Salmeterol

Aka: Salmeterol, Serevent, Advair, AirDuo Respiclick, Wixela Inhub

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II. Indications

  1. Moderate Persistent Asthma
  2. Severe Persistent Asthma
  3. Chronic Obstructive Pulmonary Disease
  4. Exercise Induced Asthma

III. Precautions

  1. See Long-Acting Beta Agonist
  2. Use in combination with CorticosteroidInhaler in Asthma
  3. Unlike Formoterol, cannot be used for Single Maintenance and Reliever Therapy
    1. Use only maintenance doses listed below (do NOT use as rescue medication)

IV. Dosing: Long-Acting Beta Agonists (LABA)

  1. Salmeterol (Serevent) Dry Powder Diskus (50 ug/inhale)
    1. Asthma, COPD (age >=4 years)
      1. One inhalation every 12 hours
    2. Exercise Induced Asthma
      1. One inhalation 30 minutes before Exercise
  2. Serevent Inhalation aerosol MDI (21 ug/puff)
    1. Asthma, COPD
      1. Adults: 2 puffs every 12 hours
      2. Child: 1-2 puffs every 12 hours
    2. Exercise Induced Asthma
      1. Inhale 1-2 puffs at 30 minutes before Exercise

V. Dosing: Combination of Long-Acting Beta Agonists with Corticosteroids (ICS, for Asthma, COPD)

  1. Advair Diskus (Fluticasone/Salmeterol: 100/50, 250/50, 500/50)
    1. One puff twice daily
  2. Wixela Inhub (Fluticasone/Salmeterol)
    1. One puff twice daily
  3. AirDuo Respiclick (Fluticasone/Salmeterol: 55/14, 113/14, 232/14)
    1. Dose: One puff twice daily

VI. Safety

  1. Pregnancy Category C
  2. Unknown safety in Lactation

VII. Pharmacokinetics

  1. Onset 20 minutes
  2. Duration 12 hours

VIII. Drug Interactions

  1. Strong CYP3A4 Inhibitors (e.g. Ketoconazole)
    1. Increased Salmeterol levels
    2. Risk of QTc Prolongation

IX. Resources

  1. Salmeterol (DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=12d9728e-6b5c-4aee-bfb0-745e542ed2e4
  2. Salmeterol and Fluticasone
    1. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=43a27267-2f2b-410d-9c30-9cb95f35d9a1

X. References

  1. (2022) Comparison of Asthma Medications, Presc Lett, #381217
  2. (2022) Inhaled Medications for COPD, Presc Lett, #381116
  3. (2020) Drugs for COPD, Med Lett Drug Ther 62: 137-44
  4. (2020) Drugs for Asthma, Med Lett Drug Ther 62: 193-200
  5. (2013) Presc Lett, 20(8): 43
  6. (2017) Presc Lett 24(7)
  7. (2001) Med Clin North Am 43(1104):39-40 [PubMed]
  8. Wilson (2001) Chest 119:2021-6 [PubMed]

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Related Studies

Cost: Medications

serevent (on 1/1/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
SEREVENT DISKUS 50 MCG $6.79 each
advair (on 2/23/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
ADVAIR 100-50 DISKUS Generic $1.41 each
ADVAIR 250-50 DISKUS Generic $1.63 each
ADVAIR 500-50 DISKUS Generic $2.89 each
ADVAIR HFA 115-21 MCG INHALER $32.46 per gram
ADVAIR HFA 230-21 MCG INHALER $42.69 per gram
ADVAIR HFA 45-21 MCG INHALER $26.18 per gram
airduo respiclick (on 8/17/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
AIRDUO RESPICLICK 113-14 MCG Generic $100.84 each
FPNotebook does not benefit financially from showing this medication data or their pharmacy links. This information is provided only to help medical providers and their patients see relative costs. Insurance plans negotiate lower medication prices with suppliers. Prices shown here are out of pocket, non-negotiated rates. See Needy Meds for financial assistance information. GoodRx is another tool for finding lower drug prices.

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