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salmeterol (Rx)Brand and Other Names:Serevent Diskus

 
 
 

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

powder

  • 50mcg/inhalation
more...

Asthma Prevention and Maintenance

1 inhalation (50 mcg) twice daily; not to exceed twice daily administration

COPD Maintenance

1 inhalation (50 mcg) twice daily; not to exceed twice daily administration

Prevention of Exercise-Induced Asthma

1 inhalation 30 minutes before exercise; a second dose not to be administered for another 12 hr; not for use in individuals receiving twice daily therapy of salmeterol

Dosage Forms & Strengths

powder

  • 50mcg/inhalation
more...

Asthma Prevention and Maintenance

< 4 years

  • Safety and efficacy not established

> 4 years

  • 1 inhalation (50 mcg) twice daily; not to exceed twice daily administration

Prevention of Exercise-Induced Asthma

< 4 years

  • Safety and efficacy not established

> 4 years

  • 1 inhalation (50 mcg) twice daily; not to exceed twice daily administration
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Interactions

Interaction Checker

salmeterol and

No Results

     
     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Adverse Effects

            >10%

            Headache (13-17%)

            Pain (1-12%)

            1-10%

            Nasal congestion (9%)

            Hypertension (4%)

            Edema (1-3%)

            Dizziness (4%)

            Sleep disturbance (1-3%)

            Migraine (1-3%)

            Contact dermatitis (1-3%)

            Urticaria (3%)

            Hyperglycemia (1-3%)

            Articular rheumatism (1-3%)

            Paresthesia (1-3%)

            Muscular stiffness (1-3%)

            Photodermatitis (1-2%)

            Bronchitis (7%)

            Influenza (5%)

            Rigidity (1-3%)

            hinitis (5%)

            Asthma (3%)

            Frequency Not Defined

            Conjunctivitis

            Hyperglycemia

            Keratitis

            Oral candidiasis

            Chest tightness

            Cataracts

            Hypokalemia

            Myositis

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            Warnings

            Black Box Warnings

            Long-acting beta2-adrenergic agonists, such as salmeterol, may increase the risk of asthma-related death. Therefore, when treating patients with asthma, this drug should only be used as additional therapy for patients not adequately controlled on other asthma controller medications (eg, low-to-medium dose inhaled corticosteroids) or whose disease severity clearly warrants initiation of treatment with 2 maintenance therapies, including this drug.

            Because of this risk, use of salmeterol for the treatment of asthma without a concomitant long-term asthma control medication, such as an inhaled corticosteroid, is contraindicated

            Once asthma control is achieved and maintained, assess the patient at regular intervals and step down therapy (eg, discontinue LABA) if possible without loss of asthma control, and maintain the patient on a long-term asthma control medication, such as an inhaled corticosteroid

            Data from a large placebo-controlled US study that compared the safety of salmeterol (inhalation aerosol) or placebo added to usual asthma therapy showed an increase in asthma-related deaths in patients receiving salmeterol (13 deaths out of 13,176 patients treated for 28 weeks on salmeterol versus 3 deaths out of 13,179 patients treated for 28 weeks on placebo)

            Contraindications

            Hypersensitivity to any component

            Status asthmaticus or other acute episodes of asthma

            Treatment of asthma without a concomitant long-term asthma control medication, such as an inhaled corticosteroid

            Cautions

            Cardiovascular disorder, convulsive disorder, thyrotoxicosis

            Not to administer > twice daily dosing

            Not for acute asthma; for acute asthma exacerbations, use short-acting beta agonists (eg, albuterol)

            Not for acute epidodes of COPD

            May increase risk of severe, potentially fatal asthma attacks; small but significant increase in asthma related deaths for pts using salmeterol vs placebo, with greater risk in African-Americans

            Risk of hypokalemia, usually transient

            Use caution in patients with hypokalemia, hepatic impairment, seizure disorders, and hyperthyroidism

            Paradoxical bronchospasm may occur

            Beta-2 agonists may increase serum glucose; use caution in patients with diabetes mellitus

            Laryngeal spasm, swelling, irritation reported with use

            Combined with asthma controller medication (eg, inhaled corticosteroid)

            Use only if not adequately controlled on asthma controller medications

            Use only for shortest duration of time

            Coadministration with CYP3A4 inhibitors may increase salmeterol levels and risk toxicity including QT prolongation

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            Pregnancy & Lactation

            Pregnancy Category: C

            Lactation: Unknown if excreted in breast milk, salmeterol plasma levels are very low following inhalation; use caution

            Pregnancy Categories

            A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA:Information not available.

            more...
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            Pharmacology

            Mechanism of Action

            Long-acting beta-2 agonist; action on beta-2 receptors relaxes bronchial smooth muscle with little effect on heart rate

            50 times more selective than albuterol

            Pharmacokinetics

            Peak serum time: 20 min

            Half-Life: 5.5 hr

            Onset: 30-48 min (asthma); 2 hr (COPD)

            Duration: 12 hr

            Absorption: Minimal (undetectable)

            Protein Bound: 96%

            Metabolism: Liver

            Excretion: Feces (60%); urine (25%)

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            Images

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            Formulary

            FormularyPatient Discounts

            To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

            Adding plans allows you to:

            • View the formulary and any restrictions for each plan.
            • Manage and view all your plans together – even plans in different states.
            • Compare formulary status to other drugs in the same class.
            • Access your plan list on any device – mobile or desktop.

            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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