Salmeterol — NZ Medication Guide
📋 Reviewed by a Registered Pharmacist NZ — This information is for general educational purposes only and does not replace professional medical advice. Always consult your doctor or pharmacist before starting, stopping, or changing any medication.
What is Salmeterol?
Salmeterol is a long-acting beta-2 adrenergic agonist (LABA) bronchodilator used for asthma and COPD, always in combination with an inhaled corticosteroid. This medication is funded by Pharmac as a combination inhaler with fluticasone (Seretide®) for asthma and COPD.
What is Salmeterol Used For?
Salmeterol is used as a long-acting add-on bronchodilator for asthma (always in combination with an inhaled corticosteroid — never as monotherapy for asthma) and for COPD. It is available as a combination inhaler with fluticasone (Seretide®).
How Does Salmeterol Work?
Salmeterol selectively activates beta-2 adrenergic receptors in bronchial smooth muscle, causing relaxation and bronchodilation that lasts 12 hours. Its prolonged action is due to the lipophilic side chain that anchors it to the receptor in the cell membrane.
How to Take Salmeterol
Taken twice daily via dry powder inhaler (DPI — Accuhaler®) or metered-dose inhaler. For asthma: always combined with an inhaled corticosteroid (most commonly as Seretide® 50/500 mcg, 50/250 mcg, or 25/250 mcg). Rinse mouth after each use to prevent oral candidiasis.
Common Side Effects of Salmeterol
- Tremor (hands)
- Palpitations
- Headache
- Muscle cramps
- Throat irritation
- Oral candidiasis (thrush — rinse mouth after use)
Serious Side Effects — Seek Medical Attention
Contact your doctor or call 111 immediately if you experience any of the following:
- Paradoxical bronchospasm (rare — stop and use reliever inhaler)
- Severe allergic reactions
- Hypokalaemia (low potassium — at high doses)
- QT prolongation (high doses)
- Cardiovascular effects — tachycardia, hypertension
Drug Interactions
Salmeterol may interact with other medicines. Always inform your doctor and pharmacist of all medications you are taking. Key interactions include:
- Beta-blockers (antagonise salmeterol’s effect and can cause severe bronchospasm — avoid non-selective beta-blockers)
- QT-prolonging medicines
- Theophylline (increased risk of hypokalaemia)
- Diuretics (additive hypokalaemia)
New Zealand Prescribing Information
Salmeterol/fluticasone (Seretide® Accuhaler® and Evohaler®) is funded by Pharmac for asthma (not well-controlled on ICS alone) and COPD. Salmeterol must NEVER be used as monotherapy for asthma — the SMART trial demonstrated increased asthma-related deaths with salmeterol alone. It is always combined with an inhaled corticosteroid.
Frequently Asked Questions
Can I use salmeterol as a reliever for sudden breathlessness?
No — salmeterol is a long-acting bronchodilator that takes time to have full effect. For sudden breathlessness or an asthma attack, use your short-acting reliever (salbutamol/Ventolin®) immediately and seek medical help if not improving.
Why should salmeterol not be used alone for asthma?
Large trials showed that salmeterol as monotherapy (without an inhaled corticosteroid) increased asthma-related deaths. In asthma, it should always be combined with an ICS. In COPD, it can be used without ICS if appropriate for the COPD phenotype.
⚠️ Disclaimer: This page is for educational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your doctor or a qualified health provider. In New Zealand, medication availability and funding may vary — check with Pharmac or your pharmacist for current information.
Reviewed by a Registered Pharmacist NZ
References & Further Information
The following New Zealand and international resources were used to inform this page: