A fixed-dose combination inhaler containing a long-acting beta2-adrenergic agonist (LABA), Salmeterol, and an inhaled corticosteroid (ICS), Fluticasone Propionate. It is a maintenance therapy for asthma and COPD, providing bronchodilation and anti-inflammatory action. It is not indicated for the relief of acute bronchospasm.
Adult: Asthma: 1 inhalation (50/500 mcg) twice daily (morning and evening, approximately 12 hours apart). COPD: 1 inhalation (50/500 mcg) twice daily. Maximum recommended dose is 1 inhalation twice daily.
Note: For oral inhalation only using a pressurized metered-dose inhaler (pMDI). Shake well before each use. Breathe out fully, place mouthpiece between lips, inhale deeply and slowly while pressing the canister, hold breath for about 10 seconds, then breathe out slowly. Rinse mouth with water and spit out after each dose to prevent oral candidiasis and systemic absorption. Do not use a spacer with all pMDI devices; check specific brand instructions.
Salmeterol is a selective LABA that produces bronchodilation by relaxing bronchial smooth muscle. Fluticasone Propionate is a potent ICS that controls inflammation by inhibiting multiple inflammatory cells and mediators. The combination provides complementary actions: prevention of bronchoconstriction and reduction of airway inflammation.
Pregnancy: Category C (US FDA). Use only if potential benefit justifies potential risk to the fetus. Systemic corticosteroids may cause fetal harm. Well-controlled asthma is important during pregnancy. Use the lowest effective dose.
Driving: Unlikely to affect ability, but patients should be cautious if they experience dizziness, tremor, or palpitations.
| Ketoconazole, Itraconazole, Ritonavir, other potent CYP3A4 inhibitors | Markedly increase plasma levels of Fluticasone and Salmeterol, increasing risk of systemic corticosteroid and cardiovascular side effects (Cushing's syndrome, adrenal suppression, QT prolongation). | Major |
| Beta-blockers (non-selective like Propranolol) | Antagonize the effect of Salmeterol, may cause severe bronchospasm in asthmatic patients. | Major |
| Diuretics (loop and thiazide), corticosteroids, xanthine derivatives | May potentiate hypokalemia caused by beta2-agonists. | Moderate |
| Monoamine Oxidase Inhibitors (MAOIs) and Tricyclic Antidepressants (TCAs) | May potentiate the cardiovascular effects of Salmeterol (tachycardia, QT prolongation). | Moderate |
| Other Beta2-agonists (oral/inhaled) | Additive sympathomimetic effects, increased risk of adverse cardiovascular events. | Moderate |
| QT-prolonging drugs (e.g., Macrolides, antipsychotics) | Increased risk of ventricular arrhythmias with Salmeterol. | Moderate |
Same composition (Salmeterol (50mcg) + Fluticasone Propionate (500mcg)), different brands: