Salmeterol belongs to a class of drugs called bronchodilators. A bronchodilator is a medication that helps relax the muscles around the airways, which helps air move in and out of the lungs.
However, salmeterol carries a boxed warning regarding asthma-related death for those who use it without using an inhaled corticosteroid (ICS) at the same time. It also warns of increased stays in the hospital for children and adolescents who do not use an ICS in conjunction with salmeterol.
This article outlines what salmeterol is, the conditions it treats, and how to use it. It also discusses the safety of salmeterol, including its possible side effects and drug interactions.
Salmeterol is a type of bronchodilator. Specifically, it belongs to a group of bronchodilators called beta2-adrenergic agonists.
Salmeterol is a long-acting beta-agonist (LABA) that people take via an inhaler. It is the active drug in the branded medication Serevent Diskus Dry Powder Inhaler. People who use Serevent Diskus for long-term asthma control must use it alongside an ICS.
Salmeterol carries a boxed warning about asthma-related death when people use the drug in isolation. It also warns of extended stays in the hospital for children and teenagers with asthma who do not use an ICS alongside a LABA, such as salmeterol.
People must not use salmeterol for the relief of acute asthma or bronchospasms.
Doctors prescribe Serevent to prevent asthma attacks, to slow the progression of COPD, and to prevent exercise-induced bronchospasms (EIBs), or exercise-induced asthma, which occurs when the airways go into spasm and constrict.
Some symptoms of EIBs include:
Salmeterol is also available as a combination drug under one of the following brand names:
- Advair Diskus
- Advair HFA
Salmeterol, in combination with an ICS, is intended to prevent bronchospasms in people over 4 years of age who have asthma.
Serevent is not a rescue medication, and people must not use it to treat sudden asthma attacks or COPD.
People take salmeterol via a Diskus inhaler. This is a type of flat, round inhaler that provides a small amount of powdered medication in a puff of air that the person breathes in.
A person should talk to their doctor or pharmacist about how to use their inhaler correctly. Parents and caregivers should assist children until they are able to use the inhaler correctly on their own.
When taking salmeterol, a person should take the dosage their doctor prescribes, and they should not use the medication for any longer than their doctor recommends.
People should store their salmeterol Diskus inhaler at room temperature and away from heat, sunlight, and moisture.
A person should take salmeterol according to their doctor’s instructions.
If a person misses a dose of salmeterol, they should wait and take the next dose at the regular time. People should not take two doses at one time. Doing so may result in an overdose.
The exact dosing instructions for salmeterol will depend on what condition a person is taking it to treat. The Food and Drug Administration (FDA) outline the following typical dosages for this medication:
- For asthma: One inhalation twice daily, about 12 hours apart.
- For COPD: One inhalation twice daily, about 12 hours apart.
- For EIB: One inhalation 30 minutes before exercise, unless the person is already taking two doses per day for asthma or COPD.
- For asthma control: Always use LABAs in combination with an ICS.
People should not take more than two doses of salmeterol per day.
People should only use salmeterol for the following conditions:
Due to the risk of asthma-related death, only people with asthma who are also using an ICS should take salmeterol.
Salmeterol is not suitable for the following groups of people:
- children younger than 4 years of age
- people who are taking another type of LABA medication
- people who are allergic to milk proteins
- people who are allergic to salmeterol or any of the ingredients listed on the medication label
- people who are pregnant, as doctors do not know the possible effects of salmeterol on the fetus
- people who are breastfeeding, as doctors do not know if salmeterol can pass into breast milk or if it could harm the baby
People whose asthma is well-controlled using an ICS should also not take salmeterol.
People with any of the following conditions should talk to their doctor before taking any product that contains salmeterol:
Anyone who experiences worsening symptoms while taking salmeterol should talk to their doctor about stopping the medication.
However, a person should not stop taking the medication unless their doctor says that it is safe for them to do so.
Salmeterol can interact with several medications. The following sections will look at these in more detail.
A person should not take salmeterol while taking any other medication that contains a LABA, as doing so could result in an overdose.
Some examples of LABA medications include:
- formoterol (Perforomist, Symbicort, Bevespi, Dulera)
- arformoterol (Brovana)
- indacaterol (Arcapta)
- olodaterol (Striverdi, Stiolto Respimat)
- vilanterol (Anoro Ellipta, Breo Ellipta, Trelegy Ellipta)
Other types of medication
Salmeterol may also interact with the following medications:
- the antidepressant nefazodone
- any medications belonging to a class of antidepressants called monoamine oxidase inhibitors
- the antibiotics clarithromycin and telithromycin
- the antifungal medications itraconazole and ketoconazole
- antiviral medications to treat HIV
- heart or blood pressure medications, such as diuretics and beta-blockers
It is good practice for a person to tell their doctor about any medications or supplements they are taking before they begin taking a new medication. This includes any of the following:
- any prescription medications
- any over-the-counter medications
- any type of dietary or herbal supplement
- any type of vitamin or mineral supplement
Salmeterol can cause side effects in some people. Some of these side effects are common and relatively harmless, while others can be much more serious.
The following sections will look at the possible side effects in more detail.
Common side effects
Some common side effects of salmeterol include:
- joint or muscle pain
- a stuffy or runny nose
- throat irritation
- a cough
- an increased susceptibility to respiratory infections, including flu
Serious side effects
Salmeterol may cause serious side effects in some cases. Examples include:
- severe headache
- a pounding sensation in the neck or ears
- blurred vision
- a fast or irregular heartbeat
- chest pain
- high blood sugar levels
- low potassium levels, which may cause:
Salmeterol may cause a serious allergic reaction, or anaphylaxis, in some people. Symptoms to look out for include:
- swelling of the face, mouth, tongue, or throat
- difficulty breathing
Anyone who experiences any symptoms of an allergic reaction after taking salmeterol needs emergency medical attention.
Experts consider salmeterol to be safe and effective as long as a person takes the medication according to their doctor’s instructions.
All medications have risks and possible side effects. Before taking salmeterol, a person should talk to their doctor to determine whether or not the potential benefits of taking the medication outweigh the risks.
A person should contact their doctor if they experience any side effects while taking salmeterol. The doctor may be able to adjust the dosage or prescribe an alternative medication.
If a person takes too much of the medication, they need emergency medical attention. Some possible symptoms of an overdose include:
- worsening shortness of breath
- an increased heart rate
- chest pain
Salmeterol is a type of LABA intended to prevent bronchospasms in people with asthma or COPD. It can slow COPD progression and prevent asthma attacks and EIBs.
People must not use salmeterol for the relief of an acute bronchspasm or asthma attack or use salmeterol inhalation to treat an asthma attack that has already started.
People using LABAs for asthma control must use them in combination with an ICS and not on their own.
Salmeterol is available on prescription only. People should always take the medication according to the doctor’s instructions and not use it for any longer than their doctor recommends.
Salmeterol can interact with certain medications, so a person must notify their doctor of any other medications or supplements they are taking.
Salmeterol can also cause side effects. Anyone who experiences any serious side effects while taking it needs medical attention.
Importantly, salmeterol also carries a boxed warning about asthma-related death.