Seretide 250 Evohaler - Inhaler Salmeterol + Fluticasone - 50mcg+250mcg 1 120 Doses Unit(s) / 120 Doses Unit Glaxo SmithKline Pharmaceuticals Ltd Introduction: Seretide 250 Evohaler is a combination of two medicines that opens the airways and makes it easier to breathe. It is used in the treatment of asthma (wheezing and shortness of breath) and chronic obstructive pulmonary disorder (a lung disorder in which the flow of air to the lungs is blocked). Your doctor will tell you how often you need to use your inhaler. The effect of this medicine may be noticeable after a few days but will only reach its maximum after a few weeks. This medicine must be used regularly to be effective, so go on taking it... Uses of Seretide 250 Evohaler: AsthmaChronic obstructive pulmonary disease (COPD) Side effects of Seretide 250 Evohaler: NauseaVomitingRespiratory tract infectionFungal infection of mouthSore throatHeadacheHoarseness of voiceCoughMusculoskeletal (bone, muscle or joint) painIncreased heart rate How to use Seretide 250 Evohaler: Check the label for directions before use. Shake the inhaler. While you are breathing in from mouth, press down on the inhaler one time to release the medication and hold your breath for 10 seconds. Repeat until you have inhaled the number of puffs as suggested by the doctor.Afterwards, rinse your mouth thoroughly with water and spit it out. How Seretide 250 Evohaler works: Seretide 250 Evohaler is a combination of two medicines: Salmeterol and Fluticasone Propionate. Salmeterol is a long-acting bronchodilator which works by relaxing the muscles in the airways and widens the airways. Fluticasone Propionate is a steroid. It works by stopping the release of certain chemical messengers that cause inflammation (swelling) of the airways. Together, they make breathing easier. Indication: Chronic Asthma, COPD Adult Dose: Inhalation Asthma Adult: As combination containing salmeterol 50 mcg and fluticasone propionate 100/250/500 mcg/dose of inhalation powder: 1 inhalation bid. As combination containing salmeterol 25 mcg and fluticasone propionate 50/125/250 mcg/dose of pressurised inhalation: 2 inhalation bid. Chronic obstructive pulmonary disease Adult: As combination containing salmeterol 50 mcg and fluticasone propionate 500 mcg/dose of inhalation powder: 1 inhalation bid. Child Dose: Inhalation Asthma Child: 4-12 yr: As combination containing salmeterol 50 mcg and fluticasone propionate 100 mcg/ dose of inhalation powder: 1 inhalation bid; As combination containing salmeterol 25 mcg and fluticasone propionate 50 mcg/dose of pressurised inhalation: 2 inhalation bid. >12 yr: As combination containing salmeterol 50 mcg and fluticasone propionate 100/250/500 mcg/dose of inhalation powder: 1 inhalation bid; As combination containing salmeterol 50/125/250 mcg and fluticasone propionate 50 mcg/dose of pressurised inhalation: 2 inhalation bid. Contraindication: Not for primary treatment of status asthmaticus or other acute attacks of asthma. Severe hypersensitivity to milk proteins. Mode of Action: Salmeterol, a long acting beta 2-agonist which acts locally in the lung to mediate bronchodilation. Fluticasone, a corticosteroid with mainly glucocorticoid activity, reduce symptoms and exacerbations of asthma. Precaution: Pulmonary TB, severe cardiovascular disorders, heart rhythm abnormalities, DM, thyrotoxicosis, hypokalaemia. Patients at risk of decreased bone mineral content (e.g. smoking, old age, sedentary lifestyle, poor nutrition, family history of osteoporosis or long term use of drugs that may decrease bone mass (e.g. anticonvulsants and corticosteroids). Do not stop therapy abruptly; therapy should be down titrated. Advise patient to rinse mouth after inhalation. Monitor height of children on prolonged therapy. Pregnancy, lactation. Side Effect: >10% Upper respiratory tract infection (21-27%),Headache (12-21%),Pharyngitis (10-13%) 1-10% Candidiasis, nonspecific site (0-10%),Throat irritation (7-9%), Musculoskeletal pain (2-9%), Bronchitis (2-8%),Upper respiratory inflammation (4-7%),Viral respiratory infections (4-6%),Nausea or vomiting (4-6%),Cough (3-6%),Sinusitis (4-5%),Hoarseness or dysphonia (2-5%),Fever (3-4%),Diarrhea (2-4%),Gastrointestinal (GI) discomfort or pain (1-4%),Oral candidiasis (1-4%),Muscle cramps or spasms (3%),Malaise or fatigue (2-3%),Viral GI infections (0-3%) Potentially Fatal: Paradoxical bronchospasm. Interaction: Increased fluticasone levels with CYP 3A4 inhibitors e.g ritonavir, ketoconazole, itraconazole. Additive effects with other beta-agonist.