effects if you are affected by a thyroid disorder.
Additionally, you may be at an increased risk of high levels of glucose in your blood (hyperglycemia) if you have diabetes.
Salmeterol is not usually used alone to prevent asthma or COPD symptoms because it may worsen symptoms when used in high doses. Instead, it is best to combine it with an inhaled corticosteroid medication (e.g. combination medication in Seretide Accuhaler) so that they can both help to prevent symptoms and you need a lower dose.
Older adults often require lower doses than normal of salmeterol and are more likely to experience side effects. It is best for them to begin taking a lower dose and gradually increase it if the symptoms of asthma or COPD are not well controlled to help to prevent this.
Pregnancy and Breastfeeding
There is not much evidence to guarantee the safety of Salmeterol for women who are pregnant or breastfeeding. However, it is important that asthma symptoms are well controlled and many women are recommended to continue taking Salmeterol as usual if they were taking it regularly before becoming pregnant.
There is little data about the use of salmeterol for women who are breastfeeding, although it should be safe to use.
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