Salmeterol Xinafoate

Salmeterol Xinafoate is indicated for reversible airways obstruction (including nocturnal asthma and prevention of exercise-included bronchospasm) in patients requiring long term regular bronchodilator therapy.

Each metered dose (puff) contains Salmeterol 25 mcg as Salmeterol Xinafoate.

Beta-2 adrenoceptor stimulation causes relaxation of bronchial smooth muscle, bronchodilation, and increased airflow. Salmeterol is hypothesized to bind to 2 sites on the beta-2 adrenoceptor.1 The saligenin moiety binds to the active site of the beta-2 adrenoceptor. The hydrophilic tail of salmeterol binds to leucine residues in the exo-site of the beta-2 adrenoceptor almost irreversibly, allowing salmeterol to persist in the active site, which is responsible for it's long duration of action. Another hypothesis is that the lipophilic drug diffuses into lipid bilayer of smooth muscle cells and provides a depot of drug to the cells over a longer period of time.

Adults: 50 micrograms (two puffs) twice daily.
More severe cases: 100 micrograms (four puffs) twice daily.
Children 5-12 years: 50 micrograms (two puffs) twice daily. Or, as directed by the registered physician.

Using an Inhaler seems simple, but most patients do not know how to use it in the right way. If the Inhaler is used in the wrong way, less medicine can reach the lungs. Correct and regular use of the Inhaler will prevent or lessen the severity of asthma attacks.

Following simple steps can help to use Inhaler effectively (According to "National Asthma Guidelines for Medical Practitioners" published by Asthma Association):

1. Take off the cap.
2. Shake the inhaler (at least six times) vigorously before each use.
3. If the inhaler is new or if it has not been used for a week or more, shake it well and release one puff into the air to make sure that it works.
4. Breathe out as full as comfortably possible & hold the inhaler upright.
5. Place the actuator into mouth between the teeth and close lips around the mouthpiece.
6. While breathing deeply and slowly through the mouth, press down firmly add fully on the canister to release medicine.
7. Remove the inhaler from mouth. Continue holding breath for at least for 10 seconds or as long as it is comfortable.
8. If doctor has prescribed more than one inhalation per treatment, wait 1 minute between puffs (inhalations). Shake the inhaler well and repeat steps 4 to 7.
9. After use, replace the cap on the mouthpiece. After each treatment, rinse mouth with water.
10. Check your technique in front of a mirror from time to time, if you see a white mist during the inhalation, you may not have closed your lips properly around mouthpiece, or you may not be breathing in as you press the can. This indicates failure of technique. If this happens, repeat the procedure from step 4 carefully.

Instructions for Cleaning Inhaler: Clean your Inhaler at least once a week. Remove canister and rinse the plastic actuator and cap in warm water but do not put the metal canister into water. Dry the actuator and cap thoroughly and gently replace the metal canister into the actuator with a twisting motion. Put the cap on the mouthpiece.

Monoamine Oxidase inhibitors and Tricyclic Antidepressants: These agents should be used with caution because Salmeterol may be potentiated by these agents.

lt is contraindicated in patients with khown to have hypersensitivity to the drug.

Adverse effects which have been associated with Seravent are dose related tremor, subjective palpitations and headaches are usually mild and transient, muscle pain, stiffness, chest pain, rash have also been reported.

Salmeterol should not be used in pregnant women except in clinical circumstance where no alternative therapy is appropriate and the potential benefit justifies the potential risk to the fetus. There are no date on the excretion of Salmeterol in human milk. A decision should be made to discontinue nursing or discontinue the drug, taking into account the importance of the drug to the mother.

Inhalation of Salmeterol may be associated with paradoxical bronchospasm and it should not be used in patients who are not also receiving and inhaled corticosteroid. Salmeterol is not appropriate for the treatment of acute symptoms.

Long-acting selective β-adrenoceptor stimulants

Store between 20-25°C. Protect from heat or sunlight. Keep out of reach of children.