As an adjunct (see literature): For the maintenance treatment of asthma and in the prevention of bronchospasm in reversible obstructive airway disease (including nocturnal asthma). Maintenance treatment of COPD-associated bronchospasm. Prevention of exercise-induced bronchospasm (EIB).
<4yrs: not recommended. ≥4yrs: 1 inh every 12 hours. EIB prevention: 1 inh at least 30 minutes before exercise. Max 2 doses/day. Do not use additional doses for EIB if already using regular dosing for asthma. COPD-associated bronchospasm: 1 inh every 12 hours.
Long-acting beta-2 agonist.
For asthma: without concomitant use of a long-term asthma control drug (eg, inhaled corticosteroid). Primary treatment of status asthmaticus or acute episodes of asthma or COPD requiring intensive measures. Allergy to milk proteins.
Increased risk of asthma-related deaths and hospitalizations. Prescribe for asthma only as additional therapy with an inhaled corticosteroid. Do not initiate in rapidly or acutely deteriorating asthma or COPD. Not for relief of acute bronchospasm. Salmeterol is not a substitute for steroids. Not for use with other long-acting β2-agonists. Do not exceed recommended dose. Cardiovascular disease (esp. coronary insufficiency, arrhythmias, hypertension). Convulsive disorders. Thyrotoxicosis. Hyperresponsiveness to sympathomimetics. Diabetes. Ketoacidosis. Hypokalemia. Hyperglycemia. Hepatic impairment (monitor). Evaluate response before altering steroid doses. Prescribe an additional short-acting, inhaled β2-agonist for acute symptoms; monitor for increased need. Labor & delivery. Pregnancy (Cat.C). Nursing mothers: not recommended.
Concomitant strong CYP3A4 inhibitors (eg, ketoconazole, itraconazole, ritonavir, atazanavir, clarithromycin, indinavir, nefazodone, nelfinavir, saquinavir, telithromycin): not recommended. Caution during or within 2 weeks of MAOIs or tricyclic antidepressants (increased cardiovascular effects). Antagonized by β-blockers. Caution with K+-depleting diuretics.
Headache, influenza, nasal/sinus congestion, pharyngitis, rhinitis, tracheitis/bronchitis, cough, musculoskeletal pain, throat irritation, viral respiratory infection; paradoxical bronchospasm (discontinue if occurs); rarely: serious asthma episode, asthma-related death.
Diskus (w. 60 blisters)—1