At a Glance
This is a brand drug (Serevent diskus) with no generic or biosimilar.
Active ingredient: Salmeterol Xinafoate.
Administration routes: Oral, Respiratory (Inhalation).
Serevent Diskus is approved for long‑term maintenance treatment of asthma (with an inhaled corticosteroid) and prevention of exercise‑induced bronchospasm in patients 4 years and older, and for maintenance treatment of COPD‑related bronchospasm in adults.
The usual dose is 1 inhalation (50 mcg) by mouth using the Diskus device twice daily about 12 hours apart, and for exercise‑induced bronchospasm 1 inhalation at least 30 minutes before exercise without repeating doses within 12 hours.
How It Works
- Serevent Diskus contains salmeterol, a long‑acting beta2‑agonist that relaxes the muscles around the airways so they stay open and it is easier to breathe.
- It begins to work within about 15–30 minutes and each dose helps keep the breathing passages open for around 12 hours.
- It is taken regularly to prevent asthma or COPD symptoms and exercise‑induced bronchospasm, and does not provide quick relief during a sudden attack.
Treatment and Efficacy
Approved indications: Serevent Diskus is an inhaled long‑acting beta2‑agonist used as add‑on maintenance therapy for asthma with a separate inhaled corticosteroid in patients 4 years and older, to prevent exercise‑induced bronchospasm in patients 4 years and older, and for long‑term twice‑daily maintenance treatment of bronchospasm associated with COPD (chronic bronchitis and/or emphysema) in adults; it is not intended for relief of sudden breathing problems.
Off‑label uses: Clinicians rarely prescribe Serevent Diskus for conditions outside asthma, exercise‑induced bronchospasm, and COPD, and there are no well‑established, evidence‑based off‑label indications; when additional long‑acting bronchodilation is needed, guidelines more often favor fixed‑dose inhaled corticosteroid/LABA combinations or other bronchodilators rather than off‑label Serevent monotherapy.
Efficacy expectations: Most people notice easier breathing and reduced wheeze within the first few doses, with fuller benefit on symptom control and reduced rescue‑inhaler use developing over several days to a couple of weeks of regular twice‑daily use; for exercise‑induced bronchospasm, a single inhalation taken at least 30 minutes before activity protects many patients for up to about 9 hours in adults and 9–12 hours in children. Compared with other LABAs, salmeterol provides similar 12‑hour bronchodilation but has a slightly slower onset than formoterol and a shorter duration than some once‑daily inhalers, so choice among agents is usually based on device preference, dosing schedule, and need for combination therapy rather than large differences in effectiveness.
Dosage and Administration
General dosing limits: Serevent Diskus is for oral inhalation only using the Diskus device, and the usual and maximum recommended dose is 1 inhalation (50 mcg) twice daily, about 12 hours apart.
Dosing by condition and age: For asthma maintenance in patients 4 years and older, the usual dose is 1 inhalation twice daily in addition to a separate inhaled corticosteroid; for prevention of exercise‑induced bronchospasm in patients 4 years and older, the dose is 1 inhalation at least 30 minutes before exercise, not repeated for at least 12 hours and not added on top of twice‑daily maintenance use; for COPD‑related bronchospasm in adults, the usual dose is 1 inhalation twice daily.
How to use the Diskus: Open the Diskus, slide the lever until it clicks to load a dose, breathe out gently away from the device, then seal your lips around the mouthpiece and inhale quickly and deeply, hold your breath for about 10 seconds, breathe out slowly away from the device, and close the Diskus; do not use a spacer, do not exhale into or wash the inhaler, and rinse your mouth with water and spit it out after each dose to reduce throat irritation and dry mouth.
Special instructions, missed doses, and overdose: Do not use Serevent Diskus more often than every 12 hours or together with other LABA‑containing inhalers, and do not use it to relieve sudden symptoms (a rapid‑acting rescue inhaler is needed for that). If a dose is missed, skip it and take the next dose at the regular time without doubling up. Taking too much can cause chest pain, rapid or irregular heartbeat, severe tremor, nervousness, or worsening shortness of breath and usually requires prompt medical evaluation.
Safety and Side Effects
Common side effects: Common effects include headache, throat irritation or hoarseness, cough, runny or stuffy nose, muscle cramps, mild tremor, nervousness, and flu‑like or respiratory infections; these are usually mild to moderate, may begin soon after starting treatment, and often improve over time.
Serious or rare adverse effects: Serious reactions can include severe allergic reactions (such as rash, swelling of the face or throat, trouble breathing), sudden worsening wheeze or breathing right after a dose (paradoxical bronchospasm), chest pain, very fast or irregular heartbeat, severe dizziness or fainting, seizures, and signs of very low potassium (muscle weakness, irregular heartbeat) or high blood sugar (unusual thirst, frequent urination); these require immediate medical attention.
Warnings and precautions: For asthma, Serevent Diskus must not be used without a concomitant inhaled corticosteroid because LABA monotherapy has been associated with increased asthma‑related deaths; it should not be used to treat acute attacks, in patients with severe milk‑protein allergy, or in children under 4 years. Caution is advised in people with heart disease, arrhythmias, high or low blood pressure, hyperthyroidism, seizures, diabetes, or significant liver impairment, and during pregnancy or breastfeeding it is generally reserved for situations where the expected benefit outweighs potential risks.
Relative safety: When used as directed with an inhaled corticosteroid for asthma, the overall safety profile is similar to other LABAs and serious events are uncommon; in COPD, available data do not show an increased risk of death compared with placebo, though cardiovascular and metabolic side effects remain possible.
Safety monitoring and reporting: Routine follow‑up typically assesses symptoms, rescue‑inhaler use, and lung function, and may include checks of heart rate, blood pressure, or laboratory tests in higher‑risk patients; in the United States, suspected side effects can be reported to the FDA MedWatch program (online or at 1‑800‑FDA‑1088), and updated safety information is provided in the prescribing information and on the FDA website.
Interactions and Precautions
Drug and supplement interactions: Using Serevent Diskus with other long‑acting or short‑acting beta‑agonist bronchodilators can increase side effects such as fast heartbeat and tremor; nonselective and selective beta‑blockers (for example propranolol or atenolol) may blunt its effect and can provoke bronchospasm in asthma; diuretics that lower potassium, xanthine derivatives, and systemic corticosteroids can add to the risk of low blood potassium; strong CYP3A4 inhibitors such as ketoconazole, itraconazole, clarithromycin, and many HIV protease inhibitors can markedly increase salmeterol blood levels and the risk of heart rhythm problems, so combined use is generally avoided unless clearly necessary. There are no major food interactions, but large amounts of caffeine or alcohol may worsen palpitations or nervousness in some people.
Other medical conditions and precautions: Serevent Diskus should be avoided or used with great caution in people with severe milk‑protein allergy, unstable asthma or COPD requiring frequent rescue‑inhaler use, significant coronary artery disease, arrhythmias, uncontrolled hypertension, hyperthyroidism, seizure disorders, or poorly controlled diabetes. It is not approved for children under 4 years of age, and older adults may be more sensitive to cardiovascular effects.
Monitoring needs: Clinicians typically monitor symptom frequency, use of rescue medication, and lung function (such as spirometry or peak‑flow readings), and may periodically check heart rate, blood pressure, electrolytes, or blood glucose in patients with cardiovascular disease, on interacting medications, or with diabetes or other risk factors.
Disposal Guidance
Storage: Store Serevent Diskus at room temperature (about 68°F to 77°F/20°C to 25°C) in a cool, dry place away from heat, moisture, and direct sunlight; keep it in the unopened foil pouch until first use, then use it for only 6 weeks or until the dose counter reaches 0 (whichever comes first), and keep the inhaler closed and dry between uses.
Disposal: Do not wash or take apart the Diskus; when the counter reads 0 or 6 weeks have passed since opening, throw the device away in household trash out of reach of children and pets, and do not burn or incinerate it.
Common Questions and Answers
Q: Is Serevent Diskus a rescue inhaler or a controller?
A: It is a long‑acting controller medicine used on a regular schedule to prevent symptoms and should not be used to treat sudden attacks; a separate fast‑acting rescue inhaler is still needed.
Q: How long does it take for Serevent Diskus to start working and how long does it last?
A: Most people begin to notice easier breathing within about 15–30 minutes after a dose, and each dose generally helps keep the airways open for around 12 hours.
Q: Can I use Serevent Diskus alone for my asthma?
A: For persistent asthma it should not be used by itself, but only in combination with a regular inhaled corticosteroid, because LABA‑only treatment has been linked to an increased risk of asthma‑related hospitalization and death.
Q: What should I do if I miss a dose of Serevent Diskus?
A: If you forget a dose, skip it and take your next scheduled dose at the usual time rather than taking two doses close together.
Q: Is Serevent Diskus safe during pregnancy or while breastfeeding?
A: Available human data do not show a clear increase in birth defects, but experience is limited, so it is typically used in pregnancy or breastfeeding only when good control of asthma or COPD cannot be achieved with safer alternatives.