SEREVENT DISKUS (SALMETEROL)

Serevent Diskus is the brand name for a generic bronchodilator- Salmeterol Xinafoate. It is a prescription oral inhalation powder that got FDA approval in 1998 for its use in the prevention of asthma attacks or exercise-induced bronchospasm. The doctors even prescribe it for the treatment of chronic obstructive pulmonary disease (COPD) including chronic bronchitis and emphysema.

Serevent Diskus is a specially designed, teal-green plastic inhaler that has a double-foil blister strip. It contains salmeterol xinafoate as its active component. Salmeterol xinafoate is white powder salt, chemically designated as 4-hydroxy-a1-[[[6-(4- phenylbutoxy)hexyl]amino]methyl]-1,3-benzenedimethanol, 1-hydroxy-2- naphthalenecarboxylate. It is the racemic form of 1-hydroxy-2- naphthoic acid salt of salmeterol.

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Serevent Diskus is an adrenergic bronchodilator, specifically a long-acting beta-2 adrenoreceptor agonist (LABA).

LABA helps ease breathing issues caused by bronchial conditions by relaxing the bronchial smooth muscles and inhibiting hypersensitivity reactions in the bronchial passage. It works to enhance the activity of beta-2 adrenergic receptors found abundantly in the airway smooth muscles. These protein particles on the cell membranes activate the intracellular activity when stimulated by the epinephrine hormone.

They stimulate adenyl cyclase- an enzyme involved in the regulation of the function of smooth muscle. This enzyme increases intracellular levels of cAMP, relaxes the bronchial smooth muscles, and dilates the air passage. It even inhibits the release of inflammatory substances from mast cells of the immune system that have a role in initiating prompt hypersensitivity reactions, common in asthma attacks.

Glyxambi comes in various different strengths, including:

Serevent Diskus is an oral inhaler containing a foil blister strip. The blister strip contains a mixture of 50 mcg of Salmeterol (micro-ionized salmeterol Xinafoate salt) in 12.5 mg of lactose monohydrate formulation.

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• Prevention of asthma attack: Asthma is a common lung disorder wherein the bronchi swell and narrow the airways, causing mild to serious breathing problems. It obstructs the airflow out of the lungs. Its symptoms include shortness of breath, wheezing, chest tightness, and coughing. Serevent Diskus is given as a concomitant therapy with an ICS in patients aged above 4 years with reversible obstructive airway disease, including those showing symptoms of nocturnal asthma.
• Prevention of Exercise: Induced Bronchospasm (EIB)- Exercise-induced bronchospasm is an asthma attack developing from the narrowing of airways due to physical activity. Serevent Diskus is given as a single agent for the prevention of EIB in patients aged 4 years and above, in case of no chronic asthma.
• Maintenance treatment of Chronic Obstructive Pulmonary Disease (COPD): COPD is a lung disorder that causes persistent blockage of airflow through the airways and in and out of the lungs (bronchi). It mainly involves two related lung diseases- emphysema and chronic bronchitis. Serevent Diskus can help manage symptoms of COPD when administered twice daily for the long term.

The maximum prescribed dosage is one inhalation twice daily, at intervals of 12 hours.

For prevention of exercise-induced bronchospasm, the suggested dose is one inhalation at least 30 minutes before exercise.

Serevent Diskus is meant for administration by oral inhalation route only. This helps in delivering its active ingredient, salmeterol, directly to the lungs. This inhalation route ensures targeted and effective treatment for conditions like asthma and COPD, optimizing therapeutic outcomes while minimizing systemic side effects. One should follow prescribed dosing instructions and consult healthcare professionals for proper usage guidance.

Using Serevent Diskus can cause minor and sometimes serious side effects. The common side effects include:

• Flu symptoms
• Runny or stuffy nose
• Nausea
• Insomnia
• Dry mouth
• Upset stomach
• Diarrhea

Seek prompt medical attention, if experiencing the following rare/serious side effects:

• Signs of high blood sugar
• Signs of low potassium
• Fast, slow, or irregular heartbeat
• Pounding in the ear or neck, severe headache, or blurred vision
• Chest pain

Many drugs, supplements, and substances are known to interact with Serevent Diskus, when taken together, and make Serevent less effective or cause serious side effects. Here are some of the drugs that can interact with Serevent:

• Antibiotics like telithromycin and clarithromycin
• Antifungals like ketoconazole and itraconazole
• Antivirals like indinavir, saquinavir, ritonavir, and nelfinavir
• Nefazodone
• MAO inhibitors such as selegiline, isocarboxazid, linezolid, rasagiline, tranylcypromine, methylene blue injection, phenelzine, and others
• Heart or blood pressure medications such as beta blockers and diuretics
• HIV/AIDS medications
• Antidepressants

Serevent Diskus is not meant for use or safe for administration by:

• People who want rescue from an already-started asthma attack or sudden breathing difficulties
• People who want relief from acute bronchospasm
• People showing hypersensitivity to milk proteins or Salmeterol
• Anyone having food or drug allergies
• Patients suffering from heart disease, thyroid disorder, epilepsy, or other seizure disorder
• Diabetic individuals
• Children aged below 4 years

While using Serevent Diskus:

• Avoid exhaling or blowing into the Diskus device. Do not let the device get wet or put it apart.
• Do not consume grapefruit juice or grapefruit-containing foods.
• Avoid or limit caffeine intake.
• Do not change the dose and dosing schedule or abruptly stop taking the dose without the doctor’s advice.
• Carefully follow the instructions given along with the medicine.
• Do not clean or separate the Diskus device. Throw the inhaler when the dose indicator shows zero or after 6 weeks of taking it out of the foil pouch, whichever is earlier.
• Consult a doctor about whether it's right to administer Serevent Diskus in pregnancy or while breastfeeding.
• Avoid drug/disease interactions with Serevent by sharing information about your current intake of drugs, and illnesses (if any) with your doctor.

Serevent Diskus comes as a disposable plastic inhaler containing a foil blister strip with 60 blisters. The inhaler has a plastic-coated, moisture-resistant foil pouch packaging.

Store the Serevent Diskus package at controlled room temperature, preferably at 20-25℃ in a cool, dry, sunlight-resistant place away from the reach of children and pets. The medication may get spoilt or its efficacy may become low below 15℃ and above 30℃.

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