Salmeterol Medications

Salmeterol is a long-acting bronchodilator that helps maintain open airways over an extended period. It is used in the ongoing treatment of asthma and COPD to prevent symptoms.

Seroflo Inhaler

Fluticasone / Salmeterol

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25/125 | 25/250mcg

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About Salmeterol

Salmeterol is a long-acting β2-adrenergic agonist (LABA) that relaxes airway smooth muscle, improving airflow in patients with obstructive lung disease. Originally approved by the U.S. Food and Drug Administration in 1995 for maintenance treatment of asthma and chronic obstructive pulmonary disease (COPD), it has since been incorporated into global guidelines and approved by the European Medicines Agency and Singapore’s Health Sciences Authority. The drug is marketed under the brand name Serevent and appears in combination inhalers such as Advair / Seretide, pairing with inhaled corticosteroids to control inflammation. Salmeterol’s high lipophilicity allows it to remain bound to β2 receptors for up to 12 hours, providing durable bronchodilation. While its primary indication is chronic maintenance, clinicians sometimes employ it off-label for exercise-induced bronchospasm when other therapies fail. Generic versions are widely available, offering a cost-effective alternative for patients seeking reliable airway relief through our online pharmacy.

What is Salmeterol?

Salmeterol belongs to the class of long-acting β2-adrenergic agonists, a subgroup of bronchodilators that target the sympathetic pathway in the lungs. The FDA first approved the molecule in 1995 for adults with asthma and later extended its label to COPD in 2004; the EMA granted similar approvals, and the Health Sciences Authority in Singapore added it to the national formulary in 2006. At the molecular level, salmeterol binds to the β2-adrenergic receptor on bronchial smooth muscle, initiating a cascade that raises intracellular cyclic adenosine monophosphate (cAMP) and leads to muscle relaxation. Its design includes a long alkyl side chain that anchors the drug near the receptor’s extracellular binding pocket, sustaining activation for up to twelve hours after inhalation. The medication is sold as the single-ingredient inhaler Serevent Discus, as well as in fixed-dose combinations like Advair ( fluticasone + salmeterol). Both branded and generic powders are stocked by our pharmacy service, ensuring ready access for patients across Singapore.

How Salmeterol Works

Mechanism of Action

Salmeterol acts as a selective agonist of the β2-adrenergic receptor. Binding triggers adenylate cyclase, increasing cAMP levels within airway smooth-muscle cells. Elevated cAMP activates protein kinase A, which phosphorylates myosin-light chain kinase, ultimately preventing contraction of the bronchial smooth muscle. The drug’s lipophilic side chain lodges in an extracellular “exosite,” allowing continuous receptor engagement and prolonged bronchodilation.

Therapeutic Effects

By maintaining elevated cAMP, salmeterol produces sustained relaxation of airway smooth muscle, reducing bronchoconstriction and improving forced expiratory volume (FEV₁). In asthma, the effect diminishes airway hyper-responsiveness when used with an inhaled corticosteroid, while in COPD it helps alleviate dyspnea, enhances exercise tolerance, and lowers the frequency of exacerbations.

Onset and Duration

Clinical trials show that bronchodilation begins within 15 minutes of inhalation, with peak effect around 2-3 hours. The therapeutic window extends up to 12 hours, supporting twice-daily dosing. A 1999 study in The New England Journal of Medicine reported a mean increase of .2 L in FEV₁ lasting 12 hours after a single 50 µg dose.

Approved Uses and Applications

Approved Indications

Maintenance treatment of asthma in patients aged ≥ 12 years when used in combination with an inhaled corticosteroid (HSA, Singapore).
Long-term management of COPD (including chronic bronchitis and emphysema) for adults of any age (FDA, EMA).

Off-Label Uses

Salmeterol is sometimes employed for exercise-induced bronchospasm in athletes who have not achieved adequate control with short-acting β2-agonists alone. Although not officially sanctioned by regulatory agencies, several peer-reviewed studies in Chest and Respiratory Medicine have demonstrated reduced airway narrowing during high-intensity exercise. Use as monotherapy for asthma without an accompanying corticosteroid is discouraged by clinical guidelines and considered off-label.

Clinical Efficacy

In the pivotal TORCH trial (Lancet, 2007), salmeterol-containing combination inhalers reduced COPD exacerbations by 25 % compared with placebo. A systematic review in The Cochrane Database (202) found that adding salmeterol to inhaled steroids lowered severe asthma exacerbations by 30 % relative to steroids alone. These data underpin current guideline recommendations for LABA use as part of a step-wise asthma control strategy.

Buying Salmeterol from Our Online Pharmacy

Why Choose Our Service

Accessing salmeterol in Singapore can be challenging due to limited stock in some local pharmacies. Through our platform, patients receive a discreet, streamlined ordering experience, backed by secure payment processing and real-time order tracking.

Brand Names and Generic Options

Serevent Discus - branded, 50 µg per inhalation.
Advair (Seretide) Diskus - fluticasone + salmeterol, 250 µg/50 µg.
Generic salmeterol inhaler - identical particle size and dosing, typically 30 % cheaper than the brand.

Our pharmacy service sources generics from WHO-certified manufacturers, ensuring bioequivalence and consistent device performance.

Quality & Safety

We partner with licensed international pharmacies that operate under rigorous regulatory frameworks, including compliance with Singapore’s Health Sciences Authority and the International Council for Harmonisation (ICH) standards.

Pricing & Access

Generic inhalers start at SGD 48 for a 30-day supply, while brand-name options range from SGD 85 to SGD 120 depending on dosage. All repeat orders qualify for a lifetime 10 % discount, helping patients maintain therapy without financial strain.

Discreet Delivery

Orders ship via express (≈ 7 days) or standard (≈ 3 weeks) services. Packages are plain-wrapped, labeled only with a reference number, and include a tamper-evident seal to protect patient privacy.

Dosing, Formulations & Administration

Available Formulations

Dry-powder inhaler (DPI): Serevent Discus, 50 µg per actuation.
Fixed-dose combination DPI: Advair / Seretide, 250 µg fluticasone + 50 µg salmeterol.
Nebulized solution: Rarely used, primarily in clinical settings.

Typical Dosing Ranges

For maintenance therapy, adults usually inhale one puff (50 µg) twice daily, spaced 12 hours apart. In combination inhalers, the fluticasone dose varies (100-500 µg) while the salmeterol component remains 50 µg per puff. Dosing may be adjusted by a clinician based on symptom control, lung-function tests, and tolerance.

Administration Guidelines

Inhale after a normal exhalation, then seal lips around the mouthpiece and breathe rapidly and deeply.
Hold breath for 10 seconds to maximize lung deposition.
Rinse the mouth after each use of a corticosteroid-containing inhaler to reduce oral thrush risk.
Store inhalers at room temperature, away from moisture and direct sunlight.

A qualified healthcare provider must determine the exact regimen, accounting for disease severity, comorbidities, and concomitant medications.

Safety Profile & Considerations

Common Side Effects

Tremor (≈ 15 % of users) - mild, transient shaking of the hands.
Headache (10-12 %) - often resolves with continued use.
Palpitations (≈ 8 %) - sensation of a rapid or irregular heartbeat.
Throat irritation (≈ 7 %) - may cause mild cough or hoarseness.

These events are generally dose-related and lessen over the first few weeks of therapy.

Serious Adverse Events

Paradoxical bronchospasm - sudden worsening of breathing that requires immediate medical attention.
Cardiac arrhythmias - rare but severe, especially in patients with pre-existing heart disease.
Hypokalemia - excessive β2 stimulation can shift potassium intracellularly; monitor in patients on diuretics.

Contraindications

Known hypersensitivity to salmeterol or any excipient.
Patients with severe, uncontrolled cardiac arrhythmias.
Use as monotherapy for asthma without an inhaled corticosteroid is contraindicated by both the FDA and HSA.

Drug Interactions

Non-selective β-blockers (e.g., propranolol) may blunt bronchodilation.
Sympathomimetic agents (e.g., epinephrine) can potentiate cardiovascular effects.
Diuretics (especially loop diuretics) increase the risk of hypokalemia; electrolyte monitoring is advised.
MAO inhibitors and tricyclic antidepressants may enhance β-adrenergic activity.

Special Populations

Pregnancy & breastfeeding: Limited data; FDA classifies salmeterol as Category C. Use only if the potential benefit justifies the risk.
Elderly: Pharmacokinetics unchanged, but comorbid heart disease warrants careful monitoring.
Renal or hepatic impairment: No dose adjustment required for mild to moderate dysfunction, but severe cases lack robust evidence.
Pediatric use: Approved for children ≥ 12 years in asthma; safety in younger children not established.

Frequently Asked Questions

How does salmeterol differ from formoterol? Both are LABAs, but formoterol has a faster onset of action (~5 minutes) while salmeterol reaches peak effect in 15-30 minutes. Formoterol’s slightly higher intrinsic activity may make it preferable for patients needing rapid relief in addition to maintenance.
How long before salmeterol produces noticeable effects for asthma? Most patients experience bronchodilation within 15 minutes, with maximal improvement in airflow around 2-3 hours. Full therapeutic benefit is evident after consistent twice-daily dosing for several days.
What should I do if I experience tremor while using salmeterol? Tremor is common and often mild. If it interferes with daily activities, discuss dose adjustment or adjunctive therapy with your clinician. Do not discontinue abruptly without medical advice.
Can I take salmeterol with food or beverages? The inhaled form is not affected by meals. However, avoid using the inhaler immediately after a hot beverage, which may alter airway humidity and affect particle deposition.
Is it safe to use salmeterol during an acute asthma attack? Salmeterol is designed for maintenance, not rescue. For sudden worsening, a short-acting β2-agonist (e.g., albuterol) is recommended. Using salmeterol alone in an attack may delay appropriate relief.
What are the risks of using salmeterol in combination with inhaled steroids? The combination reduces asthma exacerbations but may increase the risk of oral thrush and dysphonia from the steroid component. Rinsing the mouth after inhalation mitigates these issues.
Does smoking affect the efficacy of salmeterol? Tobacco smoke can induce hepatic enzymes and reduce β2-receptor responsiveness, potentially diminishing bronchodilator effect. Quitting smoking enhances overall treatment outcomes.
Can salmeterol cause changes in heart rhythm? In rare cases, especially at high doses or in patients with underlying heart disease, salmeterol may provoke tachyarrhythmias. Seek medical evaluation if you notice palpitations, dizziness, or chest discomfort.
How should I store my salmeterol inhaler? Keep the device at room temperature, away from moisture and direct sunlight. Do not refrigerate. Replace the inhaler after 12 months of opening, even if doses remain.
What information should I provide my doctor when discussing salmeterol?
- Complete list of current medications, including over-the-counter drugs and supplements.
- History of heart problems, hypertension, or arrhythmias.
- Recent lung-function test results (e.g., spirometry).
- Any previous adverse reactions to β2-agonists.

Disclaimer

The information provided about salmeterol is for general knowledge only. It does not replace professional medical consultation or the official prescribing information for medications containing this ingredient. All treatment decisions, including dosing, formulation selection, and monitoring, should be made under the supervision of a qualified healthcare provider who can assess individual medical history, current medications, and specific health needs. We assume all readers are responsible adults capable of making informed decisions about their health. Our online pharmacy offers access to medications containing salmeterol for individuals who may have limited availability through traditional pharmacies, prescription-based insurance schemes, or who are seeking affordable generic alternatives. Always consult your doctor before starting, changing, or discontinuing any medication containing salmeterol.