salmeterol

Salmeterol is a drug belonging to the class of long-acting selective β2-adrenergic receptor agonists.

Salmeterol is a bronchodilator, which is why it is used in the treatment of asthma. In fact, it is available in the form of pharmaceutical formulations suitable for inhalation.

Salmeterol - Chemical Structure

Examples of medicinal specialties containing Salmeterol

Aliflus ®
Serevent ®
Seretide ®

Indications

For what it uses

The use of salmeterol is indicated for:

Prolonged symptomatic therapy of bronchospastic states;
Long-term treatment of bronchial obstruction in patients with COPD (chronic obstructive pulmonary disease).

Warnings

During treatment of asthma with salmeterol, patients should be adequately monitored to see how they respond to ongoing therapy.

Salmeterol treatment should not be started in patients whose asthma is significantly worsening or in case of exacerbations.

The worsening of asthma can be extremely dangerous for the patient, therefore, if this occurs, it is necessary to undergo an urgent medical evaluation.

If deemed necessary, the doctor may decide to add a corticosteroid therapy to the salmeterol treatment.

Salmeterol has a long duration of action (about 12 hours), but has a slow onset of action (10-20 minutes), therefore it should not be used in acute asthmatic attacks. Salmeterol, in fact, is especially useful for preventing the onset of nocturnal asthma symptoms.

Interactions

The concomitant administration of salmeterol and ketoconazole (an antifungal) could cause an increase in the plasma concentration of salmeterol itself, thus increasing the risk of onset of side effects induced by the latter.

Salmeterol should be administered with extreme caution in patients receiving MAOI (monoamine oxidase inhibitors) or tricyclic antidepressants . The same caution should be used in those patients who have finished therapy with these drugs for less than two weeks.

In any case, it is always necessary to inform your doctor if you are taking - or have recently been - medicines of any kind, including non-prescription medicines and herbal and / or homeopathic products.

Side effects

Salmeterol can cause various types of side effects, although not all patients experience them. This is due to the different sensitivity that each individual has towards the drug. Therefore, it is not said that the undesirable effects occur all with the same intensity in each person.

The main adverse effects that may occur during salmeterol therapy are briefly listed below.

Allergic reactions

Like any other drug, salmeterol can also trigger allergic reactions, sometimes severe, in sensitive individuals. These reactions can occur in the form of:

Skin rash;
Edema;
Angioedema;
bronchospasm;
Anaphylactic shock.

Nervous system disorders

Salmeterol treatment can cause disorders such as:

Headache;
Tremors;
Dizziness.

Psychiatric disorders

Salmeterol-based therapy can promote the onset of nervousness and insomnia.

Lung and respiratory tract disorders

During treatment with salmeterol there may be undesirable effects on the respiratory tract, such as paradoxical bronchospasm and oropharyngeal irritation.

Cardiac disorders

Salmeterol therapy may cause:

Tachycardia;
Palpitations;
Atrial fibrillation;
Supraventricular tachycardia;
Extrasystoles.

Musculoskeletal disorders

Treatment with salmeterol can promote the onset of muscle cramps and arthralgia.

Metabolism and nutrition disorders

During salmeterol therapy, hypokalaemia (ie decreased blood potassium levels) and hyperglycaemia may occur.

Other side effects

Nausea and non-specific chest pain may also occur during treatment with salmeterol.

Overdose

If an excessive dose of salmeterol is taken, symptoms such as:

Headache;
Tremors;
Dizziness;
Tachycardia;
Increased systolic blood pressure;
Hypokalemia.

Treatment in case of overdosing is only a support.

In any case, if you suspect an overdose of salmeterol, you must contact your doctor immediately and contact the nearest hospital.

Action mechanism

Salmeterol is a selective β2-adrenergic receptor agonist. This type of receptors are present at the bronchial level and when stimulated they favor bronchodilation.

When salmeterol binds to the aforementioned receptors, it promotes the release of the calcium ion Ca ++ - which is involved in the bronchoconstriction mechanism - from bronchial smooth muscle cells, thus causing them to relax.

Method of use and dosage

Salmeterol is available as a pressurized suspension for inhalation and as a powder for inhalation which must be administered through the appropriate device.

Regardless of the type of pharmaceutical formulation used, the dose of salmeterol recommended in adults and children over four years of age is 50 micrograms of drug, to be taken twice a day.

Use of the drug in children under four years of age is not recommended.

For instructions on the use of inhalers, see the illustrative leaflet of the individual medicinal products.

Pregnancy and breastfeeding

As there are insufficient data on the safe use of salmeterol in pregnant women and breastfeeding mothers, as a precautionary measure, the use of the drug in this category of patients is not recommended.

In any case, pregnant women and mothers who are breast-feeding, before taking any type of medication, should always seek the advice of the doctor.