Salmeterol

Dosing Summary

Asthma – Maintenance (Adults & Children ≥4 yrs)

• Dose: 50 mcg (1 inhalation) orally twice daily, ~12 hours apart
• Note: Must be used with an inhaled corticosteroid in persistent asthma.
• If ineffective: Reassess overall asthma control plan.
• Rescue symptoms: Use a short-acting beta2-agonist (SABA).

Bronchospasm Prevention (Exercise-Induced) (EIB)

• Adults & Children ≥4 yrs: 50 mcg (1 inhalation) orally 30 minutes before exercise
• Duration: Protection may last up to 9–12 hours
• Avoid: Repeat dosing within 12 hours
• Note: Patients receiving twice daily doses for asthma should not use extra doses for EIB.

COPD – Maintenance (Adults)

• Dose: 50 mcg (1 inhalation) orally twice daily, ~12 hours apart
• Use: Long-term treatment of bronchospasm in COPD, including emphysema & chronic bronchitis

🚫 Not Approved for Children <4 years

Pediatric Notes

• For patients under 18 with asthma, prefer fixed-dose of ICS/LABA combination pfoduct to ensure adherence with both drugs.
• If separate ICS + LABA are used, appropriate steps to ensure adherence with both treatment components.

Always use salmeterol as part of a long-term asthma control plan, not for quick relief.

Precautions & Warnings

US Boxed Warning: Asthma-Related Death

• LABAs like salmeterol increase risk of asthma-related death when used without an inhaled corticosteroid (ICS).

Pediatric Considerations

• LABA monotherapy increases risk of hospitalization in children and teens.
• Use ICS + LABA combo products to ensure adherence.
• Not approved for:
  • Asthma in patients <4 years
  • COPD in patients <18 years

Contraindications

• Treatment of asthma without an ICS
• Acute asthma/COPD episodes or status asthmaticus
• Severe milk protein allergy

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Usage & Administration

• Oral inhalation only
• Do not exceed recommended dose or frequency
• If dose is missed, skip and take next dose on time—do not double dose
• Follow inhaler instructions from the manufacturer