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Salmeterol is a bronchodilator which is similar to albuterol (Proventil® or Ventolin®) and other "shorter-acting" medications such as bitolterol (Tornalate®), pirbuterol (Maxair®) and terbutaline (Brethaire®). Salmeterol differs from these medications in that it does not begin working immediately and has a longer duration of action. This allows for twice daily dosing rather than the usual four times daily or every 4-6 hours dosing.

Recently, there has been concern over the potential for a greater risk of dying of acute asthma attacks in persons treated with salmeterol. This has received much attention in newspapers and magazines. While the association between salmeterol and deaths due to asthma remains unclear, proper use of this medication can minimize any risks.

Salmeterol, with its slow onset of action and long duration of action, is not intended for use as a "rescue" medication. Therefore it should not be used for relief of acute symptoms such as coughing, wheezing, chest tightness or shortness of breath. Salmeterol's longer onset of action, the time it takes to begin working, means that you may not feel immediate relief after taking a treatment. Thus, you should continue to use your shorter-acting agent for relief of symptoms, especially those that occur suddenly. Because salmeterol is a long-acting bronchodilator, you may feel relief for a longer period of time and may require fewer treatments of your shorter-acting bronchodilator.

Why is this drug prescribed?

Serevent relaxes the muscles in the walls of the bronchial tubes, allowing the passageways to expand and carry more air. Taken regularly (twice a day), the drug helps prevent wheezing and other symptoms of asthma, as well as exercise-induced asthma. A relatively long-acting medication, it is recommended for people who need shorter-acting bronchodilators such as Alupent and Ventolin on a frequent, regular basis.

Serevent is available in an aerosol inhaler and as Serevent Diskus (Acculhaler) inhalation powder. The aerosol inhaler is also used to treat the airway constriction that marks such chronic lung diseases as emphysema and chronic bronchitis. Both forms of Serevent can be used with or without inhaled or oral steroid therapy.

Most important fact about this drug

Serevent is intended only for long-term prevention of symptoms, and should not be used more than twice a day. Do not use it to treat acute asthma attacks, and do not attempt to relieve worsening asthma by increasing the frequency of your doses. (Your doctor will prescribe a short-acting bronchodilator to relieve acute attacks.)

Seriously worsening asthma is a dangerous-even life-threatening-condition that needs immediate medical attention. Alert your doctor if your short-acting bronchodilator is becoming less effective or you need more inhalations than usual. Also consider it a warning sign if you need 4 or more inhalations daily for 2 days or more in a row, or find that you are finishing a 200-dose canister in less than 8 weeks.

How should you take this medication?

Use no more than the prescribed dose and follow package directions closely. Space your two daily doses approximately 12 hours apart, in the morning and evening. To be effective, the drug must be used regularly every day.

Serevent aerosol inhaler must be shaken thoroughly before each use. Test-spray the inhaler 4 times before the first use and whenever 4 weeks have passed since the last use. Avoid spraying in the eyes.

Serevent Diskus should never be used with a spacer. Always activate the Diskus device in a level, horizontal position. Never exhale into the Diskus device, and always keep it dry. Do not wash the mouthpiece or any other part of the device.