Seretide (Fluticasone and Salmeterol 125mcg/25mcg) Inhaler

Seretide Inhaler general information

What is Seretide Inhaler used for?

Breathing difficulty is a feature of chronic airway diseases.  These include asthma, which is caused by inflammation of the lungs and narrowing of the small airways of the lungs called bronchioles.  Chronic obstructive pulmonary disease (COPD) is caused by permanent damage to the airways, which is not reversible.  Seretide Inhaler 25/125 is an inhaled medication that is used for regular long-term treatment and management of asthma.  It is also used for long-term maintenance treatment of COPD to control symptoms and to prevent the damage from getting worse. 

A combination inhaler like Seretide 25/125 is helpful If you are already using two different types of inhaler, but your asthma symptoms are not adequately controlled, and you are still having symptoms.  These include a preventer and a reliever that help control your asthma by reducing inflammation and relieving airway constriction.  However, Seretide Inhaler 25/125 is not suitable for immediate relief of asthma attack; for this, you should use a reliever inhaler. 

Asthma symptoms and triggers

Symptoms of asthma include wheezing and coughing, tightness of the chest, and shortness of breath.  Having asthma means you have sensitive airways that are reactive to specific triggers.  These include triggers that cause an allergic reaction, such as pollen, dust, or mould, and this type of asthma is called allergic asthma.  Non-allergic asthma triggers include irritants like inhaled chemicals, cigarette smoke, cold air, an infection, stress, exercise, or some medications.  Exercise-induced asthma is a particular type of asthma that only happens after exertion but can last for over an hour after you stop exercising.  Eventually, exposure to an asthma trigger causes inflammation of the sensitive bronchiole lining so that they become swollen and inflamed.  Another sign of inflammation of the airways is the overproduction of mucus, usually produced to keep the airways moist, and this further blocks the airways. 

Bronchioles are lined by bands of smooth muscle that are usually relaxed, allowing the bronchioles to expand and air to pass freely through into the air sacs or alveoli of the lungs.  When the airways are inflamed, the smooth muscle contracts, which narrows the bronchioles making breathing more difficult.  As the airways narrow, it becomes harder to inhale and requires more effort to blow air out of the lungs.  This narrowing of the bronchioles is called bronchospasm.  If the bronchioles are already in a state of chronic inflammation, an asthma trigger may cause sudden constriction and narrowing of the bronchioles, which can cause an asthma attack.

What causes COPD?

COPD causes breathing difficulties due to lung damage.  Over time, inhaling irritants gradually damages the lung cells until a point is reached where the damage cannot be reversed.  Smoking is the most common cause, also workplace chemicals.  Untreated asthma can also cause scarring of the lung tissue that leads to COPD.  Scarring results in airway remodelling, which means thickening of the airway walls and narrowing of the tubes.  This causes the airways to be blocked, making breathing permanently and irreversibly difficult. 

Symptoms of COPD

COPD symptoms are similar to asthma and include a chronic cough with the production of thick mucus or phlegm, wheezing, and tightness of the chest.  Breathing is difficult, making you feel short of breath, and because COPD is not reversible, breathing difficulty gets progressively worse.  At first, shortness of breath is related to exercise or mild exertion but eventually happens even when you are resting.  You are more likely to get a chest infection and can feel tired and fatigued much of the time.  COPD also includes lung conditions like chronic bronchitis, which is inflammation of the upper airways, including the bronchi (large airways) and the bronchioles (small airways).  Emphysema is caused by damage to the air sacs of the lungs (alveoli), making it more and more difficult for the lungs to get enough oxygen into the blood.  COPD in all its forms, limits daily activities, restricts exercise and exertion and reduces the quality of life.

How does Seretide Inhaler work?

Seretide Inhaler 25/250 contains a combination of two medications that work by different mechanisms of action to control obstructive airways disease in asthma and chronic obstructive pulmonary disease (COPD). 

Fluticasone in Seretide 25/125 Inhaler is a corticosteroid and anti-inflammatory medication.  It works by blocking the production of inflammatory chemicals produced by specific cells of the immune system, including leukocytes and macrophages.  These cells are recruited to the site of inflammation, where they release chemicals into the airways, such as prostaglandins and leukotrienes.  Other cell mediators called cytokines are released to attract more inflammatory cells and prolong the inflammatory response. 

Salmeterol is a long-acting beta2-agonist and bronchodilator.  It works by dilating (relaxing) the muscles of the small airways of the lungs (bronchioles) to widen the airways.  This reduces bronchospasm (constriction or the airways), relieving symptoms of asthma such as tightness of the chest, wheezing, and shortness of breath and provides relief for up to 12 hours. 

Fluticasone and salmeterol in Seretide Inhaler 25/125 are delivered in an aerosol directly into the bronchioles of the lung.  They work together to improve lung function, which reduces symptoms and exacerbations of asthma, and helps manage symptoms of COPD.

What does Seretide Inhaler contain?

Seretide Inhaler 25/125 is a metered dose inhaler (MDI) that contains the active ingredients salmeterol xinafoate a bronchodilator (25mcg), and fluticasone propionate (125mcg), a corticosteroid used in combination to treat asthma and COPD.  Each dose contains 25mcg salmeterol xinafoate and 125mcg fluticasone propionate.  It also contains the non-CFC propellant norflurane (also known as HFA 134a or 1,1,1,2-tetrafluoroethane), which delivers a single dose (puff) as an aerosol into your lungs each time your actuate (press down) your inhaler.  Each inhaler contains 120 actuations (doses). 

What are the side effects of Seretide Inhaler?

Most medications have some side effects, but they are not experienced by everyone.  Some side effects are commonly experienced when taking Seretide Inhaler25/125, but others are not so common, and you should discuss any problems or concerns with your primary care physician. 

Common side effects when taking Seretide Inhaler include a sore throat or tongue, which may be due to candida infection (thrush), hoarseness or throat irritation, contusion in the skin (bruising), tachycardia (rapid heartbeat), tremor (shaky or tense feeling), palpitations, mouth or throat irritation and muscle cramps. 

When should Seretide Inhaler not be used?

Have a talk with your primary healthcare physician before taking Seretide Inhaler 25/125 so that you have a full understanding of what this medicine is for and how to use it.  There are some reasons for not taking a medication; these are called contraindications, and for Seretide Inhaler you should consider the following before taking Seretide Inhaler:

• Have you ever had an unusual reaction or an allergy when taking Seretide Inhaler?
• Are you pregnant or breastfeeding?
• Do you have diabetes, as Seretide inhaler may increase your glucose levels?
• Do you have tuberculosis of the lung or other long term lung infection?
• Do you have a thyroid condition, high blood pressure, or a heart condition?

What are the health risks of Seretide?

Long term use of Seretide inhaler 25/125 may cause the adrenal glands, which produce endogenous (naturally occurring) corticosteroids, to stop working efficiently.  This may slow down the growth rate in children and will need regular monitoring.  Seretide inhaler may also cause decreased bone mineral density if used for long periods.

What is paradoxical bronchospasm?

All inhaled asthma medications can cause paradoxical bronchospasm.  This is when the inhaled medication that is taken to relieve or prevent bronchospasm makes it worse, causing wheezing, shortness of breath and tightness of the chest.  If this happens, you should inform your doctor and take their advice.

What medications interact with Seretide Inhaler?

Some medicines interact with Seretide Inhaler 25/125 and may affect the way it works, or are affected by Seretide Inhaler or increase side effects; you should discuss possible interactions with your primary care physician.  These may include beta-blockers, such as propranolol, the antifungal ketoconazole, ritonavir for HIV infection.

If other medications may interact with Seretide Inhaler, your doctor will discuss these with you. 

How should Seretide Inhaler be taken and for how long?

You should take your Seretide by inhaling two puffs twice a day, morning and evening.  The dose you take and how often depends on what you are being treated for, the severity of your condition, your age, and your doctor’s recommendation.  Seretide inhaler 25/125 does not work immediately.  It is intended as a long-term medication, which may take up to a week to start to work, and it may take several weeks before you feel the maximum benefit.  You should not stop taking your Seretide inhaler, even if you feel better.

Follow the instructions provided when using your Seretide inhaler.  You can use a spacer device to help you inhale correctly. 

Missed dose of Seretide Inhaler

If you miss a dose of Seretide Inhaler 25/125 take it as soon as you remember, unless it is time to take the next dose, then skip the missed dose.  Do not take a double dose.

How should Seretide Inhaler be stored?

You should store your Seretide Inhaler 25/125 below 25°C in a cool dry place.