Serevent

Serevent is the brand name for salmeterol, a long-acting beta-2 adrenoceptor agonist (LABA) used as maintenance bronchodilator treatment for asthma and chronic obstructive pulmonary disease (COPD).

It provides sustained bronchodilation for approximately 12 hours, making it suitable for twice-daily dosing to help control symptoms and prevent exercise-induced bronchospasm.

Salmeterol works by stimulating beta-2 adrenergic receptors in the smooth muscle of the airways.

This triggers a cascade of intracellular events that leads to relaxation of the airway smooth muscle, resulting in bronchodilation and improved airflow.

Unlike short-acting bronchodilators, salmeterol has a slow onset of action (approximately 10 to 20 minutes) but provides prolonged relief.

In asthma management, Serevent must always be used in combination with an inhaled corticosteroid (ICS).

It should never be used as the sole therapy for asthma, as it does not address the underlying airway inflammation.

In COPD, salmeterol may be used alone or alongside other inhaled therapies as part of a stepwise management plan.

Inhale the prescribed dose from the Accuhaler or metered-dose inhaler twice daily, in the morning and evening, approximately 12 hours apart.

Follow the technique instructions provided with your specific inhaler device. Serevent is a maintenance treatment and should be taken regularly.

It is not suitable for relieving sudden breathlessness; always keep your short-acting reliever inhaler to hand for acute symptoms.

Adults and children over 12 years: 50 micrograms (one inhalation) twice daily.

For prevention of exercise-induced bronchospasm: 50 micrograms at least 30 minutes before exercise, though regular twice-daily dosing usually provides sufficient protection.

Children aged 4 to 12 years: 50 micrograms twice daily. Do not exceed the recommended dose, as higher doses do not improve efficacy and may increase the risk of adverse effects.

Common (1 in 10 to 1 in 100): headache, tremor, palpitations, muscle cramps. Uncommon (1 in 100 to 1 in 1,000): tachycardia, nervousness, rash, arthralgia.

Rare (1 in 1,000 to 1 in 10,000): hypersensitivity reactions including bronchospasm, angioedema, urticaria. Very rare (less than 1 in 10,000): cardiac arrhythmias, hypokalaemia, hyperglycaemia.

Paradoxical bronchospasm may occur immediately after inhalation; if this happens, discontinue Serevent and seek medical advice.

Serevent must not be used as monotherapy in asthma. It should always be combined with an appropriate dose of inhaled corticosteroid.

Increasing use of short-acting bronchodilators to relieve symptoms indicates deteriorating asthma control and the need for medical review.

Salmeterol should be used with caution in patients with thyrotoxicosis, cardiovascular disease, QT prolongation, or diabetes.

Hypokalaemia may result from high-dose beta-2 agonist therapy, particularly when combined with certain diuretics or corticosteroids.

Serevent is contraindicated in patients with known hypersensitivity to salmeterol or any of the excipients. It must not be used to treat acute asthma symptoms or acute exacerbations of COPD.

Serevent should not be used as the only treatment for asthma without a concurrent inhaled corticosteroid.