Use of Seretide for asthma: properties, indications, contraindications

Seretide is a combined bronchodilator for asthma control. The drug reduces the risk of exacerbations by 30%, prevents the development of bronchospasm.

Using Seretide for asthma as part of basic therapy, it is possible to reduce the intensity of the inflammatory process, improve airway patency. 

Seretide is a bronchodilator based on 2 bioactive compounds: salmeterol xinafoate and fluticasone propionate.

Salmeterol and fluticasone suppress bronchospasm and inflammation in the respiratory system. Active compounds stimulate β-adrenergic receptors in the airways. The main active ingredients have a desensitizing, immunosuppressive, anti-shock and antitoxic effect.

The mechanism of action of the main components of the drug is different. Salmeterol prevents bronchial spasm, relaxes their smooth muscles. The substance provides long-term bronchodilation.

The potent compound suppresses the negative effects of inflammatory mediators secreted by mast cells. It protects the body from the negative effects of histamine, leukotrienes and prostaglandin D2 for 12 hours. The reaction to inflammatory mediators decreases within 15-20 minutes after using Seretide.

Salmeterol suppresses the reaction to allergens even after its bronchodilatory effect has ceased. Bronchial hyperreactivity decreases after the first inhalation. Therapeutic doses of the bioactive substance do not affect the activity of the cardiovascular system.

Fluticasone propionate restores lung function. The substance belongs to the category of glucocorticosteroids (GCS) – hormones that relieve inflammation, allergic reactions in the respiratory system. Fluticasone relieves asthma symptoms, reduces the number of exacerbations. After taking the medication, there are no side reactions characteristic of systemic corticosteroids.

With prolonged use of Seretide in the maximum allowed dosages, the daily production of adrenal cortex hormones does not exceed the maximum allowable rate in people of any age. If a person switches to fluticasone propionate from other inhaled corticosteroids, the production of adrenal hormones is stabilized.

Inhalation normalizes the functioning of the adrenal glands. In response to the stimulating effect of fluticasone propionate, cortisol is synthesized at an acceptable concentration.

Seretide is an alternative drug for people taking a β2-adrenoreceptor agonist and inhaled corticosteroids together. The use of this medication has a greater therapeutic effect than corticosteroid monotherapy.

For patients using salmeterol and fluticasone, the dosage of fast-acting bronchodilators should be reduced. Seretide reduces the incidence of exacerbations and asthma attacks. The quality of life of patients is significantly improved.

Release form

Pharmaceutical companies produce the drug in 3 versions:

  1. Seretide Evohaler is an aerosol for inhalation, packaged in aluminum cans with a dispensing nozzle. The container contains 120 doses of medicine. The bottle is packed in a cardboard box.
  2. Seretide Diskus is a dosed powder preparation. In the cells of each blister, 60 doses are sealed. The carton contains a device necessary for inhalation, instructions and 1 blister.
  3. Seretide Multidisc is an inhalation powder poured into round plastic containers with a dispenser. Inhaler discs contain 28 or 60 doses of medication.

Indications for use

Seretide is prescribed for the treatment of asthma if the patient needs the systematic use of inhaled corticosteroids and beta-adrenergic agonists acting for a long time.

The medication is prescribed:

  • in case of insufficient control of the disease with monotherapy with corticosteroid agents for inhalation and the irregular use of short-acting beta-adrenomimetics;
  • patients who use long-acting beta2-adrenergic agonists and corticosteroids for inhalation to control pathology;
  • patients with persistent bronchial asthma in order to support and control the disease at the initial stage of treatment (with daily use of quick-acting drugs to relieve bronchospasm);  
  • people with obstructive pulmonary disease for maintenance treatment;
  • patients with frequent exacerbations, persistent symptoms of pathology with constant treatment with bronchodilators.

Contraindications

Seretide is not prescribed:

  • patients with hypersensitivity to active ingredients and auxiliary components;
  • patients in serious condition;
  • children under 4 years old.

The medicine is carefully used for the following concomitant pathologies:

  • tuberculosis;
  • diseases of the heart and blood vessels;
  • diabetes mellitus;
  • hypokalemia;
  • diseases of the respiratory system caused by viruses, bacteria or fungi;
  • diseases of the thyroid gland;
  • pheochromocytoma;
  • hypertension;
  • arrhythmias;
  • ischemia;
  • cataract;
  • glaucoma;
  • osteoporosis.

During pregnancy and lactation, Seretide is prescribed when the expected therapeutic effect is higher than the likely complications for the mother and baby.

Mode of application

A pronounced therapeutic effect is observed with regular use of the inhalation agent. The medicine continues to be taken even after the symptoms of asthma have disappeared. The course of treatment and dosage is determined by the doctor. Patients are prescribed a dose in accordance with the severity of the course of the disease.

When asthma cannot be controlled with glucocorticosteroid monotherapy, Seretide, a combination medicine for asthma, is prescribed.

Switching to a long-acting agent in a controlled course of the disease reduces the frequency of the use of fast-acting corticosteroids.

Spray can

Seretide Evohaler is a product for inhalation use. The aerosol is used daily, even in the absence of asthma attacks. The doctor monitors the intake of the medication, if necessary, reduces the dosage of the drug. It is impossible to correct the medication intake on your own.

If a beta2-receptor agonist is simultaneously used with an aerosol, the spray is inhaled once a day:

  • for attacks that occur at night, the medicine is taken before bedtime;
  • for attacks occurring during the day, the remedy is used in the morning.

Algorithm for using the inhaler:

  1. When using for the first time or after a 7-day break, remove the lid of the mouthpiece, spray a fine cloud into the air.
  2. Before starting the procedure, the can must be shaken. Hold the device upright when spraying.
  3. Take a deep breath, grab the nozzle with your lips. A finely dispersed cloud is released once on inhalation.
  4. Hold their breath.
  5. Before the introduction of the second dose, maintain a 30-second interval.
  6. After the procedure, the mouth is rinsed with water after a short period of time.
  7. A cap is put on the mouthpiece.
  8. The device is cleaned once every 7 days. The details are wiped with a dry cloth.
  9. It is difficult for children to inhale on their own. Relatives should be instructed on how to spray the inhalation aerosol.

Doses and duration of treatment are determined by a pulmonologist, taking into account the severity of asthma. Usually, adults and children after 12 years of age are recommended to carry out 2 inhalations daily at doses: 25 μg / 50 μg, 25 μg / 125 μg or 25 μg / 250 μg. Children after 4 years of age are prescribed 1 dose of spray 25 mcg / 50 mcg twice a day.

When asthma can be brought under control, the dosage is reduced to 1 procedure in 24 hours. Cancel the remedy gradually. Abrupt cessation of treatment has a negative impact on the patient’s condition.

Powder

Seretid Diskus powder is used daily, regardless of the presence of asthmatic attacks. The duration of therapy and dosage is determined by the doctor.

Inhalation procedure:

  1. The plastic device is opened and charged.
  2. Then repeat the steps similar to those performed when the spray was inhaled.
  3. The number of unused doses is shown by the indicator.

Adults and children over 12 years old take 1 serving (50 mcg / 100 mcg, 50 mcg / 250 mcg, 50 mcg / 500 mcg) 2 times over 24 hours. With a short-term therapeutic course, 2 procedures are carried out daily, using 2 servings of Seretida Discus.

The duration of treatment should not exceed 14 days. Children from 4 years of age are given 1 serving (50 mcg / 100 mcg) twice a day. They refuse to use the medication gradually.

Seretide Multidisc is a medicine for inhalation use only. The dosage and duration of the course is determined by the pulmonologist. Adults and children from 12 years of age are given 2 procedures daily.

Patients receive 1 serving of the drug (50 μg / 100 μg or 50 μg / 250 μg or 50 μg / 500 μg). If there are special indications, 2 portions are inhaled with each inhalation.

An increased dosage of the drug is prescribed for no more than 14 days. Children from 4 years of age are given 1 serving of the drug (50 μg / 100 μg). 2 inhalation procedures are performed per day.

Side effects

When using Seretide, adverse reactions may occur. After using the inhaler, you may experience:

  • nausea and vomiting syndrome;
  • dyspepsia;
  • hyperglycemia;
  • Cushing’s syndrome;
  • decrease in bone mineralization;
  • dysfunction of the adrenal glands;
  • stunting in children;
  • tachycardia and other cardiac pathologies;
  • rhinonasopharyngitis, sinusitis;
  • paradoxical spasm of the bronchi;
  • pneumonia, bronchitis;
  • urticaria, skin rashes, Quincke’s edema, anaphylactic shock;
  • cataract, glaucoma;
  • soreness and muscle spasms;
  • hoarseness of voice;
  • joint pain;
  • fungal infections in the oropharynx;
  • side effects from the nervous system: irritability, anxiety, sleep disorders, headaches, hand tremors, impaired behavioral reactions.

In children, the likelihood of unwanted manifestations is quite high. It is necessary to constantly monitor the condition of the child.

Exceeding the 2-week dose of Seretide by 2 times leads to the occurrence of adverse reactions. Negative consequences develop under the influence of β-adrenergic agonist. Patients note:

  • hand tremor;
  • increased heart rate;
  • convulsions;
  • candidiasis of the oral mucosa;
  • hoarseness of voice.

Excessive amounts of fluticasone inhibit the adrenal glands. The organ dysfunction disappears spontaneously after drug withdrawal or dosage reduction.

With a constant overdose, Cushing’s syndrome occurs, growth retardation, and bone mineralization is impaired. Overdose can be avoided if the patient takes the medicine in the recommended doses under the strict supervision of a doctor.

special instructions

Therapy for bronchial asthma is recommended to be performed step by step. During treatment, it is imperative to monitor the development of clinical reactions in the patient to the drug and the functioning of the respiratory system. Patients are taught how to use inhalation devices correctly.

Seretide is a long-acting asthma drug ; it is not used to quickly relieve asthma attacks and acute symptoms of the disease. For this purpose, short-acting inhaled bronchodilators are taken. People with asthma should keep a fast-acting seizure reliever (such as Salbutamol) with them.  

The medication is suitable for supportive treatment in the early stages of the development of pathology. It is used for persistent bronchial asthma in 3 situations:

  • for everyday relief of symptoms of the disease;
  • to prevent attacks that occur every day;
  • if mandatory use of corticosteroids is required.

Continuous use of fast-acting bronchodilators to suppress symptoms indicates an out-of-control disease. If you need more of the drug, a person should contact a pulmonologist.

An unexpected release of bronchospasms out of control poses a threat to life. The increase in shortness of breath after inhalation indicates the occurrence of paradoxical bronchospasm. The patient needs:

  • urgently use a fast-acting bronchodilator;
  • stop using Seretide;
  • urgently consult a pulmonologist (perhaps the doctor will increase the dosage of glucocorticosteroids).

When the recommended dosage of Seretide does not allow controlling the course of the pathology, the patient should consult with the attending physician. He will additionally prescribe corticosteroids, and when a bacterial infection is attached, he will recommend antibiotics.

Discontinuation and side effects

It is strictly forbidden to stop taking Seretide, this practice leads to the development of dangerous complications. The dose of the drug should be reduced gradually under medical supervision.

An inhaled drug may cause unwanted systemic effects. Most often, negative manifestations occur with prolonged intake of high doses.

With the use of Seretide, the effects appear less frequently than with the use of oral corticosteroids. To minimize the risk of negative systemic effects, the dosage of the drug is reduced to the lower limit that allows you to control the disease.

The inhalation agent must be used in stressful situations in which the adrenal glands are inhibited. When carrying out resuscitation actions and operations, it is necessary to take into account the likelihood of developing adrenal insufficiency.

Growth is continually measured in children who are taking additional inhaled corticosteroids. The functioning of the adrenal glands must be investigated:

  • in patients with hypersensitivity to inhaled glucocorticosteroid drugs;
  • people who switched from oral administration of GCS to inhalation of Seretide.

In such patients, the work of the adrenal cortex is often disrupted, which causes the development of dangerous complications.

Allergic reactions

The transition from systemic corticosteroids to inhalation is sometimes accompanied by the appearance of an allergic reaction (rhinitis, eczema). Previously, undesirable effects were stopped by the action of systemic glucocorticosteroids.

With the development of allergies, symptomatic treatment is prescribed. Patients are prescribed:

  • antihistamines;
  • local medications, including GCS.

After the introduction of Seretide into the treatment regimen, systemic corticosteroids are gradually discontinued. The patient is given a special card. The document emphasized that a person under stress may require additional doses of glucocorticosteroids.

With an exacerbation of the disease and oxygen starvation, the amount of potassium in the blood plasma is controlled. This prevents the development of hypokalemia. Seretide is able to raise blood sugar levels. People with diabetes need to control their glucose levels.

Selected features and compatibility

It has not yet been revealed how Seretide affects the ability to drive a car and operate machinery. But doctors recommend taking into account the side effects that occur after using the product. Some negative manifestations (hand tremor, tachycardia) can provoke dangerous situations for the health and life of people.

Aerosol Seretide is used in combination with beta2-blockers in exceptional cases due to possible bronchospasm. The joint use of drugs is allowed if there are serious grounds for such a complex therapy.

The drug is not recommended to be combined with Ritonavir. With the simultaneous administration of drugs, dangerous systemic effects occur. The therapeutic effect of the drug increases when it is used simultaneously with various beta-adrenergic agonists.

Self-medication with Seretid is unacceptable. The drug can cause dangerous side reactions. The medicine is used strictly as directed by the pulmonologist.

Finally

Seretide is an effective remedy for preventing bronchospasm and asthma attacks. The medicine relieves the condition of the patient suffering from asthma.

The state of health worsens only with the development of adverse reactions. Patients are informed about the likely occurrence of negative effects and how to prevent them.

With proper regular treatment, the disease can be controlled. If a person strictly adheres to the treatment regimen drawn up by a doctor, the frequency of asthma exacerbations decreases and the likelihood of developing complications decreases.

event_note October 6, 2020

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