Seroflo represents a significant advancement in respiratory medicine, combining two established therapeutic agents into a single, convenient inhaler for the management of asthma and chronic obstructive pulmonary disease (COPD). This fixed-dose combination inhaler contains Fluticasone Propionate, a potent inhaled corticosteroid (ICS) that reduces airway inflammation, and Salmeterol, a long-acting beta2-agonist (LABA) that provides sustained bronchodilation. It is designed for patients whose condition is not adequately controlled on monotherapy with inhaled corticosteroids or whose disease severity warrants initiation with dual therapy. By consolidating treatment into a single device, Seroflo enhances adherence, simplifies dosing regimens, and provides a synergistic approach to achieving and maintaining optimal lung function and symptom control.

Features

• Fixed-dose combination of Fluticasone Propionate (ICS) and Salmeterol Xinafoate (LABA).
• Available in multiple strength configurations (e.g., 50/25 mcg, 125/25 mcg, 250/25 mcg per actuation) to allow for individualized dosing.
• Delivered via a pressurized metered-dose inhaler (pMDI) with a built-in dose counter for accurate tracking of remaining medication.
• Formulated with hydrofluoroalkane (HFA) as a propellant, which is chlorofluorocarbon (CFC)-free.
• Each cannister contains 120 metered inhalations.

Benefits

• Superior Symptom Control: Provides comprehensive management by simultaneously addressing underlying inflammation (with the corticosteroid) and bronchoconstriction (with the bronchodilator), leading to significantly fewer day-time and night-time symptoms.
• Reduced Exacerbation Risk: The anti-inflammatory action of fluticasone effectively lowers the frequency and severity of asthma attacks and COPD flare-ups, reducing the need for oral corticosteroids and emergency healthcare visits.
• Improved Lung Function: The bronchodilatory effect of salmeterol helps to open airways, resulting in measurable and sustained improvements in Forced Expiratory Volume (FEV1) and peak expiratory flow (PEF) rates.
• Enhanced Treatment Adherence: Combining two medications into a single inhaler simplifies the treatment regimen, minimizing the potential for dosing errors and making it easier for patients to comply with long-term therapy.
• Increased Quality of Life: By ensuring better overall disease control, patients experience fewer limitations on daily activities, improved sleep quality, and a greater sense of well-being.

Common use

Seroflo is indicated for the regular treatment of asthma where the use of a combination product is appropriate, specifically for patients not adequately controlled on inhaled corticosteroids and “as-needed” short-acting beta2-agonists, or for those whose disease severity clearly warrants initiation of treatment with both an inhaled corticosteroid and a long-acting beta2-agonist. It is also indicated for the symptomatic treatment of patients with severe COPD (FEV1 < 50% predicted normal) with a history of repeated exacerbations, who have significant symptoms despite regular therapy with short-acting bronchodilators.

Dosage and direction

Dosage is individualized based on disease severity and prior therapy. The inhaler must be shaken well before each use.

• Asthma (Adults and Adolescents 12 years and older): The usual recommended dose is two inhalations twice daily (morning and evening). The strength (50/25, 125/25, or 250/25 mcg) is determined by the prescribing physician.
• Asthma (Children 4-11 years): The usual recommended dose is two inhalations of Seroflo 50/25 mcg twice daily.
• COPD (Adults): The usual recommended dose is two inhalations of Seroflo 125/25 mcg or 250/25 mcg twice daily. Patients must rinse their mouth with water and spit it out after inhalation to reduce the risk of oropharyngeal candidiasis (thrush) and systemic absorption. This is not a reliever medication for acute bronchospasm; patients must have a separate short-acting beta2-agonist inhaler for immediate symptom relief.

Precautions

• Seroflo is a maintenance medication and must not be used to treat acute asthma attacks or episodes of acute bronchospasm, as it does not provide immediate relief.
• Patients should be instructed on the proper inhalation technique by a healthcare professional to ensure effective drug delivery to the lungs. The dose counter should be monitored.
• Systemic effects of corticosteroids may occur, particularly at high doses and over prolonged periods. These may include adrenal suppression, growth retardation in children and adolescents, decrease in bone mineral density, cataract, and glaucoma.
• An increase in the incidence of pneumonia has been observed in patients with COPD receiving ICS; physicians should remain vigilant for the signs of pneumonia in COPD patients.
• Paradoxical bronchospasm (i.e., immediate airway tightening after dosing) can occur; if this happens, treatment should be discontinued immediately and alternative therapy instituted.
• Patients should be advised not to stop therapy abruptly, as this may lead to a worsening of underlying disease.

Contraindications

Seroflo is contraindicated in patients with a history of hypersensitivity to Fluticasone Propionate, Salmeterol, or any of the excipients (e.g., lactose). It should not be used as the primary treatment for patients with acute or significantly deteriorating asthma, or for the treatment of status asthmatics.

Possible side effect

Like all medicines, Seroflo can cause side effects, although not everybody gets them.

• Very common (>1/10): Headache.
• Common (≥1/100 to <1/10): Oropharyngeal candidiasis (thrush), hoarseness/dysphonia, throat irritation, cough, palpitations, tremor, muscle cramps, nausea and vomiting, musculoskeletal pain.
• Uncommon (≥1/1,000 to <1/100): Skin reactions (rash, urticaria, pruritus), anxiety, sleep disturbances, tachycardia, atrial fibrillation, hyperglycemia, cataracts, glaucoma.
• Rare (≥1/10,000 to <1/1,000): Anaphylactic reactions, angioedema, psychiatric effects including depression and behavioral changes (primarily in children), hypokalemia.
• Frequency not known: Pneumonia (in COPD patients), systemic corticosteroid effects (e.g., adrenal suppression, Cushing’s syndrome), paradoxical bronchospasm.

Drug interaction

Concomitant use of other beta-adrenergic drugs (e.g., other LABAs, oral beta-agonists) may potentiate the sympathetic effects of Salmeterol. Caution is advised in patients being treated with monoamine oxidase inhibitors (MAOIs) and tricyclic antidepressants, as these can potentiate the cardiovascular effects of beta-agonists. Strong inhibitors of the cytochrome P450 3A4 (CYP3A4) system (e.g., ketoconazole, ritonavir, clarithromycin) can increase systemic exposure to Fluticasone, increasing the risk of systemic corticosteroid side effects. Beta-blockers (including eye drops) may antagonize the bronchodilatory effect of Salmeterol and may produce severe bronchospasm in asthmatic patients.

Missed dose

The patient should take the next dose at the usual time. Do not take a double dose to make up for a forgotten one. It is important to maintain a regular dosing schedule for optimal control.

Overdose

Overdose with Seroflo may lead to manifestations of excessive beta-adrenergic stimulation and/or systemic corticosteroid effects.

• Salmeterol overdose: Potential signs include tachycardia, tremor, headache, hyperglycemia, hypokalemia, and arrhythmias.
• Fluticasone overdose: Acute overdose is unlikely to cause acute problems. Chronic overdose may lead to signs of hypercorticism (e.g., moon face, central obesity). There is no specific antidote. Treatment should be symptomatic and supportive. Cardiac monitoring is recommended in cases of significant overdose. In the event of an overdose, a healthcare professional should be contacted immediately.

Storage

Store at room temperature (15°C to 30°C). Do not puncture or incinerate the canister, even when it is empty. Keep away from direct sunlight and heat sources. Keep out of the sight and reach of children. The inhaler should be discarded when the dose counter reads “000” or 3 months after removal from the foil pouch, whichever comes first.

Disclaimer

This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or before starting any new treatment. Never disregard professional medical advice or delay in seeking it because of something you have read here.

Reviews

“Clinical trials and extensive post-marketing surveillance have consistently demonstrated the efficacy and safety profile of the fluticasone/salmeterol combination. In the GOAL study, a significantly greater proportion of patients achieved and maintained well-controlled asthma with this combination compared to inhaled corticosteroid alone. For the COPD population, the TORCH study showed a significant reduction in the rate of exacerbations and a modest improvement in survival and lung function. From a clinical perspective, it remains a cornerstone of therapy for moderate-to-severe persistent asthma and a valuable option for a specific subset of COPD patients, offering a validated strategy for improving long-term outcomes.” – Pulmonology Today Journal

“Patient feedback often highlights the convenience of a two-in-one inhaler. Many report a marked reduction in the frequency of their rescue inhaler use and a greater sense of control over their breathing. The most commonly reported issues are the aftertaste and the necessity of rinsing the mouth to prevent thrush, but most agree these are minor inconveniences compared to the benefit of improved daily symptom control.” – Patient Support Group Survey Data