Salmeterol (brand name Serevent), manufactured by GlaxoSmithKline (GSK), is used to prevent breathing difficulties such as wheezing, shortness of breath, coughing and chest tightness caused by COPD.

How does salmeterol for COPD work?

Salmeterol is a long-acting beta agonist (LABA) bronchodilator that works by relaxing and opening the airways, making breathing easier.

As a selective LABA, the effects of salmeterol are caused by the stimulation of an enzyme called adenyl cyclase that’s located in the cells of the lung muscles. This enzyme helps convert adenosine triphosphate (ATP) to cyclic adenosine monophosphate (cAMP). When the levels of cAMP increase, the muscle cells relax.

Beta2-receptors are predominant in the muscle cells of the lungs, but they are also present in the heart, which means salmeterol may affect the heart, such as irregular heartbeats.

Studies of salmeterol

Two studies that evaluated salmeterol 50 mcg showed improvement in lung function in people with chronic bronchitis with airflow limitation, with or without emphysema, although it did not show a significant improvement in COPD symptoms.

The onset of action and duration of effects were also evaluated, with improvement in pulmonary function after two hours of treatment, and peak bronchodilator effect at 4.75 hours. This peak bronchodilator effect was reduced to 3.27 hours after 12 weeks of treatment.

Indications and side effects

Salmeterol is not intended to treat asthma. People with asthma who take LABA medicines such as salmeterol have an increased risk of death due to asthma problems.

Salmeterol comes as a powder to inhale by mouth and is usually used twice a day.

When salmeterol is used before exercising to prevent breathing difficulties, it should not be used more often than every 12 hours. If it is used on a daily basis, twice a day, it should not be used before exercising.

It helps control the symptoms of COPD and other respiratory conditions but it does not cure them.

The most common salmeterol side effects include headache, flu symptoms, joint or muscle pain, throat irritation, cough, or a stuffy or runny nose.

There is no generic version of Serevent available at this time.

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