- Composition
- Product form
- Pharmacological action
- Pharmacodynamics and pharmacokinetics
- Indications
- Contraindications
- Side effects
- Instructions for use of Seretide (Method and Dosage)
- Overdose
- Cooperation
- Terms of sale
- Storage conditions
- Shelf life
- Cautions
- Analogs
- Babies
- During pregnancy (and lactation)
- Reviews
- Price, where to buy
Composition
(INN): Salmeterol plus fluticasone
The preparation Seretide Evohaler contains salmeterol (Form Salmeterol xinafoate ) fluticasone propionate And also further substances.
The preparation Seretide Diskus contains salmeterol (a form of salmeterol xinafoate), micronized fluticasone propionate And also further substances.
Powder Seretide Multidisk the composition contains salmeterol (Form xinafoate) fluticasone propionate and additional substances.
Product form
Aerosol Seretide Evohaler It fits into an aluminum aerosol container, which includes means 120 doses. The container is equipped with a metering valve. A container cap and a plastic nebulizer contains a pack of cardboard.
Metered powder Seretide Diskus for inhalation is contained in a blister pack acheikova foil (60 doses agents). In each cell contains one dose of the agent. The cardboard package contains a plastic device for inhalation and one blister pack.
Seretide Multidisk - A powder for inhalations white or off-white shade. The cardboard package contains all the plastic inhaler with a dose counter. One package may contain 28 or 60 doses.
Pharmacological action
Seretide Evohaler . Seretide Diskus . Seretide Multidisk - Combined with anti-asthma drugs influence. These compositions comprise fluticasone propionate and salmeterol .
Salmeterol - It is a selective agonist of beta2-adrenergic receptors. It has a long action, which lasts at least 12 hours. Under the impact of salmeterol relaxes bronchial smooth muscle, prevents the development of bronchospasm.
Fluticasone propionate included in the group of corticosteroids. Fluticasone propionate provides anti-inflammatory influence. It reduces the frequency, severity of attacks asthma . In the application of fluticasone propionate do not develop those adverse effects, which are often seen with systemic corticosteroids.
When combined fluticasone and salmeterol The pharmacokinetics of these compounds is similar to their action when used alone.
In the application of funds Seretide Diskus provides control over the onset of symptoms Asthma and the effect is more effective than monotherapy glucocorticosteroids . When using combined treatment salmeterol and fluticasone exacerbations occur at 29% less than in the monotherapy corticosteroids. When treating agent reduces the need to use short-acting bronchodilator reduced the frequency of exacerbations of asthma, and there is a general improvement in the quality of life in people with asthma.
Pharmacodynamics and pharmacokinetics
Salmeterol It has a local effect in the lung tissue. During the inhalation observed plasma concentration is low. After multiple inhalations in blood in low concentrations detected gidroksinaftoevaya acid .
Fluticasone propionate It has bioavailability in healthy human 10-30% of the dose, depending on whether the inhaler is used.
People who are ill asthma and COPD In the blood plasma have a lower concentration of fluticasone propionate. The drug is mostly absorbed in the lungs, initially observed a strong adsorption, and later she slowed down.
Part of the amount used for inhalation, a person may be swallowed, but its effect on the body is minimal, since fluticasone propionate poorly soluble in water. When vacuuming Valium bioavailability from the gastrointestinal tract is less than 1%.
During inhalation of increasing doses there is an increase in the plasma concentration of fluticasone propionate. There is a high degree of binding to blood proteins Valium - 91%. Fluticasone propionate is actively excreted from the blood is mainly due to metabolism. The half-life is about 8 hours. In the urine as metabolites are less than 5% of the administered dose. Through the intestine appears mostly in the form of hydroxylated metabolite .
Salmeterol hardly enters the bloodstream when it is used by inhalation. The substance is not cumulated in the body, 1 year after initiation of therapy, the plasma levels of salmeterol did not increase.
Indications
Medicine Seretide Evohaler used for the regular treatment asthma in those cases, if it is necessary the use of corticosteroids with bronchodilators complex. The inhaler Seretide Evohaler given to patients with asthma who use inhaled corticosteroids and beta-agonists short-acting, and who indicated unsatisfactory control of the disease.
Seretide Diskus appointed for the purpose of treatment of reversible obstructive diseases of the respiratory system , Including Asthma in children and adults, including if necessary to carry out a combination treatment bronchodilator and inhalation corticosteroid . Seretide Diskus is indicated for patients who receive maintenance doses of inhaled corticosteroids and selective beta2-agonists long-acting.
It is used to treat patients whose monotherapy when corticosteroids are showing signs of obstructive respiratory diseases. It is also prescribed to people receiving bronchodilators if necessary, assign them to inhaled corticosteroids.
Seretide Diskus is also used as a basic remedy for people with chronic obstructive pulmonary disease (including chronic bronchitis . emphysema ).
Seretide Multidisk used for the treatment of bronchial asthma in people who need combination therapy with inhaled corticosteroids and beta2-agonists long-acting.
Used as starting a support means for persistent asthma patients, if they have evidence to the destination GCS.
It is used as maintenance therapy for chronic lung diseases obstruktivyh.
Contraindications
Seretide is not used to treat people who have marked intolerance to fluticasone, salmeterol, or other substances.
Do not use tool in disease exacerbations and severe violations of human health.
Be wary appoint people with active TB or with latent TB, and patients suffering from cardiovascular diseases . diabetes . hypokalemia .
Seretide Multidisk It is not indicated for the treatment of patients with chronic bronchitis with a high sensitivity to the drug.
Carefully appointed people suffering Tuberculosis . infectious diseases respiratory viral, bacterial and fungal nature diabetes . thyrotoxicosis , Uncontrolled hypokalemia . pheochromocytoma . hypertension . arrhythmia . CHD . cataracts . hypothyroidism . glaucoma . osteoporosis .
Side effects
Before the drug Seretide may be a manifestation of some side effects. In particular, the use Seretide Evohaler can cause such side effects:
- nausea, dyspeptic symptoms . hyperglycemia ;
- nervousness, feeling of causeless anxiety, sleep problems, headache , Tremors, changes in behavior;
- Cushing's syndrome . Cushingoid symptoms , A violation of mineralization of bone, adrenal suppression in children - growth retardation;
- tachycardia and beats, atrial fibrillation;
- nasopharyngitis . sinusitis , Irritation of the throat, paradoxical bronchospasm;
- hives , Skin rash, angioedema, anaphylactic shock;
- bronchitis, pneumonia . cataract , Muscle spasm and muscle pain, glaucoma . arthralgia ;
- hoarseness and oral candida lesions of the mouth and throat.
There is a higher probability of side effects provoked by exposure to fluticasone in children. It is necessary to closely monitor the health of the baby in treating drug.
The development of similar side effects, which are caused by the influence on the organism of fluticasone and salmeterol, can occur in the use of funds Seretide Diskus . In the treatment with this drug may develop paradoxical bronchospasm after inhalation instantly increased shortness of breath.
Similar side effects develop and the treatment means Seretide Multidisk In which the composition also contains salmeterol and fluticasone propionate .
Instructions for use of Seretide (Method and Dosage)
Seretide Evohaler It is used by inhalation. Instruction in Ceredo provides the means taken by patients with asthma as a prophylactic, ie, it must be used constantly, even during periods of asthmatic attacks.
Once you start using the drug to carry out regular studies of the patient, because it will give opportunity to pick up the minimum effective dose of the agent. But adjust the dose without doctor's approval is prohibited. If necessary, use beta2 receptor agonist is recommended Seretide Evohaler once a day. At night attacks mainly I use it in the evening, with daily attacks - in the morning.
Use the inhaler as follows: If this is the first time, or if the cartridge has not been used for seven days, you need to remove the cap of the mouthpiece and the first to conduct spraying once into the air. Each time before using the inhaler should be shaken. When spraying the inhaler is held vertically. It is necessary to take a deep breath, lips and embrace the mouthpiece Spray once for breath. After that, it is desirable to briefly hold your breath. If you want to enter a second dose, before the need to wait for 30 seconds. After some time, it is desirable to thoroughly rinse the cavity with water. After use, the mouthpiece should be sure to close the cap.
If necessary, children need help to use the inhaler, making sure that the spraying was carried out on a breath. Clean the inhaler should be not less than once a week.
Dosage Seretide Evohaler and determines the duration of the course of treatment the doctor. Depending on the severity of the disease in adults and children from 12 years: 2 doses of Seretide Evohaler (25 mcg / 50 mcg, 25 mcg / 125 mcg, 25 mcg / 250 mcg) twice daily. Upon reaching full control of the disease the dose can be reviewed.
Children from 4 years of age shall be appointed by means of a single dose of Seretide Evohaler 25 mcg / 50 mcg twice daily.
Cancellation of a drug gradually during heavy suspension treat human condition can get worse.
Instructions on Seretide Diskus It provides that the drug is used constantly, even in the absence of asthma attacks. The duration of treatment and the dose determined by the physician. To conduct inhalation, you need to initially open and charge the device from the plastic. Further inhalation carried out as and when using the drug Seretide Evohaler. The number of remaining doses can be seen on display doses.
Adults and children patients after 12 years old, they tend to get one dose Seretide Diskus (50 g / 100 g, 50 g / 250 g, 50 g / 500 g) twice a day. If you need a short corticosteroid treatment, it is possible to use two doses of drugs twice a day. This regimen should not last longer than two weeks.
Children from 4 years of age shall be appointed by means of a single dose Seretide Diskus 50 mcg / 100 mcg twice a day.
Cancel agents should be carried out gradually.
Instructions for use Seretide Multidisk It involves the use of funds only for inhalation. Dosage, duration of treatment is established expert individually.
Adults and children over 12 years after the usually prescribed by one inhalation Seretid Multidisk (50 ug / 100 ug or 50 ug / 250 ug or 50 ug / 500 mg) twice a day. If necessary, possible to use two PM doses twice per day. This regimen should not last longer than two weeks.
Children from 4 years of age shall be appointed for a single dose drug 50 mg / 100 mg twice daily.
Overdose
When using very high doses of Seretide there may be an overdose as the salmeterol And fluticasone .
Salmeterol Overdosing can lead to tachycardia . tremor , Headache, hypokalemia . If there are signs of such an overdose kardioselyh shows the use of beta-blockers. People with hypokalemia shown potassium supplements.
An overdose of fluticasone leads to the development of reversible adrenal suppression. This state of their own passes after a few days. Chronic overdose can trigger the development of Cushing's syndrome , Stunted growth, disorders of bone mineralization. To prevent chronic overdose, it is necessary to ensure close monitoring of the patient's condition.
Cooperation
Do not appoint Seretide Evohaler together with selective and non-selective beta2-adrenergic blockers. This combination is possible only when there are serious indications.
Effectiveness salmeterol can increase when used in conjunction with other beta-adrenergic agonist.
The concentration in plasma fluticasone and salmeterol may increase while the application Ritonavir and other drugs that inhibit cytochrome P450 3A4. Such an increase leads to an increase in systemic effect fluticasone.
The slight increase in the concentration of salmeterol in plasma is possible at the same time taking moderate inhibitors CYP3 A4 .
The combined use of Seretide and GCS , Xanthine derivatives and diuretics increase the risk of symptoms of hypokalemia.
Simultaneous treatment of tricyclic antidepressants and MAO inhibitors increase the risk of side effects in the cardiovascular system.
Terms of sale
Sold by prescription.
Storage conditions
Seretide Evohaler and Seretide Diskus must be stored and transported at a temperature of from 15 to 25 degrees, in the original package. The container should be protected from direct sunlight, fire, heat.
Seretide Multidisk It must be stored in a temperature not exceeding 30 ° C. LAN should be protected from access by children.
Shelf life
Seretide Evohaler It can be stored for 2 years.
Seretide Diskus and Seretide Multidisk It can store 1, 5 years.
Cautions
The patient asthma you must initially learn how to use the inhaler.
It is recommended to regularly monitor the growth of children receiving prolonged treatment with inhaled corticosteroids.
Rarely, the treatment drug is an increase in the content Glucose in the blood, so patients with diabetes means used with caution.
Analogs of Seretide
Match code ATC 4th level: 
Foradil Combi
The drugstore chain has a analogues Seretide: Flomax . Flomax H . Symbicort Turbuhaler . Biasten . Foradil Combi . Foster . Zenheyl . In no case can not be interchanged without the consent of medications with your doctor.
Babies
Seretide is not applicable for the treatment of children who are under 4 years old.
During pregnancy and lactation
There is not enough research on the use of means of Seretide to pregnant women and nursing mothers. Therefore, during pregnancy means acceptable to use only in the presence of vital evidence. Expectant mothers who undergo such treatment, it is important to constantly observed by a doctor, who will adjust the dose.
Seretide in the treatment of women in the period of breast-feeding should be interrupted feeding.
Reviews of Seretide
People who practice the treatment of asthma drug Seretide Evohaler or other species of this tool, post reviews, and continuous and successful use of funds. People who write reviews on the forum, noted that virtually no side effects observed. Leaving comments on Seretide Multidisk et al., the authors point out that after application of drugs should always rinse your mouth to avoid candidiasis . It is important to take Seretide only for the scheme, which is determined by a physician, and use it regularly.
Price Seretide where to buy
Cost Seretide Multidisk 50+ 500 between 2000 to 2100 rubles.
Cost Seretide Diskus +250 25 averages 2,000 rubles; +125 25 inhaler will cost about 1,500 rubles.
Buy Seretide Evohaler It can be as low as 1,800 to 3,500 rubles, depending on the dosage.
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