Health Centres - Seretide
How does it work?
Seretide accuhalers and evohalers contain two active ingredients, fluticasone propionate and salmeterol.
Fluticasone is a type of medicine known as a corticosteroid. Corticosteroids are hormones that are produced naturally by the adrenal glands. They have many important functions, including control of inflammatory responses. Fluticasone is a synthetic corticosteroid and is used to decrease inflammation in the lungs. (NB. Corticosteroids are often simply called steroids, but it should be noted that they are very different from another group of steroids, called anabolic steroids, which have gained notoriety because of their abuse by some athletes and body builders.)
When fluticasone is 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 that 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 is a type of medicine called a long-acting beta 2 agonist. It works by acting on receptors in the lungs called beta 2 receptors. When salmeterol stimulates these receptors it causes the muscles in the airways to relax. This allows the airways to open.
In asthma there is narrowing of the airways. By opening the airways, salmeterol makes it easier to breathe. Salmeterol doesn't open the airways as quickly as short-acting beta 2 agonists such as salbutamol or terbutaline, however, it does keep the airways open for much longer. The effects of salmeterol last for about 12 hours, whereas those of salbutamol or terbutaline last for about 3 to 5 hours. This means salmeterol is used to prevent asthma attacks, wheezing, chest tightness or shortness of breath, rather than to relieve them.
This combination of medicines is used for asthma that is not sufficiently controlled by using just a regular steroid inhaler and a reliever inhaler (eg salbutamol). Seretide 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.
What is it used for?
-
Asthma.
- Severe chronic obstructive pulmonary disease (Seretide 500 accuhaler only).
Warning!
- This medicine is known as a preventer and it should be taken regularly to prevent asthma attacks. It should not be used to relieve an asthma attack, as it will not work for this purpose. An asthma attack needs to be treated with a medicine that quickly opens the airways, such as salbutamol or terbutaline. These are known as relievers, and you should make sure you carry your reliever inhaler with you at all times to relieve an asthma attack if it happens. Consult your doctor if you need to use your reliever more frequently than normal, or if it becomes less effective at treating attacks, as this may indicate that your asthma is getting worse and your doctor may need to prescribe you another medicine.
- Do not exceed the dose of this medicine that your doctor has prescribed for you.
- You should not suddenly stop taking this medicine unless your doctor tells you otherwise, as your asthma symptoms are likely to return.
- Inhalers may cause an unexpected increase in wheezing and difficulty breathing (paradoxical bronchospasm) straight after using them. If this happens, don't use the inhaler again, use your reliever inhaler to open your airways and consult your doctor.
- Inhaled corticosteroids can sometimes cause a fungal infection in the mouth called oral thrush. To minimise the chances of this you should rinse your mouth with water or clean your teeth after inhaling each dose. Using a spacer device can also help avoid this problem. 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.
- Inhaled corticosteroids have considerably fewer side effects than steroids taken by mouth. However, when taken for long periods of time at high doses, inhaled steroids do have the potential to cause side effects such as glaucoma, cataracts, thinning of the bones (osteoporosis), slowed growth in children and adolescents, and to suppress the functioning of the adrenal glands (glands that produce natural steroid hormones). For this reason your doctor will prescribe the lowest effective dose to control your symptoms, and monitor for these side effects. It is recommended that children receiving long-term treatment with corticosteroids have their growth monitored. If a child's growth appears to be slowed your doctor may refer them to a specialist respiratory paediatrician. For further information talk to your doctor or pharmacist.
- People with severe asthma should have regular blood tests to monitor the amount of potassium in their blood. This is because low oxygen levels in the blood (hypoxia) and various asthma medicines, including this one, can lower blood potassium levels.
- Data from a large clinical trial (the Salmeterol Multi-Center Asthma Research Trial, SMART) has suggested that African-American people may be at increased risk of side effects or death when using salmeterol inhalers compared with placebo (dummy) inhalers. If you are of black African or Afro-Caribbean ancestry you should consult your doctor if your asthma symptoms are not improved or get worse while using this medicine.
Use with caution in
-
Tuberculosis infections of the lungs
- Severe disease involving the heart and blood vessels
- Irregular heart beats (arrhythmias)
- People with low levels of potassiumin the blood (hypokalaemia)
-
Diabetes mellitus
-
Thyrotoxicosis.
Not to be used in
- 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.
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.
- It is important that asthma is well controlled in pregnant women. Wherever possible, asthma medications should be taken by inhaler, as this minimises the amount of medicine that enters the bloodstream and crosses the placenta. This medicine should be used with caution during pregnancy. Seek medical advice from your doctor.
- In general, asthma inhalers can be used as normal during breastfeeding, because the amount of medicine that passes into the breast milk after using an inhaler is negligable and unlikely to harm the baby. However, it is not known if the medicines in this inhaler pass into breast milk and you should seek medical advice from your doctor before breastfeeding while using this medicine.
Label warnings
- Do not stop taking this medication except on your doctor's advice.
- Follow the printed instructions you have been given with this medication.
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