Salmeterol: Drug Information
1. Drug Name
Generic Name
Salmeterol
Brand Name(s)
- Pakistan: BrandX
- India: BrandY
- US: BrandZ
- UK: BrandW
2. Pharmacological Class
Class
Long-acting beta-adrenergic agonist (LABA)
Subclass
Bronchodilator
3. Mechanism of Action
Salmeterol is a selective, long-acting beta-2 adrenergic receptor agonist. It acts by relaxing the smooth muscles of the airways, which opens up the air passages and makes breathing easier. It has a duration of action of at least 12 hours.
4. Indications
Primary Indications
- Asthma, maintenance treatment
- Chronic obstructive pulmonary disease (COPD), including chronic bronchitis and emphysema
Off-label Uses
- Exercise-induced bronchoconstriction (EIB)
- Prevention of nocturnal asthma symptoms
5. Dosage and Administration
Standard Dosage
The dosage of salmeterol varies depending on the condition being treated and the age of the patient. Consult with a healthcare provider for specific dosing.
Route of Administration
Salmeterol is administered via oral inhalation as a metered-dose inhaler (MDI).
Special Populations
- Pediatric: Safety and efficacy not established in children under 4 years old.
- Geriatric: No dosage adjustment necessary based on age alone.
6. Pharmacokinetics
Absorption
Salmeterol is well absorbed following inhalation administration.
Distribution
It is extensively bound to plasma proteins.
Metabolism
Metabolized primarily by the liver via cytochrome P450 enzymes, including CYP3A4.
Excretion
Excreted mainly via feces.
Half-life
The elimination half-life is approximately 5.5 hours.
7. Contraindications
Salmeterol is contraindicated in patients with hypersensitivity to salmeterol or any components of the formulation.
8. Warnings and Precautions
- Increased risk of asthma-related death; use with caution.
- Do not use for relief of acute bronchospasm.
- Use with caution in patients with cardiovascular disorders.
9. Side Effects
Common Side Effects
- Headache
- Throat irritation
- Tremor
Serious Side Effects
- Cardiovascular effects such as palpitations and tachycardia
- Hypokalemia
- Hypersensitivity reactions
10. Drug Interactions
Major Interactions
- Beta-blockers
- MAO inhibitors
Moderate Interactions
- Diuretics
- Tricyclic antidepressants
Minor Interactions
- Antihistamines
- Antifungals
11. Pregnancy and Lactation
Pregnancy Category
Category C - Risk cannot be ruled out.
Breastfeeding Considerations
It is not known whether salmeterol is excreted in human milk; use with caution.
12. Patient Counseling Information
- Use salmeterol exactly as prescribed; do not increase your dose or use it more frequently than prescribed.
- If you have any questions about how to use your inhaler, ask your healthcare provider or pharmacist.
- Seek medical attention if your breathing problems worsen quickly or if you use your rescue inhaler more often than usual.