Serevent Inhaler
(Salmeterol Xinafoate)

What Serevent inhaler is and what it is used for

• NeoventTM Inhaler contains the medicine salmeterol. It is a long-acting bronchodilator. It helps the airways in the lungs to stay open. This makes it easier for air to get in and out. The effects can usually be noticed within 10 to 20 minutes and last for 12 hours or more.
• The doctor has prescribed NeoventTM Inhaler to help prevent breathing problems. These could be caused by asthma. Taking NeoventTM Inhaler regularly will prevent asthma attacks including asthma brought on by exercise or at night.
• Taking NeoventTM Inhaler regularly will also help prevent breathing problems caused by other chest illnesses such as chronic obstructive pulmonary disease (COPD) NeoventTM Inhaler helps to stop breathlessness and wheezing coming on. It does not work once you are breathless or wheezy. If that happens you need to use a fast-acting “reliever” medicine, such as salbutamol.
• NeoventTM Inhaler is supplied to you in an inhaler. You breathe the medicine through your mouth directly into your lungs.
• NeoventTM Inhaler contains norflurane and does not contain any chlorofluorocarbons (CFCs). Norflurane-containing inhalers are less harmful to the environment than older CFC-containing inhalers. NeoventTM Inhaler may taste differently to older CFC-containing inhalers. This will make no difference to how your medicine works. If you are being treated for asthma, you should always be given both a NeoventTM Inhaler and a steroid inhaler (or rarely steroid tablets) to use together. Both inhalers must be used regularly.

How to take Serevent inhaler

Always use this medicine exactly as your doctor or pharmacist has told you. Check with your doctor or pharmacist if you are not sure.
• If you are being treated for asthma, you should always be given both a NeoventTM Inhaler and a steroid inhaler to use together.
• Use NeoventTM Inhaler every day until your doctor advises you to stop.
• You will start to feel your medicine working within the first day of use. NeoventTM Inhaler is for inhalation through the mouth only. Dosage for adults and adolescents 12 years and older with asthma
• The usual starting dose is 2 puffs twice a day.
• If you have more severe asthma, your doctor may increase your dose to 4 puffs twice a day. Children The safety and efficacy of NeoventTM Inhaler have not been demonstrated in children. Therefore NeoventTM Inhaler should not be used in children 12 years of age and younger. Dosage for adults with Chronic Obstructive Pulmonary Disease (COPD), including bronchitis and emphysema
• The usual starting dose is 2 puffs twice a day. Not applicable for children and adolescents. Instructions for use Your doctor or pharmacist should show you how to use your inhaler. They should check how you use it from time to time. Incorrect use, not using the inhaler as prescribed or not using it as described in this Leaflet, may mean that the medicine will not work as it should and so will not help your asthma or COPD. The medicine is contained in a pressurised canister in a plastic casing with a mouthpiece. Testing your inhaler When you use the inhaler for the first time you should test if it works properly. 1. Remove the mouthpiece cover by gently pressing the sides with your thumb and index finger. 2. Shake the inhaler well for a minimum of 10 seconds, point the mouthpiece away from you and press the canister twice to release two puffs into the air. If you have not used the inhaler for a week or more or if you have cleaned the inhaler, you should release one puff into the air 1. You should either stand up or sit upright when using the inhaler. 2. Remove the mouthpiece cover. Check the mouthpiece inside and outside to see that it is clean (figure 1). 3. Shake the inhaler well for a minimum of 5 seconds before use (figure 2) to ensure that any loose objects are removed and that the contents of the inhaler are evenly mixed. 4. Hold the inhaler upright with your thumb on the base, below the mouthpiece. 5. Breathe out as far as is comfortable (figure 3). 6. Place the mouthpiece in your mouth between your teeth and close your lips around it but do not bite it (figure 4). 7. Just after starting to breathe in as slowly as you can through your mouth, press down on top of the inhaler to release a puff into your mouth while still breathing in steadily and deeply (figure 4). 8. While holding your breath, take the inhaler from your mouth and take your finger from the top of the inhaler. Continue holding your breath for as long as is comfortable (figure 5). 9. If you are to take a second puff, wait about half a minute before repeating steps 3 to 8. 10. After use always replace the mouthpiece cover to keep out dust and fluff. The mouthpiece cover is replaced by firmly pushing and snapping it into position. Practise in front of a mirror the first few times. If you see “mist” coming from the top of your inhaler or the sides of your mouth you should start again. If you find it difficult to use the inhaler, a Volumatic® spacer device may help to overcome this problem. Contact your doctor or pharmacist. If you do need to use the Volumatic® spacer device, please refer to the instruction leaflet provided with the spacer device, which includes all the information you need to use the spacer correctly. If the inhaler gets very cold, take the metal canister out of the plastic case and warm it in your hands for a few minutes. Never use anything else to warm it up. After warming up the inhaler, spray one puff in the air before use. Cleaning your inhaler To prevent your inhaler from getting blocked up it should be cleaned at least once a week. To clean your inhaler:
• Remove the mouthpiece cover.
• Do not remove the canister from the plastic casing at any time.
• Wipe the inside of the mouthpiece and the plastic casing with a dry cloth or tissue.
• Release one puff into the air before next using the inhaler to test the inhaler.
• Replace the mouthpiece cover. Do not put the metal canister into water. If you take more NeoventTM Inhaler than you should It is important to use the inhaler as instructed. If you accidentally take a larger dose than recommended you should contact your doctor or pharmacist. You may notice your heart beating faster than usual and that you feel shaky and/or dizzy. You may also have a headache, muscle weakness and aching joints. If you forget to use NeoventTM Inhaler If you forget to use your inhaler you should take the next dose when it is due. Do not take a double dose to make up for a dose you have forgotten. If you have any further questions on the use of this product, ask your doctor or pharmacist.

Possible side effects

Like all medicines, NeoventTM Inhaler can cause side effects, although not everybody gets them. To reduce the chance of side effects your doctor will prescribe the lowest dose to control your asthma or COPD. The following side effects have been reported by patients using NeoventTM Inhaler. Allergic reactions: you may notice that your breathing suddenly gets worse after using NeoventTM Inhaler. You may experience:
• Wheezing or coughing.
• Rash, itching, swelling (usually of the face, lips, tongue or throat). If you experience any of these side effects or if they occur suddenly after using NeoventTM Inhaler you should tell your doctor immediately. Allergic reactions to NeoventTM Inhalerare very rare (occurring in less than 1 in 10,000 patients).

Other side effects are:

Common (may affect up to 1 in 10 people)
• Muscle cramps.
• Feeling shaky, fast or irregular heartbeat (palpitations), headache, shaking hands (tremor). Tremors are more likely to occur if you are taking more than two puffs twice daily. These side effects do not last long and occur less as treatment with salmeterol continues.

Uncommon (may affect up 1 in 100 people)
• Rash.Very fast heart rate (tachycardia). This is more likely to occur if you are taking more than two puffs twice daily.
• Feeling nervous.

Rare (may affect up to 1 in 1,000 people)
• Dizziness.
• Difficulty in sleeping (insomnia).
• A fall in the amount of potassium in the blood (you may notice an irregular heartbeat, muscle weakness and/or muscle cramp). Your doctor may ask you to have blood tests to check the amount of potassium in your blood from time to time. If you have any concerns discuss them with your doctor.

Very rare (may affect up to 1 in 10,000 people)
• Breathing difficulties or wheezing that gets worse straight after using NeoventTM Inhaler. If this happens stop using your NeoventTM Inhaler. Use your fast-acting “reliever” inhaler to help your breathing and tell your doctor straight away.
• Irregular heartbeat or your heart gives an extra beat (arrhythmia). If this happens do not stop using NeoventTM Inhaler but tell your doctor.
• An increase in the amount of sugar (glucose) in your blood (hyperglycaemia). If you have diabetes your doctor may want to monitor your blood sugar more frequently than usual and may need to adjust the treatment you take for your diabetes.
• Sore mouth or throat.
• Feeling sick (nausea).
• Aching, swollen joints.
• Chest pain.

Reporting of side effects If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the yellow card scheme at www.mhra.gov.uk/yellowcard. By reporting side effects, you can help provide more information on the safety of this medicine.

How to Store Serevent inhaler

• Keep this medicine out of the sight and reach of children.
• Straight after use, replace the mouthpiece cover firmly and click into position. Do not use excessive force.
• Store below 30ºC.
• Do not freeze.
• This canister contains a pressurised liquid. Do not expose to temperatures higher than 50°C.
• Do not puncture, break or burn the canister, even if you think it is empty.
• Do not use NeoventTM Inhaler after the expiry date which is stated on the label and the carton after the letters EXP. The expiry date refers to the last day of that month. Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help to protect the environment.