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Description
How does it work?
This medicine contains two active ingredients, fluticasone propionate and salmeterol.
Fluticasone belongs to a group of medicines known as
corticosteroids. Corticosteroids are hormones produced naturally by the
adrenal glands that have many important functions, including control of
inflammatory responses.
Fluticasone is a synthetic corticosteroid and is used to decrease
inflammation in the lungs. When inhaled into the lungs it is absorbed
into the cells of the lungs and airways. Here it works by preventing
the release of certain chemicals from the cells. These chemicals are
important in the immune system and are normally involved in producing
immune and allergic responses, which result in inflammation. By
decreasing the release of these chemicals in the lungs and airways,
inflammation is reduced.
In asthma, the airways tighten due to inflammation and can also be
blocked by mucus. This makes it difficult for air to get into and out
of the lungs. By preventing the inflammation and excess mucus
formation, fluticasone helps prevent asthma attacks.
Salmeterol belongs to a group of medicines called long-acting beta
2 agonists. It works by acting on receptors in the lungs called beta 2
receptors. Stimulation of these receptors causes the muscles in the
airways to relax, allowing the airways to open.
In asthma there is narrowing of the airways. By opening the
airways, salmeterol makes it easier to breathe. Salmeterol opens the
airways for longer than short-acting beta 2 agonists (relievers), such
as salbutamol or terbutaline, so it is used to prevent shortness of
breath rather than to treat it.
This combination inhaler provides these two preventative medicines
in one inhaler, so that preventing asthma is not made more complicated.
It is used for asthma that is not sufficiently controlled by using just
a regular steroid inhaler and a reliever inhaler (eg salbutamol). This
inhaler should be used regularly, even when you have no asthmatic
symptoms, to reduce the inflammation in the lungs and to help keep the
airways open. You should still keep your reliever inhaler with you at
all times in case you do have an asthma attack.
This combination inhaler can also be used to treat chronic
obstructive lung disease (COPD) such as chronic bronchitis or
emphysema. However, the Seretide 500 accuhaler is the only Seretide
product that contains the correct dose of active ingredients for this
use.
Inhaling this medicine allows it to act directly in the lungs where
it is needed most. It also reduces the potential for side effects in
other parts of the body, as the amount absorbed into the blood through
the lungs is lower than if it is taken by mouth.
What is it used for?
Warning!
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Inhalers may cause an unexpected increase in
wheezing (paradoxical bronchospasm) straight after using them. If this
happens, stop using the inhaler immediately and consult your doctor.
The medicine should be stopped and an alternative treatment found.
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You should not suddenly stop taking this medicine unless your doctor tells you otherwise.
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Inhaling corticosteroids can sometimes cause
a fungal infection called thrush in the mouth. To minimise the risk of
this, you should rinse your mouth with water after each time you use
this inhaler. Consult your doctor if you develop white patches in your
mouth or throat, as these are symptoms of thrush and it may need to be
treated.
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This medicine should never be used to treat
asthma attacks - you should keep your normal reliever inhaler, eg
salbutamol or terbutaline, ready for this. Consult your doctor if you
need to use your reliever more frequently than normal, or if it becomes
less effective at treating attacks.
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When taken for long periods of time at high
doses, corticosteroids have the potential to cause glaucoma, cataracts,
thinning of the bones (osteoporosis), growth retardation in children
and adolescents, and to decrease the functioning of the adrenal glands
(glands that produce certain hormones). For this reason your doctor
will prescribe the lowest effective dose for your symptoms, and monitor
for these side effects. In particular, children and adolescents taking
long-term corticosteroids should have their growth monitored. For
further information discuss this with your doctor.
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Blood potassium levels should be monitored in
people with severe asthma, as low oxygen levels in the blood (hypoxia)
and various asthma medicines, including this one, can lower blood
potassium.
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This medicine has not been studied in people with decreased liver function.
Use with caution in
Not to be used in
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Known sensitivity or allergy to any ingredient
This medicine should not be used if you are
allergic to one or any of its ingredients. Please inform your doctor or
pharmacist if you have previously experienced such an allergy.
If you feel you have experienced an allergic reaction, stop using
this medicine and inform your doctor or pharmacist immediately.
Pregnancy and Breastfeeding
Certain medicines should not be
used during pregnancy or breastfeeding. However, other medicines may be
safely used in pregnancy or breastfeeding providing the benefits to the
mother outweigh the risks to the unborn baby. Always inform your doctor
if you are pregnant or planning a pregnancy, before using any medicine.
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This medicine should be used with caution
during pregnancy, and only if the expected benefit to the mother is
greater than any possible risk to the foetus. Seek medical advice from
your doctor.
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It is not known if this medicine passes into
breast milk. It should be used with caution in nursing mothers, and
only if the benefits to the mother outweigh any risks to the nursing
infant. Discuss this with your doctor.
Label warnings
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Do not stop taking this medication except on your doctor's advice.
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Follow the printed instructions you have been given with this medication.
Side effects
Medicines and their possible side
effects can affect individual people in different ways. The following
are some of the side effects that are known to be associated with this
medicine. Because a side effect is stated here, it does not mean that
all people using this medicine will experience that or any side effect.
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Headache
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Shaking, usually of the hands (tremor)
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Muscle cramps
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Abnormal heart beats (arrhythmias)
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Unexpected narrowing of the airways (paradoxical bronchospasm)
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Awareness of your heartbeat (palpitations)
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Hoarse voice
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Throat irritation
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Yeast infection of the mouth and throat (candidiasis)
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Pain in the muscles and joints
The side effects listed above may not include all of the side effects reported by the drug's manufacturer.
For more information about any other possible risks associated with
this medicine, please read the information provided with the medicine
or consult your doctor or pharmacist.
How can this medicine affect other medicines?
Beta-blockers such as atenolol,
propranolol or timolol should not generally be taken with this
medicine. This is because beta-blockers have an opposite action to
salmeterol and can cause the airways to narrow, which can result in
breathing difficulties for people with asthma. Eye drops containing
beta-blockers should also be avoided.
This medicine can potentially cause a serious decrease in the
levels of potassium in the blood (hypokalaemia), which may result in
adverse effects. This effect can be increased by the following
medicines:
- xanthine derivates, eg theophylline and aminophylline
- corticosteroids, eg beclometasone and prednisolone
- diuretics, eg bendroflumethiazide and furosemide
- beta agonist bronchodilators, eg salbutamol and terbutaline.
Under normal circumstances only low amounts of fluticasone are
found in the blood after inhalation. However, the following medicines
may increase the amount of fluticasone in the blood and may therefore
increase the risk of fluticasone side effects:
- ritonavir
- ketoconazole
- itraconazole.
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