Explanation

Salmeterol and fluticasone (also together called Seretide^TM) are medicines used to stop you getting asthma.

Salmeterol belongs to a family of medicines called bronchodilators.

Fluticasone belongs to a family of medicines called called corticosteroids.

What do salmeterol and fluticasone do?

Salmeterol and fluticasone work in different ways to stop you getting asthma.

Fluticasone helps to control your asthma by preventing and reducing the inflammation in your lungs.

Inflammation makes your lungs swell up and stops them from working properly. This can cause some of the feelings of asthma, like wheeziness and breathlessness. Fluticasone stops your body over-reacting to the things that trigger your asthma by reducing inflammation.

Salmeterol helps the airways in your lungs stay open, so that you can breathe more easily.

Together, salmeterol and fluticasone help stop the feelings of asthma from happening in the first place. This is why it's called a preventer medicine.

What does it look like?

Salmeterol and fluticasone come stored either in an inhaler as a powder (Seretide^TM Acuhaler^TM), or in a small pressured canister (Seretide^TM Evohaler^TM).

When do I have to take it?

It is important that you take your salmeterol and fluticasone regularly, every day, to help to stop you getting asthma attacks.

Your doctor or asthma nurse will tell you exactly how many puffs to take and how often. You will probably use your inhaler two times each day.

If you use the Seretide^TM Evohaler^TM you will probably take two puffs, twice a day. If you use the Seretide^TM Acuhaler^TM you will probably take one dose, twice a day.

You usually take it in the morning and evening, or just in the evening.

DO NOT use salmeterol and fluticasone if you SUDDENLY get breathless or wheezy, because it will not help. You will need another type of medicine for this. The medicine you take if you feel breathless or wheezy is called a reliever. Your doctor might have already given you an inhaler that holds this sort of medicine. If so, make sure you don't get your inhalers mixed up!

But what if I don't feel like taking it?

If you don't take your salmeterol and fluticasone regularly every day, then it won't work properly. Your lungs might get inflamed again and you will be more likely to have an asthma attack.

Even if you feel better you still need to keep taking it! Don't stop unless your doctor tells you to.

What should I do if I forget to take it?

If you do forget to take your salmeterol and fluticasone, don't worry. Take the next dose when it's due as normal.

Don't take twice your normal dose to make up for the one you forgot. Remember the three Ds: Don't double dose!

How much do I take?

This depends on how old you are and how bad your asthma is.

Depending on your dose, you will have a different inhaler with different amounts of salmeterol and fluticasone inside it.

Your doctor or asthma nurse will tell you exactly how many puffs YOU need to take each day. You will probably need to take a dose in the morning and the evening.

If you use the Seretide^TM EvohalerT^TM you will probably take two puffs, twice a day. If you use the SeretideT^TM AcuhalerT^TM you will probably take one inhalation twice a day.

Always make sure to use your inhaler exactly as your doctor or asthma nurse has told you!

Your doctor will try to give you the lowest dose possible to control your asthma.

It takes a few days before the medicine starts to work.

Don't use your inhaler more often than your doctor tells you to! It's important to take just the right amount. It's the best way to stay well, without getting side effects.

What are the most likely side effects I might get if I take salmeterol and fluticasone?

The side effects you are most likely to get include having a sore throat after using your inhaler, or your voice being a little bit croaky. You might feel shaky, or may have a headache or pains in your muscles.

You might also get an infection called oral thrush in your mouth or throat. Rinsing your mouth out with water or cleaning your teeth right after using your inhaler can help to stop these things from happening.

Tell your doctor if you notice any of these side effects, but don't stop taking your salmeterol and fluticasone unless he or she tells you to.

What other side effects might I get?

Other, less likely, side effects that you might get include:

A rash on your skin

Having a very fast heart beat

If you notice any of these side effects tell your doctor.

Are there any other side effects that you haven't mentioned?

It's possible that you could get some other side effects, but they are very unusual. They include:

Feeling nervous or not sleeping well

Problems with your vision
Weak bones

Glaucoma - this can be found in eye tests

Gaining weight

Growing more slowly

Painful joints and muscles

Salmeterol and fluticasone can make you wheezy immediately after you use it, and make it hard to breathe, although this is very unusual. If it happens stop using your inhaler straight away and use your reliever inhaler. Also, tell your doctor as soon as you can.

Is it safe for me to be taking salmeterol and fluticasone?

Before using salmeterol and fluticasone, you should tell the doctor about any other medical problems that you know you have.

Especially if you:

Have ever had tuberculosis (TB)

Have high blood pressure

Have a problem with your thyroid gland

Have diabetes

Have any heart problems

Have low levels of potassium in your blood - your doctor will be able to check for this with blood tests

Also, remember to tell your doctor if you have any allergies - to salmeterol and fluticasone or anything else.

The Seretide^TM Acuhaler^TM also contains lactose (a type of sugar), and small amounts of milk protein, which can cause an allergic reaction in some people. Make sure you tell your doctor if you are allergic to either of these.

The Seretide^TM Evohaler^TM also contains norflurane so tell you doctor if you are allergic to this.

Is it OK for me to be taking salmeterol and fluticasone if I'm already taking other medicine?

Make sure you tell your doctor if you're taking any other medicines, including anything for treating asthma, or any that you have bought without a prescription.

You should also mention any special foods or herbal remedies you're using.

It's especially important to tell your doctor if you're taking anti-fungal or anti-viral drugs like:

ketoconazole

intraconazole

ritonavir

You should also tell you doctor if you're taking:

any other medicine which might contain corticosteroids - these could be as tablets or in inhalers

a type of medicine called beta blockers

Do I need to know anything else about salmeterol and fluticasone?

If you notice that your wheeziness is getting worse, or if you find that you are using your reliever inhaler more often, tell the adults looking after you or your doctor as soon as you can. It may be that your asthma is getting worse and perhaps you need extra medicine to help.

Don't stop taking your salmeterol and fluticasone without talking to your doctor. Suddenly stopping it or lowering the dose can occasionally cause side effects like:

A sore tummy

Feeling tired

Not feeling hungry

Losing weight

Low blood pressure

Seizures

A low amount of a mineral called potassium in your blood (this shows up in blood tests)

What if I have any more questions?

If you have any other questions, you can ask your doctor, or chat to other people with asthma in the Medikidz forums and virtual world, Mediland.