Buy Serevent Online

Serevent Diskus (salmeterol xinafoate)

BOXED WARNING

Long-acting β2-adrenergic agonists (LABAs) increase the risk of asthma-related death. Contraindicated in asthma without use of a concomitant long-term asthma control medication (eg, inhaled corticosteroid). Do not use if asthma is adequately controlled on low- or medium-dose inhaled corticosteroids. LABAs may increase the risk of asthma-related hospitalization in pediatric and adolescent patients.

View FDA-Approved Full Prescribing Information for Serevent Diskus

THERAPEUTIC CLASS

Beta2 agonist

DEA CLASS

RX

INDICATIONS

Treatment of asthma and prevention of bronchospasm only as concomitant therapy with a long-term asthma control medication (eg, inhaled corticosteroid) in patients ≥4 yrs of age with reversible obstructive airway disease, including patients with symptoms of nocturnal asthma. Prevention of exercise-induced bronchospasm (EIB) in patients ≥4 yrs of age. Maintenance treatment of bronchospasm associated with chronic obstructive pulmonary disease (COPD) (eg, emphysema, chronic bronchitis).

ADULT DOSAGE

Asthma

Use only as concomitant therapy w/ a long-term asthma control medication (eg, inhaled corticosteroid) in patients w/ reversible obstructive airway disease, including patients w/ symptoms of nocturnal asthma

1 inh bid (12 hrs apart)

Chronic Obstructive Pulmonary Disease

Long-Term Maint Treatment of Bronchospasm:
1 inh bid (12 hrs apart)

Exercise-Induced Bronchospasm

Prevention:
1 inh ≥30 min before exercise (additional doses should not be used for 12 hrs after administration or if already on bid dose)

PEDIATRIC DOSAGE

Asthma

Use only as concomitant therapy w/ a long-term asthma control medication (eg, inhaled corticosteroid) in patients w/ reversible obstructive airway disease, including patients w/ symptoms of nocturnal asthma

≥4 Years:
1 inh bid (12 hrs apart)

Exercise-Induced Bronchospasm

Prevention:
≥4 Years:

1 inh ≥30 min before exercise (additional doses should not be used for 12 hrs after administration or if already on bid dose)

ADMINISTRATION

Oral inh route

HOW SUPPLIED

Disk: 50mcg/inh [28, 60 blisters]

CONTRAINDICATIONS

Treatment of asthma without concomitant use of long-term asthma control medication (eg, inhaled corticosteroid). Primary treatment of status asthmaticus or other acute episodes of asthma/COPD where intensive measures are required. Milk protein hypersensitivity.

WARNINGS/PRECAUTIONS

Not indicated for acute bronchospasm relief. Do not initiate during rapidly deteriorating or potentially life-threatening episodes of asthma or COPD; serious acute respiratory events reported. D/C regular use of oral/inhaled short-acting β2-agonist (SABA) when beginning treatment. Not a substitute for corticosteroids. Do not use more often or at higher doses than recommended; clinically significant cardiovascular (CV) effects and fatalities reported with excessive use. May produce paradoxical bronchospasm; treat immediately with an inhaled, short acting bronchodilator; d/c and institute alternative therapy. Upper airway symptoms reported. Immediate hypersensitivity reactions and CV/CNS effects may occur. Caution with CV disorders, convulsive disorders, thyrotoxicosis, hepatic disease, diabetes mellitus (DM), ketoacidosis, and in patients unusually responsive to sympathomimetic amines. Clinically significant and dose-related changes in blood glucose and/or serum K+ reported.

ADVERSE REACTIONS

Nasal/sinus congestion, pharyngitis, cough, viral respiratory infection, musculoskeletal pain, rhinitis, headache, tracheitis/bronchitis, influenza, throat irritation.

DRUG INTERACTIONS

Do not use with other medicines containing a LABA. Not recommended with strong CYP3A4 inhibitors (eg, ketoconazole, ritonavir, clarithromycin); increased CV adverse effects may occur. Extreme caution with MAOIs or TCAs, or within 2 weeks of discontinuation of such agents; action on the vascular system may be potentiated. β-blockers may block pulmonary effects and produce severe bronchospasm; if such therapy is needed, consider cardioselective β-blockers and use with caution. Caution is advised when coadministered with non-K+-sparing diuretics (eg, loop, thiazide).

PREGNANCY AND LACTATION

Category C, caution in nursing.

MECHANISM OF ACTION

LABA; attributable to stimulation of intracellular adenyl cyclase, the enzyme that catalyzes the conversion of ATP to cAMP. Increased cAMP levels cause relaxation of bronchial smooth muscle and inhibition of release of mediators of immediate hypersensitivity from cells, especially from mast cells.

PHARMACOKINETICS

Absorption: Cmax=167pg/mL; Tmax=20 min. Distribution: Plasma protein binding (96%). Metabolism: Liver (extensive) by hydroxylation; α-hydroxysalmeterol (aliphatic oxidation) via CYP3A4. Elimination: Urine (25%), feces (60%); T1/2=5.5 hrs.

ASSESSMENT

Assess for hypersensitivity to milk proteins, status asthmaticus, asthma/COPD status, CV disorders, convulsive disorders, thyrotoxicosis, DM, ketoacidosis, hepatic disease, pregnancy/nursing status, and possible drug interactions.

MONITORING

Monitor for deteriorating disease, paradoxical bronchospasm, upper airway symptoms, immediate hypersensitivity reactions, CV and CNS effects, changes in blood glucose and/or serum K+, and other adverse reactions.

PATIENT COUNSELING

Counsel about the risks and benefits of therapy. Inform that the medication should only be used as additional therapy when long-term asthma control medications do not adequately control asthma symptoms. Inform that drug is not meant to relieve acute asthma or exacerbations of COPD symptoms and extra doses should not be used for that purpose; advise to treat acute symptoms with an inhaled SABA (eg, albuterol). Instruct to seek medical attention immediately if experiencing a decrease in effectiveness of inhaled SABA, a need for more inhalations than usual of inhaled SABA, or a significant decrease in lung function. Advise not to d/c therapy without physician guidance and not to use other LABA. Advise that therapy is not a substitute for oral or inhaled corticosteroids; instruct not to change dosage or stop therapy without consulting physician. Advise that immediate hypersensitivity reactions may occur; instruct to d/c if such reactions occur. Inform of adverse effects (eg, palpitations, chest pain, rapid HR, tremor, nervousness). Inform patients treated for EIB not to use additional doses for 12 hrs and not to use additional doses for prevention of EIB if receiving therapy bid. Inform that the inhaler is not reusable and advise not to take the inhaler apart.

STORAGE

20-25°C (68-77°F); excursions permitted from 15-30°C (59-86°F). Store in a dry place away from direct heat or sunlight. Store inside the unopened moisture-protective foil pouch and only remove from the pouch immediately before initial use. Discard 6 weeks after opening the foil pouch or when the counter reads "0," whichever comes 1st.

TAGS

generic serevent, buy serevent, buy cheap salmeterol, generic salmeterol, purchase serevent online, order salmeterol online, buy salmeterol online, buy serevent online, purchase salmeterol online, buy salmeterol, order salmeterol, purchase serevent, order serevent, order serevent online, purchase salmeterol, buy cheap serevent