Salmeterol (inhalation)

Salmeterol (inhalation) is a medicine that helps open up the airways. It is used to prevent asthma attacks or breathing problems caused by exercise.

Salmeterol (inhalation) is also used to treat chronic obstructive pulmonary disease (COPD), which includes emphysema and chronic bronchitis.

Salmeterol (inhalation) may also be used for other reasons that are not listed in this medication guide.

Do not use salmeterol (inhalation) to treat an asthma attack that has already started.

Salmeterol may increase the risk of asthma-related death. Use only the dose your doctor prescribed, and do not use it for longer than your doctor recommends. Follow all patient instructions for safe use. Talk with your doctor about your individual risks and benefits of using salmeterol (inhalation).

If you use salmeterol (inhalation) for asthma, you must use it along with an inhaled steroid medicine for long-term asthma control. Seek medical attention if you think any of your asthma medications are not working as well as they usually do.

You should not use salmeterol if you are allergic to salmeterol or to milk proteins.

Tell your doctor if you have ever had:

• a food or drug allergy;
• heart disease or high blood pressure;
• epilepsy or other seizure disorder;
• diabetes;
• a thyroid disorder; or
• liver disease.

It is not known whether this medicine will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.

It may not be safe to breastfeed while using this medicine. Ask your doctor about any risk.

Salmeterol can increase the risk of asthma-related hospitalization in children and teenagers. It is very important that children using salmeterol inhalation for asthma use it together with another long-term asthma control medication.

Do not give this medication to a child younger than 4 years old.

Get emergency medical help if you have signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Salmeterol may cause serious side effects. Call your doctor right away if you experience:

• worsening asthma symptoms, or other breathing problems after using salmeterol;
• severe headache, blurred vision, or a pounding sensation in your neck or ears;
• chest pain, fast or irregular heartbeats;
• tremors, nervousness;
• high blood sugar—such as increased thirst, increased urination, dry mouth, or fruity breath odor; or
• low potassium level—such as leg cramps, constipation, irregular heartbeats, fluttering in your chest, increased thirst or urination, numbness or tingling, or muscle weakness or feeling limp.

Common side effects of salmeterol may include:

• headache;
• flu symptoms;
• joint or muscle pain;
• throat irritation, cough; or
• stuffy or runny nose.

This is not a complete list of side effects, and others may occur. Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Follow all directions on your prescription label and read all medication guides or instruction sheets. Salmeterol may increase the risk of asthma-related death. Use the medicine exactly as directed.

Salmeterol is not a rescue medicine for asthma attacks. Use only fast-acting inhalation medicine for an attack. Seek medical attention if your breathing problems get worse quickly, or if you think your asthma medications are not working as well.

Read and carefully follow any Instructions for Use provided with your medicine. Ask your doctor or pharmacist if you do not understand these instructions.

If you use salmeterol inhalation for asthma, you must use it together with an inhaled steroid medicine for long-term asthma control. Use all asthma medications as directed. Your dose needs may change due to surgery, illness, stress, or a recent asthma attack. Do not change your dose or dosing schedule without your doctor's advice.

Call your doctor if your symptoms do not improve after 7 days.

Do not stop using salmeterol inhalation without first talking to your doctor. Your asthma symptoms may get worse after you stop using the medication.

If you also use a steroid medication, you should not stop using it suddenly. Follow your doctor's instructions about tapering your dose.

Store at room temperature away from moisture, heat, and sunlight.

Do not try to clean or take apart the Diskus device. Throw it away 6 weeks after you have taken it out of the foil pouch, or if the dose indicator shows a zero, whichever comes first. Each Diskus device contains 60 doses.

Skip the missed dose and take your next dose at the usual time. Do not take two doses at once.

Get your prescription refilled before you completely run out of medicine.

Seek emergency medical help or call the Poison Help line at 1-800-222-1222.

Do not exhale or blow into the Diskus device. Do not take the device apart or let it get wet.

Do not use a second form of salmeterol (like Advair) or a similar inhaled bronchodilator unless your doctor instructs you to. This includes formoterol (Perforomist, Symbicort, Bevespi, Dulera), arformoterol (Brovana), indacaterol (Arcapta), olodaterol (Striverdi, Stiolto Respimat), or vilanterol (Anoro Ellipta, Breo Ellipta, Trelegy Ellipta).

Tell your doctor about all the medicines you are currently taking. Many drugs can affect salmeterol, especially:

• nefazodone;
• an antibiotic--clarithromycin, telithromycin;
• antifungal medicine--itraconazole, ketoconazole;
• antiviral medicine for HIV/AIDS--indinavir, nelfinavir, ritonavir, saquinavir;
• heart or blood pressure medicine--such as a diuretic ("water pill") or a beta-blocker (atenolol, carvedilol, labetalol, metoprolol, propranolol, sotalol, timolol, and others); or
• an MAO inhibitor--isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, tranylcypromine, and others.

This list is not complete, and many other drugs may also affect salmeterol. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.