Salmeterol | Side Effects, Dosage, Uses & More
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Generic Name:

salmeterol, Inhalation Powder

All Brands

  • Serevent Diskus
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Highlights for salmeterol

Inhalation Powder
1

Salmeterol is used to treat asthma, chronic obstructive pulmonary disease (COPD), and exercised-induced bronchospasm.

2

Salmeterol is available as an oral metered inhalation you inhale.

3

Salmeterol is available as brand-name drug called Serevent Diskus. It isn’t available as a generic drug.

4

The more common side effects of this drug include headache, nasal congestion, bronchitis, throat irritation, cough, runny nose, and flu.

5

Don’t use other drugs that contain a long-acting beta agonist (LABA) while you’re taking this drug. Ask your doctor or pharmacist if any of your other medications are LABA drugs.

IMPORTANT INFORMATION

FDA warning

This drug has a black box warning. This is the most serious warning from the Food and Drug Administration (FDA). A black box warning alerts doctors and patients about drug effects that may be dangerous. 

Asthma-related death warning. Salmeterol can increase the risk of asthma-related death. If you have asthma, you should only take this drug if your asthma isn’t controlled on a long-term asthma drug, such as an inhaled corticosteroid. You shouldn’t use this drug if your asthma is well controlled on a low- or medium-dose inhaled corticosteroid.

Hospitalization warning. Salmeterol may increase the risk of asthma-related hospitalization in children and adolescents. If your child needs to use this drug and an inhaled corticosteroid, they should use a fixed-dose product containing both medications to make sure both drugs are taken.

Sudden shortness of breath

This drug doesn’t relieve sudden symptoms of breathing problems. Always have a rescue inhaler with you to treat sudden symptoms.

Allergic reactions

Don’t use salmeterol if you have a severe allergy to milk proteins. This drug contains lactose, a milk protein, which may cause an allergic reaction.

Appropriate use

Don’t use this drug for exercise-induced bronchospasms if you’re using salmeterol twice per day. You can use it 30 minutes before an exercise, but you have to wait 12 hours to use your second regular dose.

Drug features

Salmeterol is a prescription drug. It’s available as an oral inhalation.

Salmeterol isn’t available as a generic drug. It’s only available as the brand-name drug Serevent Diskus.

Salmeterol may be used as part of a combination therapy. This means you may need to take it with other medications.

Why it's used

Salmeterol is used to treat asthma in people 4 years and older. It’s also used to manage narrowing of the airways (bronchospasms) in people with chronic obstructive pulmonary disease (COPD) and to prevent exercise-induced bronchospasms.

How it works

Salmeterol belongs to a class of drugs called long-acting beta2 adrenergic agonists. A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions.

More Details

How it works

Salmeterol belongs to a class of drugs called long-acting beta2 adrenergic agonists. A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions.

Salmeterol works by relaxing the muscles in your airway passages (bronchial tubes) in your lungs. This opens up your breathing airways and makes it easier for you to breathe.

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salmeterol Side Effects

Inhalation Powder

More Common Side Effects

The more common side effects of salmeterol can include:

  • headache

  • throat irritation

  • nasal congestion

  • bronchitis

  • runny nose

  • flu

  • muscle pain

  • cough

  • respiratory infection

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious Side Effects

Call your doctor right away if you have serious side effects. Call 9-1-1 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

  • Heart problems. This drug may cause an irregular heartbeat, chest pain, low blood flow to your heart, or a heart attack. Symptoms include:

    • high blood pressure
    • fast or irregular heart rate
    • chest pain
    • tremors
    • nervousness
  • Sudden breathing problem right after inhaling your medication

  • Worsening in your breathing problems

  • Your rescue inhaler doesn’t work well to relieve your symptoms

Pharmacist's Advice
Healthline Pharmacist Editorial Team

Salmeterol doesn’t cause drowsiness.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.
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salmeterol May Interact with Other Medications

Inhalation Powder

Salmeterol can interact with other medications, vitamins, or herbs you may be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well.

To help avoid interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbs you’re taking. To find out how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Medications that might interact with this drug

Antibiotics (macrolides)

Certain antibiotics may cause salmeterol to build up in your body to an amount that’s too high.

Examples of these drugs include:

  • clarithromycin
  • telithromycin

Antifungal drugs

Certain antifungal drugs may cause salmeterol to build up in your body to an amount that’s too high.

Examples of these drugs include:

  • itraconazole
  • ketoconazole
  • voriconazole
  • posaconazole

Blood pressure drugs

Certain blood pressure medications may block the effects of salmeterol or cause airway narrowing on their own. 

Examples of these drugs include:

  • beta blockers, such as:
    • acebutolol
    • atenolol
    • betaxolol
    • bisoprolol
    • esmolol
    • metoprolol
    • nadolol
    • nebivolol
    • penbutolol
    • pindolol
    • propranolol
    • sotalol
    • timolol

Depression drugs

Certain medications to treat depression can increase the toxic effects of salmeterol. This can cause more side effects. 

Examples of these drugs include:

  • monoamine oxidase inhibitors (MAOIs), such as:
    • phenelzine
    • selegiline
    • tranylcypromine
  • tricyclic antidepressants, such as:
    • amitriptyline
    • clomipramine
    • doxepin
    • imipramine
    • nortriptyline
    • protriptyline

Certain drugs used to treat depression may cause salmeterol to build up in your body to an amount that’s too high.

Examples of these drugs include:

  • nefazodone

Hepatitis C virus (HCV) drugs

Certain HCV drugs may cause salmeterol to build up in your body to an amount that’s too high. 

Examples of these drugs include:

  • paritaprevir
  • ombitasvir
  • dasabuvir
  • telapravir
  • boceprevir

Human immunodeficiency virus (HIV) drugs

Certain HIV drugs may cause salmeterol to build up in your body to an amount that’s too high. 

Examples of these drugs include:

  • atazanavir
  • darunavir
  • indinavir
  • lopinavir
  • nelfinavir
  • ritonavir
  • saquinavir
  • cobicistat
  • tipranavir

Water pills (diuretics)

Taking salmeterol with diuretics can change the activity of your heart and lower the amount of potassium in your body. 

Examples of these drugs include:

  • furosemide
  • hydrochlorothiazide
  • bumetanide
  • ethacynic acid
  • furosemide
  • torsemide
  • chlorothiazide
  • chlorthalidone
  • indapamide
  • metolazone

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.

People with a history of seizures

Ask your doctor whether salmeterol is safe for you if you have a history of seizures or convulsions. This drug may cause seizures.

People with diabetes

Salmeterol may cause changes in blood sugar making it too high. If you have diabetes, monitor your blood sugar carefully while you’re on this drug.

People with thyroid problems

Ask your doctor whether salmeterol is safe for you if you have thyroid problems. It may make your condition worse.

People with heart problems, including high blood pressure

Salmeterol can cause chest pain, a fast or irregular heart rate, an increase in blood pressure, and changes to the amount of potassium in your body, which can lead to heart problems.

People with liver problems

Salmeterol is processed by your liver. If your liver doesn’t work well, more of this medication will stay in your body longer. This puts you at risk for side effects. Your doctor will monitor you closely.

Pregnant women

Salmeterol is a category C pregnancy drug. That means two things: 

  1. Research in animals has shown adverse effects to the fetus when the mother takes the drug.
  2. There haven’t been enough studies done in humans to be certain how the drug might affect the fetus. 

Talk to your doctor if you’re pregnant or planning to become pregnant. This drug should be used only if the potential benefit justifies the potential risk to the fetus.

Women who are breast-feeding

It isn’t known if salmeterol passes into breast milk. There’s a chance it may cause side effects in a child who is breast-fed.

Talk to your doctor if you breast-feed your baby. You may need to decide whether to stop breast-feeding or stop taking this medication.

For seniors

The liver and kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, more of a drug stays in your body for a longer time. This increases your risk of side effects. Your doctor will monitor you closely.

For children

This drug hasn’t been studied in children and shouldn’t be used in children younger than 4 years.

When to call the doctor

Call your healthcare provider or get medical care right away if:

  • Your breathing problems get worse.
  • You need to use your rescue inhaler more often than usual.
  • Your rescue inhaler doesn’t work as well to relieve your symptoms.
  • You need to use 4 or more inhalations of your recue inhaler in 24 hours for 2 or more days in a row.
  • You use 1 whole canister of your rescue inhaler in 8 weeks.
  • Your peak flow meter results decrease. Your healthcare provider will tell you the numbers that are right for you.
  • You have asthma and your symptoms don’t improve after using salmeterol for one week.

Allergies

Salmeterol can cause a severe allergic reaction. Symptoms can include: 

  • skin rash
  • hives
  • swelling of your face, mouth, and tongue
  • breathing problems 

If you have an allergic reaction, call your doctor or local poison control center right away. If your symptoms are severe, call 9-1-1 or go to the nearest emergency room.

Don’t take this drug again if you’ve ever had an allergic reaction to it. Taking it again could be fatal (cause death).

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How to Take salmeterol (Dosage)

Inhalation Powder

All possible dosages and drug forms may not be included here. Your dosage, drug form, and how often you take the drug will depend on:

  • your age
  • the condition being treated
  • how severe your condition is
  • other medical conditions you have
  • how you react to the first dose

What are you taking this medication for?

Asthma

Brand: Serevent Diskus

Form: Inhalation powder
Strengths: 50 mcg
Adult dosage (ages 18 years and older)

One inhalation (50 mcg) taken by mouth twice daily, about 12 hours apart. This drug should be used in addition to treatment with an inhaled corticosteroid.

Child dosage (ages 4–17 years)

One inhalation (50 mcg) taken by mouth twice daily, about 12 hours apart. This drug should be used in addition to treatment with an inhaled corticosteroid.

Child dosage (ages 0–3 years)

This drug hasn’t been approved to be used in children younger than 4 years.

Chronic obstructive pulmonary disease

Brand: Serevent Diskus

Form: Inhalation powder
Strengths: 50 mcg
Adult dosage (ages 18 years and older)

One inhalation (50 mcg) taken by mouth twice daily, about 12 hours apart.

Child dosage (ages 0–3 years)

This drug hasn’t been approved to be used in children younger than 4 years.

Exercise-induced bronchospasm

Brand: Serevent Diskus

Form: Inhalation powder
Strengths: 50 mcg
Adult dosage (ages 18 years and older)

One inhalation (50 mcg) taken by mouth at least 30 minutes before exercise. Don’t take another dose for at least 12 hours. Don’t take more than 2 doses in one day or 24 hours.

Child dosage (ages 4–17 years)

One inhalation (50 mcg) taken by mouth at least 30 minutes before exercise. Don’t take another dose for at least 12 hours.

Child dosage (ages 0–3 years)

This drug hasn’t been approved to be used in children younger than 4 years.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always to speak with your doctor or pharmacist about dosages that are right for you.
Pharmacist's Advice
Healthline Pharmacist Editorial Team

Salmeterol comes with serious risks if you don’t take it as prescribed.

If you stop taking the drug or don’t take it at all

If you stop taking the medication or don’t take it at all, your symptoms could get worse. This could lead to more breathing problems. 

If you miss doses or don’t take the drug on schedule

Your medication may not work as well or may stop working completely. For this drug to work well, a certain amount needs to be in your body at all times. You may need to use your rescue inhaler more often.

If you take too much

You could have dangerous levels of the drug in your body. Symptoms of an overdose of this drug can include:

  • seizures
  • high or low blood pressure
  • chest pain
  • fast heart rate
  • dizziness

If you think you’ve taken too much of this drug, call your doctor or local poison control center. If your symptoms are severe, call 9-1-1 or go to the nearest emergency room right away.

What to do if you miss a dose

If you miss a dose of salmeterol, just skip that dose. Take your next dose at your usual time. Never try to catch up by taking two doses at once. This could result in dangerous side effects.

How to tell if the drug is working

You’ll be able to tell that salmeterol is working if your symptoms are better controlled. You’ll be less likely to have breathing problems.

Salmeterol is used for long-term treatment.

Important considerations for taking salmeterol

Store this drug carefully

  • Store salmeterol at room temperature between 59°F and 86°F (15°C and 30°C).
  • Keep it in a dry place away from heat and sunlight.
  • Don’t store this medication in moist or damp areas, such as bathrooms.
  • Store salmeterol in its unopened foil pouch. Only open it when you’re ready to use it.
  • Throw away salmeterol 6 weeks after you open the foil pouch or when the counter on your diskus reads zero, whichever comes first. Safely throw the drug away in the trash.

A prescription for this medication is refillable

You should not need a new prescription for this medication to be refilled. Your doctor will write the number of refills authorized on your prescription.

Travel

When traveling with your medication:

  • Always carry your medication with you. When flying, never put it into a checked bag. Keep it in your carry-on bag.
  • Don’t worry about airport x-ray machines. They can’t hurt your medication.
  • You may need to show airport staff the pharmacy label for your medication. Always carry the original prescription-labeled box with you.
  • Don’t put this medication in your car’s glove compartment or leave it in the car. Be sure to avoid doing this when the weather is very hot or very cold.

Self-management

You doctor may ask you to use a peak flow meter to check how well your lungs are working. Your doctor will teach you how to use a peak flow meter. 

Your doctor may also ask you to keep a diary of your asthma or shortness of breath attacks to check how well your drug regimen is working.

Talk to your doctor or pharmacist about how to use salmeterol, which comes in a diskus inhalation device.  Read the medication guide before starting this drug.  

Clinical monitoring

While you’re on salmeterol, your doctor will monitor certain health issues. This can help make sure you stay safe while you take this drug. These issues include: 

  • heart function
  • blood sugar levels
  • potassium levels
  • lung function

Are there any alternatives?

There are other drugs available to treat your condition. Some may be better suited for you than others. Talk to your doctor about other drug options that may work for you.


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Content developed in collaboration with University of Illinois-Chicago, Drug Information Group

Medically reviewed by Creighton University, Center for Drug Information and Evidence-Based Practice on October 15, 2015

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
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