Fluticasone + salmeterol, by GlaxoSmithKline.

Seretide disk info

Fluticasone and salmeterol inhalation disk is a prescription drug that is used to prevent asthma attacks. It will not treat an asthma attack that has already begun. Fluticasone and salmeterol inhalation disk is also used to treat chronic obstructive pulmonary disease (COPD) associated with chronic bronchitis.

Drug class

• Fluticasone is a steroid. It prevents the release of substances in the body that cause inflammation.
• Salmeterol is a bronchodilator. It works by relaxing muscles in the airways to improve breathing.

Interactions

Before using fluticasone and salmeterol inhalation, tell your doctor if you are using any of the following drugs:

• amiodarone (Cordarone);
• a diuretic or "water pill";
• HIV medicines such as ritonavir (Norvir), indinavir (Crixivan), nelfinavir (Viracept);
• an MAO inhibitor such as isocarboxazid (Marplan), tranylcypromine (Parnate), phenelzine (Nardil), or selegiline (Eldepryl, Emsam);
• antidepressants such as amitriptyline (Elavil), nortriptyline (Pamelor), desipramine (Norpramin), or imipramine (Tofranil);
• certain antibiotics such as ketoconazole (Nizoral), itraconazole (Sporanox), clarithromycin (Biaxin), erythromycin (E-Mycin, Ery-Tab, E.E.S.); or
• medicines for depression such as fluoxetine (Prozac), or fluvoxamine (Luvox).

If you are using any of these drugs, you may not be able to use fluticasone and salmeterol, or you may need dosage adjustments or special tests during treatment.

Do not use a second form of salmeterol (such as Serevent) or use a similar inhaled bronchodilator such as formoterol (Foradil) unless your doctor has told you to.

There may be other drugs not listed that can affect fluticasone and salmeterol inhalation. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Side effects

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

Call your doctor at once if you have any of these serious side effects:

• weakness, tired feeling, nausea, loss of appetite, weight loss;
• chest pain, fast or pounding heartbeats, excitement or restless feeling;
• seizure (convulsions), feeling light-headed, fainting;
• wheezing, choking, or other breathing problems after using this medication;
• skin rash, bruising, severe tingling, numbness, pain, muscle weakness;
• changes in the shape or location of body fat (especially in your arms, legs, face, neck, breasts, and waist); or
• worsening asthma symptoms.

Other, less serious side effects may be more likely to occur, such as:

• headache;
• dryness in your mouth, nose, or throat;
• white patches or sores inside your mouth or on your lips;
• nausea, vomiting, diarrhea, upset stomach;
• stuffy nose, sinus pain, cough, sore throat; or
• hoarseness or deepened voice.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

Dosage

• Use this medication exactly as it was prescribed for you. Do not use the medication in larger amounts, or use it for longer than recommended by your doctor.
• Do not use fluticasone and salmeterol inhalation to treat an asthma attack that has already begun. It will not work fast enough to reverse your symptoms. Use another, faster-acting inhalation medication to treat an asthma attack.
• Asthma is usually treated with a combination of different drugs. To best treat your condition, use all of your medications as directed by your doctor. Do not change your doses or medication schedule without advice from your doctor.
• If you use this medication to treat COPD, do not use the medicine for longer than 6 months unless your doctor has told you to.
• Seretide Disk is a powder form of fluticasone and salmeterol that comes with a special inhaler device preloaded with blister packs containing measured doses of the medicine. The device opens and loads a blister each time you use the inhaler. This device is not to be used with a spacer.
• This medication comes with patient instructions for safe and effective use. Follow these directions carefully. Ask your doctor or pharmacist if you have any questions.
• To reduce the chance of developing a yeast infection in your mouth, rinse with water after using fluticasone and salmeterol inhalation. Do not swallow.
• It is important to use fluticasone and salmeterol inhalation regularly to get the most benefit.
• If you were switched from an oral (taken by mouth) steroid to fluticasone and salmeterol inhalation, you may need to go back to taking the oral medicine if you are under stress or have an asthma attack or other medical emergency. Carry an identification card or wear a medical alert ID to let others know that you may need an oral steroid in an emergency.
• Seek medical attention if you think any of your asthma medications are not working as well as usual. An increased need for medication could be an early sign of a serious asthma attack. If you use a peak flow meter at home, call your doctor if your numbers are lower than normal.
• Store this medication at room temperature away from moisture and heat. Keep the medicine canister away from high heat, such as open flame or in a car on a hot day. The canister may explode if it gets too hot.

Contraindications

Before using this medication, tell your doctor if you have been sick or had an infection of any kind. You may not be able to use fluticasone and salmeterol inhalation until you are well.

Fluticasone and salmeterol inhalation can lower the blood cells that help your body fight infections. This can make it easier for you to get sick from being around others who are ill. Avoid being near people who are sick or have infections. Contact your doctor if you have been exposed to someone with measles or chicken pox.

Do not exhale or blow into the Disk device. Do not take the device apart or allow it to get wet.

Salmeterol is a drug that has been shown to increase the risk of asthma-related death. It is critical that you use only the prescribed dose of this medicine and follow all patient instructions for safe use of the medication. Talk with your doctor about your individual risks and benefits in using fluticasone and salmeterol.

Before using fluticasone and salmeterol, tell your doctor if you have:

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

If you have any of these conditions, you may not be able to use fluticasone and salmeterol, or you may need a dosage adjustment or special tests during treatment.

Seretide is in pregnancy category C. This medication may be harmful to an unborn baby and should not be used by a woman who is pregnant. Tell your doctor if you become pregnant during treatment. It is not known whether this medication passes into breast milk or if it could harm a nursing baby. Do not use fluticasone and salmeterol inhalation without telling your doctor if you are breast-feeding a baby. Fluticasone and salmeterol inhalation can affect growth in children. Talk with your doctor if you think your child is not growing at a normal rate while using this medication.

Do not give this medication to a child younger than 4 years old. Long-term use of steroids may lead to bone loss (osteoporosis), especially if you smoke, if you do not exercise, if you do not get enough vitamin D or calcium in your diet, or if you have a family history of osteoporosis. Talk with your doctor about your risk of osteoporosis

Storage

Store at controlled room temperature, 20 degrees C to 25 degrees C (68 degrees to 77 degrees F), in a dry place away from direct heat or sunlight. Keep out of reach of children. The disk inhalation device is not reusable. The device should be discarded 1 month after removal from the moisture-protective foil overwrap pouch or after all blisters have been used (when the dose indicator reads "0"), whichever comes first. Do not attempt to take the device apart.