Salmeterol (By breathing)

Introduction

Salmeterol Xinafoate (sal-ME-ter-ol zye-NAF-oh-ate)

Prevents asthma attacks or EIB (exercise-induced bronchospasm) and treats other lung problems such as COPD (chronic obstructive pulmonary disease), including chronic bronchitis and emphysema.

Brand Name(s)

Serevent Diskus

When This Medicine Should Not Be Used

How to Use This Medicine

Powder Under Pressure, Disk

• Your doctor will tell you how much of this medicine to use and how often. Do not use more medicine or use it more often than your doctor tells you to.
• This medicine should come with a Medication Guide. Read and follow these instructions carefully. Ask your doctor or pharmacist if you have any questions. Ask your pharmacist for the Medication Guide if you do not have one.
• This medicine comes with patient instructions. Read and follow these instructions carefully. Ask your doctor or pharmacist if you have any questions.
• Serevent® Diskus® is a powder that is used with its own special inhaler device. Individually measured doses of the powder are held in a foil blister package that is placed into the Diskus®. The Diskus® pierces each blister one at a time to load the correct dose into the chamber when you are ready to use the medicine. Do not use the Diskus® with a spacer.
• Keep the Diskus® inhaler closed when you are not using it. Keep the inhaler dry at all times. Do not blow into it.
• Before inhaling your dose, breathe out fully, trying to get as much air out of the lungs as possible. Hold the Diskus® level and away from your mouth.
• Open your mouth and breathe in quickly and deeply through the Diskus®. Do not breathe in through your nose.
• Remove the Diskus® from your mouth. Hold your breath for about 10 seconds or as long as possible, then breathe out slowly.

If a dose is missed:

• If you miss a dose or forget to use your medicine, use it as soon as you can. If it is almost time for your next dose, wait until then to use the medicine and skip the missed dose. Do not use extra medicine to make up for a missed dose.

How to Store and Dispose of This Medicine

• Keep the medicine in the foil pouch until you are ready to use it. Store at room temperature, away from heat and direct light. Do not freeze.
• Ask your pharmacist, doctor, or health caregiver about the best way to dispose of the used medicine container and any leftover medicine. You will also need to throw away old medicine after the expiration date has passed. Throw the medicine away 6 weeks after it is removed from the foil pouch or after all the blisters have been used.
• Keep all medicine away from children and never share your medicine with anyone.

Drugs and Foods to Avoid

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• This medicine should not be used together with similar inhaled medicines such as arformoterol (Brovana?), budesonide/formoterol (Symbicort®), formoterol (Foradil®, Perforomist?), or salmeterol/fluticasone (Advair®).
• Make sure your doctor knows if you have used medicine for depression (such as amitriptyline, doxepin, nortriptyline, Elavil®, Pamelor®, or Sinequan®) or an MAO inhibitor (such as Eldepryl®, Marplan®, Nardil®, or Parnate®) within the past 2 weeks.
• Tell your doctor if you are using medicine to treat depression (such as nefazodone or Serzone®), medicine to treat an infection (such as clarithromycin, itraconazole, ketoconazole, telithromycin, Biaxin®, Ketek®, Nizoral® or Sporanox®), or medicine to treat HIV or AIDS (such as atazanavir, indinavir, nelfinavir, ritonavir, saquinavir, Crixivan®, Fortovase®, Invirase®, Norvir®, Reyataz®, or Viracept®).
• Make sure your doctor knows if you are also using any diuretics or "water pills" (such as furosemide, hydrochlorothiazide [HCTZ], torsemide, Demadex®, or Lasix®) or blood pressure medicines (such as atenolol, metoprolol, propranolol, Inderal®, Tenormin®, or Toprol®).

Warnings While Using This Medicine

• Make sure your doctor knows if you are pregnant or breastfeeding, or if you have liver disease, heart or blood vessel disease, heart rhythm problems, high blood pressure, diabetes, epilepsy or seizures, thyroid problems, or low potassium in the blood.
• If you use any type of corticosteroid medicine to control your asthma, keep using it as ordered by your doctor. This includes corticosteroid medicines that are taken by mouth or inhaled (such as cortisone, prednisone, Azmacort®, Celestone®, Cortone®, Deltasone®, Flovent®, Prelone® Pediapred®, Vanceril®). Take all of your COPD medicines as your doctor ordered. Do not change your doses or stop using your medicines without asking your doctor.
• This should not be the first and only medicine you use for asthma or COPD. This medicine will not stop an asthma or COPD attack that has already started. Your doctor may prescribe another medicine for you or your child to use in case of an acute asthma attack or an acute COPD flare-up. If the other medicine does not work as well, or if you have used more than four puffs daily for 2 days in a row, tell your doctor right away.
• If any of your asthma medicines do not seem to be working as well as usual, call your doctor right away. Do not change your doses or stop using your medicines without asking your doctor.
• This medicine may cause paradoxical bronchospasm, which means your breathing or wheezing will get worse. Paradoxical bronchospasm may be life-threatening. Stop using this medicine and check with your doctor right away if you or your child have coughing, difficulty breathing, shortness of breath, or wheezing after using this medicine.
• If you or your child develop a skin rash, hives, or any allergic reaction to this medicine, stop using the medicine and check with your doctor as soon as possible.
• Check with your doctor right away if you or your child have chest pain, a fast heartbeat, nervousness, shaking of the hands or feet, noisy breathing, a feeling of choking, or tightness or irritation of the throat while using this medicine.
• If your symptoms do not improve or if they get worse, call your doctor.
• Your doctor will need to check your progress at regular visits while you are using this medicine. Be sure to keep all appointments.

Possible Side Effects While Using This Medicine

Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Chest pain or shortness of breath.
• Cough, fever, chills, sore throat, runny or stuffy nose, and body aches.
• Difficulty with swallowing.
• Dry mouth, increased thirst, muscle cramps, nausea, or vomiting.
• Fast, pounding, or uneven heartbeat.
• Increased asthma attacks or other breathing problems.
• Lightheadedness, dizziness, or fainting.
• Seizures or tremors.
• Troubled breathing.
• Unusual tiredness or weakness.

If you notice these less serious side effects, talk with your doctor:

• Headache.
• Muscle or bone pain.
• Nausea, vomiting, or upset stomach.
• Numbness or tingling in hands or feet.
• Skin rash.

If you notice other side effects that you think are caused by this medicine, tell your doctor

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088