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What is fluticasone-salmeterol?

Fluticasone is a steroid. It prevents the release of substances in the body that cause inflammation. Salmeterol is a bronchodilator. It works by relaxing muscles in the airways to improve breathing.

Fluticasone and salmeterol inhalation is used to prevent asthma attacks. It is also used prevent flare-ups or worsening of chronic obstructive pulmonary disease (COPD) associated with chronic bronchitis and/or emphysema.

Fluticasone and salmeterol may also be used for other purposes not listed in this medication guide.

Precautions

Instructions

Side-effects

Interactions

Precautions

Do not use this medication if you are allergic to fluticasone (Flonase, Flovent), salmeterol (Serevent), or milk proteins, or if you are having an asthma attack or severe COPD symptoms.

Salmeterol has been shown to increase the risk of asthma-related death. It is critical that you use only the prescribed dose of this medicine and follow all patient instructions for safe use of the medication.

Before using fluticasone and salmeterol, tell your doctor if you are allergic to any medications, or if you have:

• a food or drug allergy;
• heart disease or high blood pressure;
• epilepsy or other seizure disorder;
• an infection of any kind;
• a weak immune system;
• diabetes;
• glaucoma;
• tuberculosis;
• osteoporosis;
• a thyroid disorder; or
• liver disease.

FDA pregnancy category C. This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment.

It is not known whether this medication passes into breast milk or if it could harm a nursing baby. Do not use fluticasone and salmeterol inhalation without telling your doctor if you are breast-feeding a baby.

Fluticasone and salmeterol inhalation can affect growth in children. Talk with your doctor if you think your child is not growing at a normal rate while using this medication.

Long-term use of steroids may lead to bone loss (osteoporosis), especially if you smoke, if you do not exercise, if you do not get enough vitamin D or calcium in your diet, or if you have a family history of osteoporosis.

Do not use a second form of salmeterol (such as Serevent) or use a similar inhaled bronchodilator such as formoterol (Foradil) unless your doctor has told you to.

Fluticasone and salmeterol can lower the blood cells that help your body fight infections. Avoid being near people who are sick or have infections. Call your doctor for preventive treatment if you are exposed to chicken pox or measles. These conditions can be serious or even fatal in people who are using steroid medicines.

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Instructions

Seek emergency medical attention if you think you have used too much of this medicine. Overdose symptoms may include angina or chest pain, fast or irregular heartbeats, seizures, tremor, weakness, headache, nausea, and vomiting.

Use the medication as soon as you remember. If it is almost time for the next dose, skip the missed dose and wait until your next regularly scheduled dose. Do not use extra medicine to make up the missed dose.

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Side-effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have any of these serious side effects:

• bronchospasm (wheezing, chest tightness, trouble breathing);
• fast or uneven heart beats, restless feeling, tremor;
• fever, chills, stabbing chest pain, cough with yellow or green mucus;
• blurred vision, eye pain, or seeing halos around lights;
• white patches or sores inside your mouth or on your lips; or
• worsening asthma symptoms.

Less serious side effects include:

• headache, dizziness;
• nausea, vomiting, diarrhea;
• dryness in your mouth, nose, or throat;
• stuffy nose, sinus pain, cough, sore throat; or
• hoarseness or deepened voice.

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect.

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Interactions

Before using fluticasone and salmeterol inhalation, tell your doctor if you are using any of the following drugs:

• amiodarone (Cordarone);
• a diuretic or "water pill";
• HIV medicines such as atazanavir (Reyataz), ritonavir (Norvir), indinavir (Crixivan), nelfinavir (Viracept), or saquinavir (Invirase);
• an MAO inhibitor such as isocarboxazid (Marplan), tranylcypromine (Parnate), phenelzine (Nardil), rasagiline (Azilect), or selegiline (Eldepryl, Emsam);
• an antidepressant such as amitriptyline (Elavil), desipramine (Norpramin), fluoxetine (Prozac), nefazodone, or imipramine (Tofranil);
• antibiotics such as ketoconazole (Nizoral), itraconazole (Sporanox), clarithromycin (Biaxin), or telithromycin (Ketek); or
• a beta-blocker such as atenolol (Tenormin), bisoprolol (Zebeta, Ziac), carvedilol (Coreg), metoprolol (Lopressor, Toprol), propranolol (Inderal, InnoPran), timolol (Blocadren), and others.

This list is not complete and there may be other drugs that can interact with fluticasone and salmeterol inhalation. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

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