Salmeterol


Concise Prescribing Info
Indications/Uses
Listed in Dosage.
Dosage/Direction for Use
Adult : Inhalation Chronic asthma 50 mcg bid, up to 100 mcg bid if necessary, w/ an inhaled corticosteroid. COPD 50 mcg bid. Prophylaxis of exercise-induced asthma 50 mcg at least 30 min prior to exercise.
Dosage Details
Inhalation/Respiratory
Chronic asthma
Adult: As metered dose aerosol or dry powd inhaler: 50 mcg bid, or up to 100 mcg bid if necessary, in asthma patients w/ more severe airways obstruction.
Child: 4-12 yr 50 mcg bid.

Inhalation/Respiratory
Prophylaxis of exercise-induced asthma
Adult: As metered dose aerosol or dry powd inhaler: 50 mcg at least 30 min prior to exercise.
Child: ≥4 yr Same as adult dose.

Inhalation/Respiratory
Chronic obstructive pulmonary disease
Adult: As metered dose aerosol or dry powd inhaler: 50 mcg bid.
Contraindications
Monotherapy in the treatment of asthma. Treatment of status asthmaticus, other acute episodes of asthma or COPD.
Special Precautions
Patient w/ CV disease, CNS disorders, DM, hyperthyroidism, hypokalaemia, seizure disorders, ketoacidosis. Not intended for the relief of acute bronchospasm. Hepatic impairment. Pregnancy and lactation.
Adverse Reactions
Asthma: Headache, influenza, nasal/sinus congestion, pharyngitis, rhinitis, tracheitis/bronchitis. COPD: Cough, headache, musculoskeletal pain, throat irritation, viral resp infection.
Potentially Fatal: Paradoxical bronchospasm.
Inhalation/Respiratory: C
MonitoringParameters
Monitor pulmonary function, BP, heart rate, CNS stimulation, hepatic function; glucose and K levels.
Overdosage
Symptoms: Dizziness, HTN or hypotension, tremor, headache, tachycardia, hypokalaemia, seizures, angina, arrhythmias, nervousness, muscle cramps, dry mouth, palpitations, nausea, fatigue, malaise, insomnia, hyperglycaemia, metabolic acidosis. Management: Symptomatic and supportive treatment. β-blockers may be considered but should be used w/ caution.
Drug Interactions
Increased risk of CV effects w/ potent CYP3A4 inhibitors (e.g. ketoconazole, ritonavir). Reduced bronchodilatory effect w/ β-blockers. Increased risk of hypokalaemia w/ non K-sparing diuretics. MAOIs and TCAs may potentiate the effect of salmeterol on vascular system.
Action
Description: Salmeterol stimulates intracellular adenyl cyclase, the enzyme that catalyses the conversion of ATP to cyclic-3',5'-adenosine monophosphate (cAMP) resulting in relaxation of bronchial smooth muscle and inhibition of release of mediators of immediate hypersensitivity from mast cells.
Onset: Asthma: 30-48 min. COPD: 2 hr.
Duration: Approx 12 hr.
Pharmacokinetics:
Absorption: Low or undetectable systemic absorption. Time to peak plasma concentration: Approx 20 min.
Distribution: Plasma protein binding: 96%.
Metabolism: Extensively metabolised via hydroxylation to α-hydroxy-salmeterol by CYP3A4 isoenzyme.
Excretion: Via faeces (60%), urine (25%). Half-life: 5.5 hr.
Chemical Structure

Chemical Structure Image
Salmeterol

Source: National Center for Biotechnology Information. PubChem Database. Salmeterol, CID=5152, https://pubchem.ncbi.nlm.nih.gov/compound/Salmeterol (accessed on Jan. 22, 2020)

Storage
Store between 20-25°C. Protect from heat or sunlight.
ATC Classification
R03AC12 - salmeterol ; Belongs to the class of adrenergic inhalants, selective beta-2-adrenoreceptor agonists. Used in the treatment of obstructive airway diseases.
References
Anon. Salmeterol. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 01/07/2015.

Buckingham R (ed). Salmeterol Xinafoate. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 01/07/2015.

Serevent Diskus (GlaxoSmithKline LLC). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 01/07/2015.

Disclaimer: This information is independently developed by MIMS based on Salmeterol from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2020 MIMS. All rights reserved. Powered by MIMS.com
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