Sermion (Salmeterol)

Sermion (Salmeterol) Uses, Dosage, Side Effects, Food Interaction and all others data.

Sermion (Salmeterol) stimulates intracellular adenyl cyclase, the enzyme that catalyses the conversion of ATP to cyclic-3',5'-adenosine monophosphate (cAMP) resulting in relaxation of bronchial smooth muscle and inhibition of release of mediators of immediate hypersensitivity from mast cells.

Sermion (Salmeterol) is a long acting beta-2 adrenergic receptor agonist that binds to both the active and exo sites of the beta-2 adrenergic receptor. Sermion (Salmeterol) has a longer duration of action than other beta-2 agonists like salbutamol. Patients should be counselled regarding the risks of long acting beta agonist (LABA) monotherapy, hypokalemia, hypoglycemia, and not to take this drug with another LABA.

Trade Name Sermion (Salmeterol)
Availability Prescription only
Generic Salmeterol
Salmeterol Other Names Salmaterol, Salmeterol, Salmeterolum
Related Drugs Dupixent, Xolair, ProAir Digihaler, albuterol, montelukast, Symbicort, Singulair, ProAir HFA, Breo Ellipta, Ventolin
Type
Formula C25H37NO4
Weight Average: 415.5656
Monoisotopic: 415.272258677
Protein binding

Salmeterol is 96% protein bound in plasma to albumin and alpha-1-acid glycoprotein.

Groups Approved
Therapeutic Class Long-acting selective β2-adrenoceptor stimulants
Manufacturer
Available Country Tunisia
Last Updated: September 19, 2023 at 7:00 am
Sermion (Salmeterol)
Sermion (Salmeterol)

Uses

Inhaled Sermion (Salmeterol) exerts a significant bronchodilating effect within 10 to 20 minutes of single-dose administration with asthma and this effect lasts for up to 12 hours or more. Sermion (Salmeterol) has a beneficial effect on airway mucociliary clearance that will reduce the incidence of respiratory tract infections.

Sermion (Salmeterol) produces a significant protective effect against Exercise Induced Asthma (EIA) for up to 9 to 12 hours in both adolescents and adults.

Sermion (Salmeterol) improves the overnight PEFR (Peak Expiratory Flow Rate) and controls the symptoms of the patients with nocturnal asthma. The use of Sermion (Salmeterol) avoids exposure of children to theophylline or high-dose corticosteroid, with their attendants risks.

Addition of Sermion (Salmeterol) to inhaled corticosteroid therapy is significantly more effective in terms of an improvement in lung function, symptom control and a reduction in the use of rescue bronchodilator therapy (use of short acting beta2-agonist).

Addition of Sermion (Salmeterol) to inhaled corticosteroid therapy also significantly reduces the use of inhaled corticosteroids

Sermion (Salmeterol) is also used to associated treatment for these conditions: Asthma, Chronic Obstructive Pulmonary Disease (COPD), Exercise-Induced Bronchospasm

How Sermion (Salmeterol) works

Beta-2 adrenoceptor stimulation causes relaxation of bronchial smooth muscle, bronchodilation, and increased airflow.

Sermion (Salmeterol) is hypothesized to bind to 2 sites on the beta-2 adrenoceptor. The saligenin moiety binds to the active site of the beta-2 adrenoceptor. The hydrophilic tail of salmeterol binds to leucine residues in the exo-site of the beta-2 adrenoceptor almost irreversibly, allowing salmeterol to persist in the active site, which is responsible for it's long duration of action.

Another hypothesis is that the lipophilic drug diffuses into lipid bilayer of smooth muscle cells and provides a depot of drug to the cells over a longer period of time.

Dosage

Sermion (Salmeterol) dosage

Inhalation/Respiratory-

Chronic asthma:

  • Adult: As metered dose aerosol or dry powder inhaler: 50 mcg bid, or up to 100 mcg bid if necessary, in asthma patients with more severe airways obstruction.
  • Child: 4-12 yr 50 mcg bid.

Prophylaxis of exercise-induced asthma:

  • Adult: As metered dose aerosol or dry powd inhaler: 50 mcg at least 30 min prior to exercise.
  • Child: ≥4 yr Same as adult dose.

Chronic obstructive pulmonary disease:

  • Adult: As metered dose aerosol or dry powder inhaler: 50 mcg bid.

Side Effects

Dose related tremor, subjective palpitations and headaches are usually mild and transient. Skin reactions, muscle cramps, non-specific chest pain, local irritation and arthralgia have been reported.

Toxicity

Patients experiencing an overdose have presented with metabolic acidosis, hyperlactatemia, anxiety, palpitations, chest pain, sinus tachycardia, ST depression, hypokalemia, hypophosphatemia. Though patients may also present with seizures, angina, hypertension or hypotension, arrhythmia, headache, tremor, muscle cramps, dry mouth, nausea, dizziness, fatigue, malaise, insomnia, and hyperglycemia. Patients should be given symptomatic and supportive treatment which may include intravenous fluids, potassium supplementation, a cardioselective beta-blocker, and cardiac monitoring.

Data regarding the LD50 of salmeterol is not readily available.

Precaution

Patient with CV disease, CNS disorders, DM, hyperthyroidism, hypokalaemia, seizure disorders, ketoacidosis. Not intended for the relief of acute bronchospasm. Hepatic impairment. Pregnancy and lactation.

Interaction

As with all the other beta2-agonists there may be interaction with betablocking agents at the receptor site when given concomitantly.

Monoamino Oxidase Inhibitors and Tricyclic Antidepressants : These agent should be used with caution because Sermion (Salmeterol) may be potentiated by these agents.

Food Interaction

No interactions found.

Sermion (Salmeterol) Hypertension interaction

[Moderate] Adrenergic bronchodilators can stimulate cardiovascular beta- 1 and beta- 2 receptors, resulting in adverse effects such as tachycardia, palpitation, peripheral vasodilation, blood pressure changes, and ECG changes (e.g., flattening of the T wave; prolongation of the QT interval; ST segment depression).

Direct stimulation of cardiac tissues is mediated by beta- 1 receptors and thus less likely to occur with beta-2-selective agents such as albuterol.

However, beta-2-selectivity is not absolute and can be lost with larger doses.

High dosages of these agents have been associated with precipitation or aggravation of angina, myocardial ischemia, and cardiac arrhythmias.

Therapy with adrenergic bronchodilators should be administered cautiously in patients with sensitivity to sympathomimetic amines, hyperthyroidism, and

The recommended dosages should not be exceeded.

Sermion (Salmeterol) Disease Interaction

Moderate: cardiovascular, diabetes, hypokalemia, seizures, hepatic dysfunction

Volume of Distribution

In asthmatic patients, the volume of distribution of the central compartment is 177L and the volume of distribution of the peripheral compartment is 3160L.

Elimination Route

In asthmatic patients, a 50µg dose of inhaled salmeterol powder reaches a Cmax of 47.897pg/mL, with a Tmax of 0.240h, and an AUC of 156.041pg/mL/h.

Half Life

The half life of salmeterol is 5.5h.

Clearance

The average clearance of salmeterol in a group of asthmatic patients was 392L/h. Further data regarding the clearance of salmeterol is not readily available.

Elimination Route

Sermion (Salmeterol) is 57.4% eliminated in the feces and 23% in the urine. Less than 5% of a dose is eliminated in the urine as unchanged salmeterol.

Pregnancy & Breastfeeding use

Pregnancy Category C. Either studies in animals have revealed adverse effects on the foetus (teratogenic or embryocidal or other) and there are no controlled studies in women or studies in women and animals are not available. Drugs should be given only if the potential benefit justifies the potential risk to the foetus.

Contraindication

Monotherapy in the treatment of asthma. Treatment of status asthmaticus, other acute episodes of asthma or COPD.

Special Warning

Hepatic Impairment: Because Sermion (Salmeterol) is extensively metabolised by the liver, patients with hepatic impairment receiving the drug should be closely monitored.

Acute Overdose

Symptoms: Dizziness, HTN or hypotension, tremor, headache, tachycardia, hypokalaemia, seizures, angina, arrhythmias, nervousness, muscle cramps, dry mouth, palpitations, nausea, fatigue, malaise, insomnia, hyperglycaemia, metabolic acidosis.

Management: Symptomatic and supportive treatment. β-blockers may be considered but should be used with caution.

Storage Condition

Store between 20-25° C. Protect from heat or sunlight.

Innovators Monograph

You find simplified version here Sermion (Salmeterol)

Sermion (Salmeterol) contains Salmeterol see full prescribing information from innovator Sermion (Salmeterol) Monograph, Sermion (Salmeterol) MSDS, Sermion (Salmeterol) FDA label

FAQ

What is Sermion (Salmeterol) used for?

Sermion (Salmeterol) is used to control wheezing, shortness of breath, coughing, and chest tightness in people with chronic obstructive pulmonary disease.

How safe is Sermion (Salmeterol)?

Sermion (Salmeterol) may increase the risk of asthma-related death. Use only the prescribed dose of this medication, and do not use it for longer than your doctor recommends. Follow all patient instructions for safe use. Talk with your doctor about your individual risks and benefits of using salmeterol inhalation.

What are the common side effects of Sermion (Salmeterol)?

Sermion (Salmeterol) may common side effects are include: 

  • shaking of a part of your body that you cannot control
  • headache
  • nervousness
  • dizziness
  • cough
  • stuffed nose
  • runny nose
  • ear pain
  • muscle pain, stiffness, or cramps
  • joint pain
  • sore, irritated throat
  • flu-like symptoms
  • nausea
  • heartburn
  • tooth pain
  • dry mouth
  • sores or white patches in the mouth
  • red or irritated eyes
  • difficulty falling asleep or staying asleep
  • burning or tingling of the hands or feet

Is Sermion (Salmeterol) safe during pregnancy?

Sermion (Salmeterol) has been considered a medication of choice if long-acting beta agonist treatment is needed during pregnancy. If a woman's asthma was well-controlled with Sermion (Salmeterol) before pregnancy, it may be recommended to continue using it during pregnancy.

Is Sermion (Salmeterol) safe during breastfeeding?

Using a Sermion (Salmeterol) inhaler is not thought to cause high enough levels in the mother's bloodstream to pass into breast milk in large amounts. Using inhaled bronchodilators is usually thought to be compatible with breastfeeding.

Can I drink alcohol with Sermion (Salmeterol)?

Yes, you can drink alcohol with Sermion (Salmeterol).

Can I drive after taking Sermion (Salmeterol) ?

Monitor serum potassium level while taking Sermion (Salmeterol). It may cause dizziness, do not drive a car or operate machinery while taking Sermion (Salmeterol).

When should Sermion (Salmeterol) be taken?

Sermion (Salmeterol) is usually used twice a day, in the morning and evening, about 12 hours apart. Use Sermion (Salmeterol) at around the same times every day.

How long does it take for Sermion (Salmeterol) to work?

Sermion (Salmeterol) is called a long-acting bronchodilator. Its effects are usually felt within 20 minutes and last for around 12 hours.

Is Sermion (Salmeterol) a reliever?

Sermion (Salmeterol) is called a long-acting bronchodilator. It is usually used with both a fast-acting reliever and preventer medicine.

Is Sermion (Salmeterol) fast acting?

Sermion (Salmeterol) is a partial agonist, has a relatively slow onset of action (10 to 30 minutes)

Does Sermion (Salmeterol) increase blood pressure?

Sermion (Salmeterol) can increase heart rate, blood pressure, and cause chest pain and excitement, especially if used in higher doses than recommended or used in those with coronary heart disease or high blood pressure.

Can Sermion (Salmeterol) cause anxiety?

Possible side effects include nervousness, sweating, fast heartbeat, and anxiety.

Can I overdose on Sermion (Salmeterol)?

If this medication is administered by a healthcare provider in a medical setting, it is unlikely that an overdose will occur. However, if overdose is suspected, seek emergency medical attention.

Does Sermion (Salmeterol) cause thrush?

Sermion (Salmeterol) may cause a fungus infection of the mouth or throat (thrush).

What happens if I miss a dose?

Skip the missed dose and continue your regular dosing schedule. Do not inhale a double dose to make up for a missed one.

Is Sermion (Salmeterol) inhaler a steroid?

Sermion (Salmeterol) a combination of a steroid plus a long-acting bronchodilator. fluticasone furoate(Trelegy Ellipta) a combination of a steroid, an anticholinergic, and a long-acting bronchodilator drug.

Can I stop using Sermion (Salmeterol)?

Do not stop using Sermion (Salmeterol) without talking to your doctor. If you suddenly stop using Sermion (Salmeterol), your symptoms may worsen. Before you use the Sermion (Salmeterol) inhaler the first time, ask your doctor, pharmacist, or respiratory therapist to show you how to use it.

How do you stop taking Sermion (Salmeterol)?

Do not stop using Sermion (Salmeterol) inhalation without first talking to your doctor. Your asthma symptoms may get worse after you stop using the medication. If you also use a steroid medication, you should not stop using it suddenly. Follow your doctor's instructions about tapering your dose.

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