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The eMC  

Last Updated 27 Jul 2015

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Seretide 250 Evohaler

Seretide (Serr-et-tide) is a medicine which is used in asthma and chronic obstructive pulmonary disease. Seretide contains fluticasone/salmeterol. It is supplied by Allen & Hanburys.

The information in this Medicine Guide for Seretide varies according to the condition being treated and the particular preparation used.

There are 6 preparations of Seretide available. If Seretide 250 Evohaler is not the preparation you are looking for, please select from the drop down list below.

Select your preparation (type) of Seretide

Seretide 250 Evohaler

Information specific to Seretide 250 Evohaler when used in asthma

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Your medicine

Seretide contains two medicines – fluticasone and salmeterol. Fluticasone belongs to a class of medicines called steroids. Steroids are used to help reduce inflammation. Salmeterol belongs to a class of medicines called long-acting beta agonists. Salmeterol helps relax the air passages in the lungs. Both ingredients in Seretide work together to help keep the airways open and make it easier to breathe.

Seretide helps to prevent attacks of breathlessness or asthma. It will not give you fast relief of your symptoms once an attack has started. You must use your fast-acting reliever inhaler (inhaled bronchodilator) to relieve an attack of breathlessness or asthma. Ask your prescriber or nurse for advice on what to do if you have an asthma attack or attack of breathlessness.

You must use Seretide every day for it to work. Seretide will only prevent attacks of breathlessness or asthma if it is used regularly. You should continue to use Seretide even if you feel that your condition is under control. It is a good idea to use it at the same time or times every day. You should make using it at a regular time part of your daily routine.

Other information about Seretide:

Do not share your medicine with other people. It may not be suitable for them and may harm them.

The pharmacy label on your medicine tells you how much medicine you should have. It also tells you how often you should have your medicine. This is the dose that you and your prescriber have agreed you should have. You should not change the dose of your medicine unless you are told to do so by your prescriber.

If you feel that the medicine is making you unwell or you do not think it is working, then talk to your prescriber.

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When to take your medicine

Some medicines work best if they are taken at a specific time of day. Getting the most from your medicine can also be affected by what you eat, when you eat and the times at which you take other medicines.

In the case of Seretide:

  • if you only have Seretide once a day try to match your medicine intake to the time when your symptoms are most severe. People with day-time symptoms should try to have their medicine in the morning and people with night-time symptoms should have it at night
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How to take your medicine

Some medicines have specific instructions about how to take them. This is because they work better when taken correctly. These instructions can include getting the right dose and special instructions for preparing the medicine.

In the case of Seretide:

  • detailed advice on how to have Seretide can be found in the Patient Information Leaflet that comes with this medicine
  • you must use your inhaler correctly to get the maximum benefit
  • remove the mouthpiece cover by gently squeezing the sides of the cover and check the mouthpiece for the presence of loose objects.
  • hold the inhaler upright between your fingers and thumb, keeping your thumb on the base below the mouthpiece
  • this inhaler has a counter on the back of the device. Each time the inhaler is activated the number on the counter will count down by one
  • shake your inhaler and release puffs of the inhaler into the air before you use it for the first time until the counter reads 120
  • if the inhaler has not been used for a week or more shake it and release two puffs of the inhaler into the air
  • when inhaling Seretide it is best to be sitting or standing up
  • breathe out and then place the mouthpiece of the inhaler into your mouth between your teeth and close your lips around it. Do not bite the mouthpiece
  • press down on the top of the inhaler while breathing in Seretide slowly and deeply through the mouth
  • whilst holding your breath, remove the inhaler from your mouth and stop pressing the top of the inhaler. Continue to hold your breath for as long as is comfortable
  • you should wait for half a minute if you need to inhale a second puff of Seretide
  • replace the mouthpiece cover onto the inhaler
  • rinse your mouth out with water after you use your Seretide inhaler. You should do this after every use as Seretide can cause mouth infections or a hoarse voice. Rinsing with water may help reduce your chance of getting these problems
  • if you find it difficult to use your inhaler, a spacer device may be helpful. For more information on spacer devices talk to your prescriber, asthma nurse or pharmacist
  • shake your inhaler before you use it to ensure that lose objects are removed and the contents are well mixed

If you are having problems taking this form of Seretide, you should talk to your prescriber or pharmacist. They may be able to give you advice on other ways to take your medicine or other preparations that are easier for you to take.

Video icon

How to use your Metered Dose Inhaler Animation

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How to use your inhaler This animated video demonstrates the correct way to use your inhaler.

To listen to the voiceover you will need your speakers switched on.

Please note that the colouring of the inhaler within the video is generic and may differ from the colour of the device you are using.

You can also read the transcript of the video or download the transcript as a PDF

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Taking too much of your medicine

Taking extra doses of some medicines can be harmful. In some cases even one extra dose can cause you problems. If you take extra doses of your medicine, you must get medical advice immediately. You may need a test to assess the effect of taking extra doses. This is because the effects of taking too much medicine are very complex so it is very important that you seek medical advice.

Contact your prescriber, pharmacist, specialist clinic or call 111 for advice.

Make sure you take all of your medicine containers with you if you are advised to go to hospital.

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Stopping your medicine

If you are not having any problems taking this medicine then do not stop having it, even if you feel better, unless advised to do so by your prescriber. If, however, you find that this medicine is causing you problems then you should talk to your prescriber about your concerns.

If your medical team decides that it is best that you do not take this medicine any more, they may advise that you do not stop Seretide abruptly. This is because, in some instances, stopping Seretide abruptly can cause withdrawal symptoms or cause your original condition to return. In these instances, reducing the dose of Seretide gradually over time may reduce the chances of having these problems.

If you are in any doubt, contact your prescriber, pharmacist, specialist clinic or call 111.

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Looking after your medicine

The instructions on how you should keep your medicine are on the pharmacy label. You should keep your medicine in the original container. This will help to keep your medicine in the best condition and also allow you to check the instructions. Do not take the medicine if the packaging appears to have been tampered with or if the medicine shows any signs of damage. Make sure that the medicine is out of the sight and reach of children.

In the case of Seretide:

  • do not store in temperatures above 25°C
  • if the canister is cold, Seretide may not work as well
  • do not break, puncture or burn the container even when it seems empty
  • the inhaler should be cleaned at least once each week. To clean the inhaler you should remove the mouthpiece cover and wipe the inside and outside of the mouthpiece and plastic casing with a dry cloth or tissue. For more information, see the patient information leaflet that comes with the medicine
  • do not put the metal container in water or remove the canister from the plastic casing
  • replace the mouthpiece cover firmly and snap it into position

You must not take the medicine after the expiry date shown on the packaging. If you have any unused medicine, return it to your pharmacist who will dispose of it safely.

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Whether this medicine is suitable for you

Seretide is not suitable for everyone and some people should never use it. Other people should only use it with special care. It is important that the person prescribing this medicine knows your full medical history.

Your prescriber may only prescribe this medicine with special care or may not prescribe it at all if you:

Furthermore the prescriber may only prescribe this medicine with special care or may not prescribe it at all for someone who is under the age of 16 years.

As part of the process of assessing suitability to take this medicine a prescriber may also arrange tests:

  • to check that this medicine is having the desired effect
  • to check that this medicine is not having any undesired effects

Over time it is possible that Seretide can become unsuitable for some people, or they may become unsuitable for it. If at any time it appears that Seretide has become unsuitable, it is important that the prescriber is contacted immediately.

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A medicine is only made available to the public if the clinical trials have shown that the benefits of taking the medicine outweigh the risks.

Once a medicine has been licensed, information on the medicine's effects, both intended and unintended, is continuously recorded and updated.

Some side-effects may be serious while others may only be a mild inconvenience.

Everyone's reaction to a medicine is different. It is difficult to predict which side-effects you will have from taking a particular medicine, or whether you will have any side-effects at all. The important thing is to tell your prescriber or pharmacist if you are having problems with your medicine.

Very common: More than 1 in 10 people who have Seretide:

  • headaches
  • inflammation of the nose and throat

Common: More than 1 in 100 people who have Seretide:

  • accidental injury more likely
  • bronchitis
  • bruising
  • hoarse voice - rinsing your mouth with water or brushing your teeth after inhaling your dose may help stop this from happening
  • infection of the mouth or throat - rinsing your mouth with water or brushing your teeth after inhaling your dose may help stop this from happening
  • irritation of the throat
  • joint pain
  • metabolic problems
  • muscle cramps
  • muscle pain or tenderness
  • pneumonia
  • sinusitis
  • voice problems

Uncommon: More than 1 in 1000 people who have Seretide:

  • angina
  • breathing difficulties
  • faster heart rate
  • feeling anxious
  • heart problems
  • if Seretide is used in large amounts or for a long period of time other side-effects may occur. These are related to the effect that steroids have on the body. These may include Cushing's syndrome or cushing-like symptoms, adrenal problems, growth suppression in children and adolescents, lowering of bone mineral density, cataracts or glaucoma
  • increased blood sugar levels
  • palpitations
  • skin hypersensitivity reactions
  • sleeping problems
  • tremors

Rare: More than 1 in 10,000 people who have Seretide:

  • anaphylactic reactions including anaphylactic shock
  • angioedema of the face or throat
  • behavioural changes
  • bronchospasm - if you develop an increase in wheezing or shortness of breath immediately after using your inhaler you must treat this immediately with a fast-acting inhaled bronchodilator and then seek immediate medical advice
  • feeling irritable
  • hyperactivity

The frequency of these side-effects is unknown:

  • abnormal laboratory test results
  • aggressive behaviour
  • depression
  • worsening of the problem that Seretide is being used to treat - seek medical advice if worsening of symptoms occur

If you feel unwell or if you have concerns about a side-effect, you will need to seek advice. If you feel very ill, get medical help straight away. Contact your prescriber, pharmacist, nurse or call 111.

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Taking other medicines

If you are taking more than one medicine they may interact with each other. At times your prescriber may decide to use medicines that interact, in other cases this may not be appropriate.

The decision to use medicines that interact depends on your specific circumstances. Your prescriber may decide to use medicines that interact, if it is believed that the benefits of taking the medicines together outweigh the risks. In such cases, it may be necessary to alter your dose or monitor you more closely.

Tell your prescriber the names of all the medicines that you are taking so that they can consider all possible interactions. This includes all the medicines which have been prescribed by your GP, hospital doctor, dentist, nurse, health visitor, midwife or pharmacist. You must also tell your prescriber about medicines which you have bought over the counter without prescriptions.

The following medicines may interact with Seretide:

The following types of medicine may interact with Seretide:

If you are taking Seretide and one of the above medicines or types of medicines, make sure your prescriber knows about it.

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Complementary preparations and vitamins

Medicines can interact with complementary preparations and vitamins. In general, there is not much information available about interactions between medicines and complementary preparations or vitamins.

If you are planning to take or are already taking any complementary preparations and vitamins you should ask your prescriber whether there are any known interactions with Seretide.

Your prescriber can advise whether it is appropriate for you to take combinations that are known to interact. They can also discuss with you the possible effect that the complementary preparations and vitamins may have on your condition.

If you experience any unusual effects while taking this medicine in combination with complementary preparations and vitamins, you should tell your prescriber.

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Driving and operating machinery

When taking any medicine you should be aware that it might interfere with your ability to drive or operate machinery safely.

Like all medicines Seretide can cause side effects. You should see how this medicine affects you and then judge if you are safe to drive or operate machinery. If you are in any doubt, talk to your prescriber.

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Medicines can interact with certain foods. In some cases, this may be harmful and your prescriber may advise you to avoid certain foods.

In the case of Seretide:

  • there are no specific foods that you must exclude from your diet when having Seretide
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Alcohol can interact with certain medicines.

In the case of Seretide:

  • there are no known interactions between alcohol and Seretide
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Family planning and pregnancy

Most medicines, in some way, can affect the development of a baby in the womb. The effect on the baby differs between medicines and also depends on the stage of pregnancy that you have reached when you take the medicine.

In the case of Seretide:

  • you should only have this medicine during pregnancy if your doctor thinks that you need it

You need to discuss your specific circumstances with your doctor to weigh up the overall risks and benefits of taking this medicine. You and your doctor can make a decision about whether you are going to take this medicine during pregnancy.

If the decision is that you should not have Seretide, then you should discuss whether there is an alternative medicine that you could take during pregnancy.

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Certain medicines can pass into breast milk and may reach your baby through breast-feeding.

In the case of Seretide:

  • it is not known whether this medicine passes into breast milk

Women who are having Seretide must not breast-feed. If you wish to breast-feed you should discuss with your prescriber whether there are any other medicines you could have. You should not stop this medicine without taking advice from your doctor.

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Ingredients of your medicine

Medicines contain active ingredients. They may also contain other, additional ingredients that help ensure the stability, safety and effectiveness of the medicine. They are also added to improve the medicine's taste and appearance and to make it easier to take. Some may be used to prolong the life of the medicine.

You should check that you are able to take the ingredients in your medicine, especially if you have any allergies.

Seretide contains:

  • fluticasone and salmeterol
  • norflurane (HFA 134a)

If you are not able to take any of the ingredients in your medicine, talk to your prescriber or pharmacist to see if they can suggest an alternative medicine. If you have reacted badly to Seretide before, do not have Seretide. Talk to your prescriber, pharmacist or nurse as soon as possible.

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Seretide, Version 24, last updated 27 Jul 2015