seretrol-F 50/100 Inhaler

Combination inhaler of a corticosteroid and a long-acting bronchodilator (LABA) for regular maintenance treatment of:

• Asthma not controlled on an inhaled steroid alone
• COPD with frequent flare-ups (reduces exacerbations)
• Not for relief of sudden asthma attacks — use a reliever (salbutamol) for that

Asthma — adults and adolescents 12 years and over: 1 inhalation (dry powder 50/100, 50/250 or 50/500 mcg) twice daily, or 2 puffs of the metered-dose inhaler (25/50, 25/125, 25/250 mcg) twice daily — strength chosen by the doctor.

Children 4–11 years: 50/100 mcg (1 dry-powder inhalation) or 25/50 mcg (2 puffs) twice daily.

COPD (adults): 50/500 mcg dry powder (or 50/250 in some guidance) twice daily.

• Use every day, even when well; step down to the lowest dose that controls symptoms.
• Rinse mouth with water and spit after each use.
• Use a spacer with the metered-dose inhaler if coordination is difficult.

• Allergy to fluticasone, salmeterol or lactose/milk protein (dry-powder forms)
• Relief of acute bronchospasm (not suitable)

Common: hoarse voice, oral thrush, headache, throat irritation, muscle cramps, tremor, palpitations.

Less common: bruising, sinusitis, low potassium, high blood sugar, anxiety, sleep disturbance.

COPD: increased risk of pneumonia.

Long-term high doses: adrenal suppression, reduced growth in children, cataract, glaucoma, osteoporosis.

Rare: paradoxical bronchospasm, irregular heartbeat, allergic reactions.

• Do not stop suddenly; review regularly.
• Seek help if the reliever is needed more often or asthma worsens.
• Heart disease, irregular heartbeat, overactive thyroid, diabetes, tuberculosis: caution.
• Monitor growth in children on long-term treatment.

May be used in pregnancy and breastfeeding when needed — uncontrolled asthma is a greater risk to the baby.

• Ritonavir, cobicistat, ketoconazole, itraconazole, clarithromycin (raise steroid levels — Cushing's syndrome, adrenal suppression; avoid)
• Beta-blockers, including eye drops (reduce bronchodilator effect; may trigger bronchospasm)
• Diuretics, theophylline, steroids (low potassium)
• Other LABA-containing inhalers (do not combine)

Salmeterol: tremor, fast heartbeat, headache, low potassium. Repeated high steroid doses: adrenal suppression. Seek medical advice.

Store below 30°C, dry. Metered-dose inhaler: do not puncture or burn; protect from heat and frost.