Precautions and warnings

Asthma attacks: Salmeterol and fluticasone should not be used to treat an acute asthma attack. If you experience sudden symptoms such as wheezing, chest tightness, or shortness of breath, use a quick-relief inhaler and seek medical attention immediately.

Allergic reactions: Some people may be allergic to salmeterol or fluticasone, and may experience symptoms such as rash, hives, itching, or difficulty breathing. If you experience any of these symptoms, stop using the medication and seek medical attention immediately.

Respiratory infections: Salmeterol and fluticasone can increase the risk of respiratory infections such as pneumonia, especially in people with COPD. If you develop symptoms such as fever, cough, or difficulty breathing, contact your doctor.

Bone loss: Long-term use of high doses of fluticasone can lead to bone loss and increase the risk of osteoporosis. Talk to your doctor if you have a history of bone loss or are at risk for osteoporosis.

Glaucoma and cataracts: Long-term use of high doses of inhaled corticosteroids such as fluticasone can increase the risk of glaucoma and cataracts. Talk to your doctor if you have a history of these conditions or if you experience changes in vision.

Drug interactions: Salmeterol and fluticasone can interact with other medications and affect their absorption or effectiveness. Talk to your doctor or pharmacist before using this medication with other medications.

Pregnancy and breast-feeding: The safety of salmeterol and fluticasone during pregnancy and breastfeeding is not well established. Talk to your doctor before using this medication if you are pregnant or breastfeeding.

It is important to follow your doctor's instructions carefully and to use salmeterol and fluticasone as prescribed to avoid potential side effects and complications.

Drug Interactions

Other medications that contain long-acting beta-agonists: Using salmeterol and fluticasone with other medications that contain long-acting beta-agonists, such as formoterol, can increase the risk of serious side effects such as asthma-related death.

Certain antibiotics: Some antibiotics, such as clarithromycin and erythromycin, can increase the concentration of salmeterol in the blood, increasing the risk of side effects.

Some antifungal medications: Certain antifungal medications, such as ketoconazole and itraconazole, can also increase the concentration of salmeterol in the blood, increasing the risk of side effects.

Beta-blockers: Beta-blockers, such as propranolol and atenolol, can block the effects of salmeterol, making it less effective.

Certain antidepressants: Some antidepressants, such as fluoxetine and paroxetine, can increase the concentration of fluticasone in the blood, increasing the risk of side effects.

Grapefruit juice: Grapefruit juice can increase the concentration of fluticasone in the blood, increasing the risk of side effects.

Contraindications

Salmeterol and fluticasone are a combination of medications used to treat asthma and chronic obstructive pulmonary disease (COPD). Here are some contraindications for the use of this medication:

Allergy: Salmeterol and fluticasone should not be used by people who are allergic to either salmeterol or fluticasone or any of the other ingredients in the medication.

Acute asthma attack: Salmeterol and fluticasone should not be used to treat an acute asthma attack. This medication is not a rescue inhaler and should not be used as the sole treatment for sudden symptoms such as wheezing, chest tightness, or shortness of breath.

Monotherapy for asthma: Salmeterol and fluticasone should not be used as the only treatment for asthma. This medication should be used in combination with other medications such as inhaled corticosteroids for the long-term management of asthma.

Active or untreated infections: Salmeterol and fluticasone should not be used by people with active or untreated infections, such as tuberculosis or fungal infections of the respiratory tract.

Hypersensitivity to lactose: Salmeterol and fluticasone contain lactose and should not be used by people who are hypersensitive to lactose.

Use with other long-acting beta-agonists: Salmeterol and fluticasone should not be used with other long-acting beta-agonists, as this can increase the risk of serious side effects such as asthma-related death.

Mode of actions

Salmeterol is a long-acting beta-agonist that works by relaxing the muscles in the airways, which makes it easier to breathe. It works by stimulating the beta-2 receptors in the airway smooth muscles, leading to bronchodilation, which helps to relieve symptoms such as wheezing and shortness of breath.

Fluticasone, on the other hand, is an inhaled corticosteroid that works by reducing inflammation in the airways. Inhaled corticosteroids are considered the most effective long-term therapy for asthma and COPD, as they decrease the frequency and severity of exacerbations, improve lung function, and reduce airway hyper-responsiveness. Fluticasone works by blocking the production and release of inflammatory substances such as cytokines, prostaglandins, and leukotrienes, which are responsible for the inflammation in the airways.

The combination of salmeterol and fluticasone provides both bronchodilation and anti-inflammatory effects, making it an effective treatment for both the symptoms and underlying inflammation of asthma and COPD. By using a combination of drugs, lower doses of each medication can be used, reducing the risk of side effects associated with high doses of either drug used alone.

Dosage & Administration

Adult: Inhalation Asthma: Per powder inhalation dose contains salmeterol 50 mcg and fluticasone propionate 100/250/500 mcg: 1 inhalation twice daily. Per pressurized inhalation contains salmeterol 25 mcg and fluticasone propionate 50/125/250 mcg: 2 inhalations twice daily.

COPD: Per powder inhalation, the dose contains salmeterol 50 mcg and fluticasone propionate 500 mcg: 1 inhalation twice daily.

Child: 4-12 years: As a combination containing salmeterol 50 mcg and fluticasone propionate 100 mcg/ dose of inhalation powder: 1 inhalation bid; as a combination containing salmeterol 25 mcg and fluticasone propionate 50 mcg/dose of pressurized inhalation: 2 inhalation bid.

Child: less than 12 years: As a combination containing salmeterol 50 mcg and fluticasone propionate 100/250/500 mcg/dose of inhalation powder: 1 inhalation bid; as a combination containing salmeterol 50/125/250 mcg and fluticasone propionate 50 mcg/dose of pressurized inhalation: 2 inhalation bid.

Pregnancy & Lactation

Although animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in pregnant women, but during pregnancy, this medicine can be used just when definitely required despite potential risks.

Mothers with a newborn baby who have used this drug during the last 3 months of pregnancy may seldom create symptoms including drowsiness, muscle stiffness or shakiness, feeding or breathing troubles, constant crying. If you notice any of these symptoms of your baby's particularly during their first month, tell the doctor immediately.

This medicine passes into breast milk. Talk to your doctor before breastfeeding.

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