Seretide Evohaler (fluticasone, salmeterol) is a maintenance inhaler used to reduce the frequency and severity of breathing issues in patients with asthma or chronic obstructive pulmonary disease (COPD). It is not a cure, and not a rescue inhaler; a rescue inhaler---such as albuterol (also spelled salbutamol) should be kept on-hand and be used as-needed.

Patients age 4 and up can use Seretide Evohaler, though dosage is lower for young children.

What this Product Is

This product is easily confused with Seretide Accuhaler. Though similar, these two products are different.

Both Seretide Evohaler and Accuhaler contain the same active ingredients:

• Fluticasone is a corticosteroid that inhibits immune response to allergens and irritants, thus reducing the inflammation that leads to restricted airways.
• Salmeterol is a long-acting beta2-adrenergic receptor agonist (LABA) bronchodilator that relaxes and widens the airways, reducing symptoms of an attack.

Where they differ is dosage and method of administration. Seretide Evohaler is a metered-dose inhaler; its contents are propelled by an HFA propellant like all inhalers since CFC propellants were banned. It resembles most other inhalers in appearance and function.

Seretide Accuhaler is actually a diskus containing powder; when actuated, patients must use the power of their lungs to inhale it.

Each dose of Seretide Evohaler delivers either:

• 25 mcg salmeterol/50 mcg fluticasone, or
• 25 mcg salmeterol/125 mcg fluticasone, or
• 25 mcg salmeterol/250 mcg fluticasone.

Seretide Accuhaler dosage is higher:

• 50 mcg salmeterol/100 mcg fluticasone
• 50 mcg salmeterol/250 mcg fluticasone
• 50 mcg salmeterol/500 mcg fluticasone

Ideally a doctor will determine which dosage is best. If using Seretide Evohaler for the first time and lacking doctor instructions, start with the lowest dose (25/50 mcg). Dosage can always be increased if needed.

Taking Seretide Evohaler

As Seretide Evohaler is a maintenance inhaler it should be taken every day regardless of symptoms, or the lack of them. As a general rule (there are exceptions) dosage and administration can be split between children age 4 to 11 and patients age 12 and up.

In patients age 12 and up:

• Administer 2 inhalations twice per day, for a total of 4 inhalations.
• Exhale fully before administering an inhalation; breathe in fully and deeply with each inhalation.
• Wait at least one minute before administering the second inhalation.

And patients age 4 to 11:

• Administer 1 inhalation twice per day, for a total of 2 inhalations.
• Exhale fully before administering an inhalation; breathe in fully and deeply with each inhalation.
• Wait at least one minute before administering the second inhalation.

In both cases, since Seretide Evohaler does contain a steroid, the mouth should be rinsed out after each treatment to prevent oral thrush or other mild infections.

Patients should not use more than 4 total daily inhalations. If the medication is not providing sufficient benefit, increasing dosage will be far more beneficial than increasing number of inhalations.

Some patients notice improvements after the first dose, but most will need to wait around one week before significant improvement is seen. It may take up to a month for maximum benefit to be reached.

For unclear reasons some individuals simply don't respond to inhaled steroids. If the condition does not improve after one month of treatment, or worsens at any point in treatment, speak with a doctor about alternative options. There are non-steroidal inhalers available, such as tiotropium bromide.

Side Effects

Most side effects of Seretide Evohaler are mild, including headache, dizziness, nausea, diarrhea, dry mouth or throat, stuffy nose, sinus pain and voice change. These are not cause for concern unless severe enough to be disruptive, and often stop occurring as the body adjusts to treatment.

A few patients experience more severe side effects which warrant medical attention:

• Worsening wheezing, chest tightness, or other difficulty breathing.
• White patches or sores on mouth or lips (can usually be prevented by rinsing the mouth after each use).
• Rapid or irregular heartbeat.
• Stabbing chest pains.
• Cough with yellow or green mucus.
• Eye pain or blurred vision.

The effects of Seretide Evohaler on unborn or nursing babies is unknown; use of this product while pregnant or nursing should be determined by the patient and doctor weighing benefits versus potential risks.