Classifications: beta2-adrenergic agonist; bronchodilator; respiratory smooth muscle relaxant; Therapeutic: bronchodilator; smooth muscle relaxant
Pregnancy Category: C
25 mcg aerosol; 50 mcg powder diskus for inhalation
Long-acting beta2-adrenoreceptor agonist and an analog of albuterol. Stimulation of beta2-adrenoreceptors relaxes bronchospasm and increases ciliary motility, thus facilitating expectoration. Inhibits the release
of mediators (i.e., histamine) from mast cells, macrophages, and eosinophils.
Relaxes bronchospasm and increases ciliary motility, thus facilitating expectoration of pulmonary secretions. Salmeterol
also decreases airway reaction to allergens.
Maintenance therapy for asthma or bronchospasm. Prevention of exercise-induced bronchospasm. Do not use to treat acute bronchospasm.
Hypersensitivity to salmeterol; other long-acting beta2-adrenergic agonists; primary treatment of status asthmaticus; acute bronchospasm; MAOI therapy; pregnancy (category C);
safety and efficacy in children <4 y not established.
Cardiovascular disorders, cardiac arrhythmias, hypertension; history of seizures or thyrotoxicosis; liver and renal impairment,
older adults, diabetes mellitus, sensitivity to other beta-adrenergic agonists; women in labor; lactation.
Route & Dosage
|Asthma or Bronchospasm
Adult/Child (≥4 y): Inhalation 2 inhalations of aerosol (42 mcg) or 1 powder diskus (50 mcg) b.i.d. approximately 12 h apart
Prevention of Exercise-Induced Bronchospasm
Adult/Child (≥4 y): Inhaled 2 inhalations of aerosol (42 mcg) or 1 powder diskus (50 mcg) 3060 min before exercise
- Do not use to relieve symptoms of acute asthma.
- Shake canister well before using; close lips tightly around the mouthpiece, and patient inhales deeply during each actuation.
- Store at room temperature, 15°30° C (59°86° F).
Adverse Effects (≥1%)CNS:
Dizziness, headache, tremor. CV:
Palpitations, sinus tachycardia. Respiratory: Respiratory arrest
Rash. Body as a Whole:
Effects antagonized by beta blockers
1020 min. Peak:
Effect 2 h. Duration:
Up to 12 h. Distribution:
9495% protein bound. Metabolism:
Dissociates in solution; salmeterol base and xinafoate salt are metabolized, absorbed, distributed, and excreted independently;
salmeterol is extensively metabolized by hydroxylation. Elimination:
Primarily in feces. Half-Life:
Assessment & Drug Effects
- Withhold drug and notify physician immediately if bronchospasms occur following its use.
- Monitor cardiovascular status; report tachycardia.
- Monitor liver enzymes periodically with long-term therapy.
Patient & Family Education
- Notify physician immediately of worsening asthma or failure to respond to the usual dose of salmeterol.
- Do not use an additional dose prior to exercise if taking twice-daily doses of salmeterol.
- Take the preexercise dose 3060 min before exercise and wait 12 h before an additional dose.