Seretide (fluticasone, salmeterol) is used to help manage symptoms of asthma or chronic obstructive pulmonary disease (COPD), including emphysema and chronic bronchitis.

The medication is a maintenance treatment taken daily over the long term regardless of symptoms. It will not help alleviate a current attack, for which a rescue inhaler should be kept on-hand and used as-needed. The most common rescue treatment is albuterol (also spelled salbutamol).

Seretide is contains two 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.

Fluticasone is a steroid, so Seretide is an inhaled steroid. Patients who respond poorly to other inhaled steroids should use Seretide with caution until effects are known. Some individuals do not respond to inhaled steroids at all, in which case this medication is unlikely to provide benefit.

Salmeterol is somewhat controversial in asthmatics. LABAs can cause increased sensitivity and rapid, severe bronchial inflammation, which can lead to death. Some studies suggest this risk is negated when a LABA is used with a corticosteroid, but others suggest it is not. The odds of death from asthma are already very small and risk of death from a LABA is practically negligible, but it is still a risk.

Note that albuterol is not a LABA; while it is a beta2-adrenergic receptor agonist, it is short-acting.

In the vast majority of cases, patients do respond well to inhaled steroids and do not suffer any ill effects from LABA use; Seretide can provide a tremendous improvement in quality of life. The medication helps to:

• Reduce frequency of asthma/COPD attacks
• Reduce the severity of asthma/COPD attacks
• Reduce chronic coughing
• Reduce use of rescue inhalers
• Reduce instances of breathing-related hospital visits
• Allow patients to sleep uninterrupted by breathing difficulties
• Improve overall lung function
• Give patients greater independence and ability to function

There are two types of Seretide; the Seretide Accuhaler and the Seretide Evohaler. Both contain the same ingredients; the difference is dosage.

Each dose of Seretide Accuhaler delivers either:

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

And each dose of Seretide Evohaler delivers either:

• 25 mcg salmeterol/50 mcg fluticasone
• 25 mcg salmeterol/125 mcg fluticasone
• 25 mcg salmeterol/250 mcg fluticasone

Additionally the delivery method varies between the two:

• Seretide Accuhaler comes in a diskus containing powder. Inhaling the powder is largely dependent on the patient's ability to breathe it in.
• Seretide Evohaler comes in a metered-dose inhaler. It is delivered via an HFA propellant, so patients do not need to rely as much on lung power.

Ideally a doctor will best decide which dosage is best for a patient. When in doubt, start low---50/100 mcg or 25/50 mcg---dosage can always be increased if needed.

Regardless of dosage, use is typically:

• One inhalation twice per day, or
• Two inhalations twice per day.

One-inhalation doses are typically reserved for young children, but there are exceptions. The majority of patients take two inhalations twice per day. In the latter case, at least one minute should pass between inhalations, and twice-per-day administrations should be evenly spread apart; for example, morning and evening.

As a maintenance inhaler, Seretide should be taken every day regardless of the presence or absence of symptoms. Using Seretide sporadically will not produce good results.

It takes about a week for improvements to be noticeable for most patients; attacks and coughing become less frequent. However, it can take up to a month of daily use to reach maximum benefit. As mentioned above inhaled steroids don't always produce good results; if there is no difference after a month or more of use speak to a doctor about alternative options. There are maintenance inhalers that don't involve steroids.