Serevent Inhaler

Serevent Inhaler Instruction

Clinical and Pharmacological Group

Bronchodilators – beta2-agonists

Pharmaceutical Form, Composition and Packing

Aerosol for inhalation dose in the form of a suspension of white or almost white.

Serevent 1 dose consists of:

salmeterol xinafoate 36.3 mg	36.3 mg
salmeterol	25 mcg

Additives: lecithin, trichlorofluoromethane, dichlorodifluoromethane.
60 doses – inhalers with pressed metal bottom, with a plastic portioning device – in packs cardboard.

Dosage

Serevent inhaler is intended solely for inhalation. The drug can be used through a spacer device. Drug should be used regularly to achieve optimal therapeutic effect. The duration of treatment is determined by doctor.

In Adults in case of asthma and COPD treatment it is the recommended dose – 2 inhalations (2 x 25 micrograms of salmeterol) 2 times / day.

The maximum dose (with more pronounced airway obstruction in asthmatic patients) – 4 inhalations (4 x 25 micrograms salmeterol) 2 times / day.

Children older than 4 years, recommended dose – 1-2 inhalations (25-50 mcg salmeterol) 2 times / day.

The maximum daily dose for children and adolescents aged 4 to 18 years old is no more than 100 micrograms of salmeterol (no more than 2 inhalations 2 times / day).
Patients with impaired renal function and in elderly patients dose change is not required.

Overdose

Symptoms: tremor, headache and tachycardia.
Treatment: it is preferable administration of cardioselective beta-blockers which requires caution, because these drugs can cause bronchospasm.

Side Effects

• Cardiovascular system: headache, palpitations; in predisposed patients – abnormal heart rhythm (atrial fibrillation, supraventricular tachycardia and extrasystoles).
• Digestive system: change in taste, abdominal pain, nausea, vomiting, mouth or throat mucous membranes irritation.
• Allergic reactions: urticaria, angioedema, bronchoconstriction.
• Other: tremor, muscle cramps, arthralgia, hypokalemia, nervousness.

Serevent inhaler online can cause paradoxical bronchospasm, which is necessary to stop immediately using quick inhaled bronchodilator (in such cases, you should immediately discontinue Serevent usage, to assess patient’s condition, conduct survey, to appoint an alternative therapy if necessary).

Contraindications

• Children under 4 years of age;
• Hypersensitivity to salmeterol and other ingredients.

Precautions

Serevent Inhalers should be prescribed for hyperthyroidism, arrhythmia, ischemic heart disease (angina III-IV functional class), acute myocardial infarction, uncontrolled hypertension, hypoxia of different genesis, pheochromocytoma, pregnancy, lactation.

Pregnancy and Lactation

Use of drug during pregnancy and lactation (breastfeeding) is not recommended except in cases where expected benefit to mother outweighs potential risk to fetus or infant.

Drug Interactions

• In application with beta-blockers (including with cardioselective) antagonism is observed.
• With simultaneous Serevent use with xanthine derivatives, corticosteroids and diuretics increases risk of hypokalemia.
• At simultaneous application with monoamine oxidase inhibitors and tricyclic antidepressants increases risk of side effects from cardiovascular system.
• It is compatible with inhaled corticosteroids and cromoglicic acid.

Special Instructions

Serevent inhaler should not be used in patients with severe course of deterioration or worsening of asthma (an increase of bronchial obstruction symptoms, decrease in efficiency and an increase in demand for high-speed inhaled bronchodilators, pick flow meter and spirometry deterioration).

During exacerbation of asthma, as well as in patients with hypoxia it is necessary to control potassium concentration in blood plasma.

Patients should be warned that they should not stop taking glucocorticosteroids, or to reduce dose without doctor’s advice, even if condition has improved during treatment with Serevent online. Serevent is not a substitute for corticosteroids or oral inhalation, and is appointed in addition to them. In addition, it should be borne in mind that for asthma symptoms relief should not be inhaled additional doses of Serevent, and is recommended to use short-acting agonists β2-adrenergic.

Since application of β2-adrenoceptor agonists in high doses may cause adverse reactions if necessary increase dose or frequency of Serevent administration requires physician control and supervision.

Data relating to placebo-controlled trial conducted in the US, which compared salmeterol and placebo security assigned in addition to ordinary asthma therapy for 28 weeks, showed small but statistically significant increase in number of deaths regarding to asthma among patients, treated with salmeterol (13 cases, 174 patients at 13 – 0.099%) compared to those treated with placebo (4 13 179 – 0.03%).

8 out of 13 patients in the first and 1 out of 4 patients in the second group were Afro-Americans, suggesting a higher risk of death associated with asthma, among this race representatives. It remains unclear whether it is related to the fact of ongoing therapy, genetic predisposition or features of social behavior of African Americans (later uptake to doctor and lack of strict adherence to doctor’s recommendations). In addition, extremely low overall incidence of reported cases does not give grounds to make a definite conclusion on results of this study.

With regular use of Serevent Inhalers most patients reduce need for short beta-agonists additional use.

It is recommended to check whether patient is using inhaler correctly.
Drug’s therapeutic effect can be reduced when cooling inhaler.
Upon cooling spray is recommended to get it out of plastic case and warm by hands for a few minutes.

The balloon should not puncture, disassemble or burn, even if it is empty.

Terms and Storage Conditions

It is possible to buy Serevent Inhaler via Asthma Inhalers Online (click here).
List B. The drug should be stored at room temperatures not above 30 ° C out of reach of children. Expiratory period is 2 years.