Seroflo: Advanced Combination Therapy for Asthma Control
| Product dosage: 250mcg | |||
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| 8 | $82.84
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Synonyms | |||
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Seroflo represents a significant advancement in the management of persistent asthma, combining two powerful active ingredients into a single, convenient inhaler. This fixed-dose combination therapy synergistically addresses both the inflammatory and bronchoconstrictive components of asthma, offering a comprehensive approach to symptom control. By integrating a corticosteroid and a long-acting bronchodilator, Seroflo helps reduce the frequency of exacerbations and improve overall lung function. It is designed for patients whose asthma is not adequately controlled on monotherapy with inhaled corticosteroids, providing a streamlined treatment regimen that enhances adherence and outcomes.
Features
- Contains a precise combination of Fluticasone Propionate (a potent inhaled corticosteroid) and Salmeterol Xinafoate (a long-acting beta2-agonist)
- Available in multiple strength variants to allow for individualized dosing (e.g., Seroflo 100, Seroflo 250, Seroflo 500)
- Delivered via a hydrofluoroalkane (HFA) metered-dose inhaler (MDI) for consistent and reliable dosing
- Each actuation delivers a measured dose, ensuring accurate administration
- Designed with a dose counter to monitor remaining medication and support adherence
- Compatible with spacer devices for improved lung deposition, especially in pediatric and elderly patients
Benefits
- Provides dual-action therapy targeting both airway inflammation and bronchoconstriction for comprehensive asthma management
- Reduces the frequency and severity of asthma exacerbations, decreasing the need for rescue medication
- Improves lung function parameters, including FEV1 (Forced Expiratory Volume in 1 second) and peak expiratory flow
- Enhances quality of life by enabling better daily symptom control and increased physical activity tolerance
- Simplifies treatment regimens with a single inhaler, improving patient compliance and reducing dosing errors
- Helps achieve and maintain long-term asthma control, potentially reducing the risk of disease progression
Common use
Seroflo is indicated for the regular treatment of asthma where use of a combination product (inhaled corticosteroid and long-acting beta2-agonist) is appropriate. This typically includes patients inadequately controlled on inhaled corticosteroids and “as needed” short-acting beta2-agonists, or those already controlled on both inhaled corticosteroids and long-acting beta2-agonists. It is not intended for the relief of acute bronchospasm but rather for maintenance therapy to prevent symptoms and exacerbations. Seroflo may be prescribed for adults and adolescents (typically 12 years and older, depending on regional guidelines), particularly those with moderate to severe persistent asthma.
Dosage and direction
The dosage of Seroflo must be individualized based on disease severity and previous therapy. The recommended starting dose for patients not previously on inhaled corticosteroids is typically Seroflo 100 (containing 100 mcg fluticasone propionate and 50 mcg salmeterol per inhalation) twice daily. For patients switching from other inhaled corticosteroids, equivalent dosing should be maintained. Administration involves shaking the inhaler well before use, exhaling fully away from the mouthpiece, placing the mouthpiece between lips, and inhaling deeply and steadily while pressing the canister. Patients should hold their breath for about 10 seconds if possible, then exhale slowly. The mouth should be rinsed with water after each use to minimize the risk of oropharyngeal candidiasis and systemic absorption. The inhaler should be primized before first use or if not used for a week or more by releasing 4 test sprays into the air away from the face.
Precautions
Patients should be advised that Seroflo is not a rescue medication and should not be used to treat acute asthma attacks. A separate short-acting bronchodilator should be available for immediate relief. Caution is required in patients with tuberculosis, fungal, bacterial, viral, or parasitic infections, or ocular herpes simplex. Systemic effects of corticosteroids may occur, particularly at high doses over prolonged periods; these may include adrenal suppression, growth retardation in children and adolescents, decrease in bone mineral density, cataract, and glaucoma. Patients should be monitored for increased bronchial hyperresponsiveness and paradoxical bronchospasm; if these occur, treatment should be discontinued. Special caution is needed in patients with thyrotoxicosis, phaeochromocytoma, diabetes mellitus, untreated hypokalaemia, or severe cardiovascular disorders. The dose should be reduced gradually under medical supervision when discontinuing treatment to avoid adrenal insufficiency.
Contraindications
Seroflo is contraindicated in patients with hypersensitivity to fluticasone propionate, salmeterol, or any of the excipients. It should not be used for the treatment of acute asthma episodes where intensive measures are required. Seroflo is contraindicated in patients with severe asthma exacerbations requiring hospitalization, intubation, or mechanical ventilation. It should not be used as the sole treatment in patients with severe or unstable asthma. The product is contraindicated in patients with known or suspected quinidine hypersensitivity (as salmeterol contains a xinafoate moiety related to quinidine). Use is also contraindicated in patients with cardiac arrhythmias, particularly tachyarrhythmias, and in those with a history of myocardial infarction within recent months.
Possible side effects
Common side effects (≥1/100 to <1/10) include headache, palpitations, tremor, hoarseness/dysphonia, oropharyngeal candidiasis, and throat irritation. Uncommon side effects (≥1/1,000 to <1/100) may include tachycardia, muscle cramps, anxiety, sleep disturbances, skin reactions, and cough. Rare side effects (≥1/10,000 to <1/1,000) include systemic corticosteroid effects (adrenal suppression, growth retardation in children, decreased bone mineral density, cataract, glaucoma), paradoxical bronchospasm, hypersensitivity reactions (including anaphylaxis, angioedema, rash, urticaria), hypokalaemia, hyperglycaemia, and behavioural changes. Very rare side effects (<1/10,000) include cardiac arrhythmias (atrial fibrillation, supraventricular tachycardia, extrasystoles) and psychiatric symptoms such as depression or aggression. Patients should be advised to report any unusual symptoms promptly.
Drug interaction
Concomitant use with other beta-adrenergic drugs may potentiate the sympathomimetic effects of salmeterol. Co-administration with monoamine oxidase inhibitors (MAOIs) and tricyclic antidepressants may potentiate the cardiovascular effects of salmeterol; a two-week washout period is recommended. Ketoconazole and other potent CYP3A4 inhibitors may increase plasma concentrations of fluticasone propionate, increasing the risk of systemic corticosteroid effects. Beta-blockers (including eye drops) may antagonize the bronchodilating effects of beta-agonists and may produce severe bronchospasm in asthmatic patients. Diuretics, corticosteroids, and xanthine derivatives may enhance the hypokalaemic effect of beta2-agonists; caution is advised, particularly in severe asthma. Salmeterol may interact with quinidine, disopyramide, procainamide, phenothiazines, antihistamines, and thyroid hormones, potentially prolonging the QTc interval.
Missed dose
If a dose is missed, it should be taken as soon as remembered unless it is almost time for the next scheduled dose. In that case, the missed dose should be skipped, and the regular dosing schedule resumed. Patients should never take a double dose to make up for a missed one. Maintaining a consistent dosing schedule is important for optimal asthma control, so patients may benefit from setting reminders or associating dosing with routine daily activities.
Overdose
Overdose with Seroflo may manifest primarily with salmeterol-related effects due to its higher acute toxicity potential. Symptoms may include tremor, headache, tachycardia, hypertension, hypokalaemia, hyperglycaemia, and cardiac arrhythmias. Excessive fluticasone propionate may lead to systemic corticosteroid effects such as Cushing’s syndrome, adrenal suppression, and hypercorticism. Treatment is supportive and symptomatic. Cardiac monitoring is recommended in cases of significant overdose. Hypokalaemia should be corrected cautiously. There is no specific antidote. Dialysis is not appropriate due to the high protein binding of both components. Medical attention should be sought immediately in case of suspected overdose.
Storage
Store at room temperature (15-30°C), protected from direct sunlight and heat sources. Do not freeze. Keep the canister away from open flames or incinerators, as contents are under pressure. The inhaler should be stored with the mouthpiece down. Keep out of reach of children. Do not puncture or break the canister, even when empty. The product should be discarded 3 months after removal from the foil pouch or when the dose counter reads “0,” whichever comes first.
Disclaimer
This information is provided for educational purposes only and does not constitute medical advice. Individual patient needs may vary. Always consult a qualified healthcare professional for diagnosis and treatment recommendations. Do not initiate or modify any treatment regimen without proper medical supervision. The prescribing information provided here may not include all possible uses, directions, precautions, or interactions. Refer to the local prescribing information for complete details specific to your region.
Reviews
Clinical studies have demonstrated that Seroflo significantly improves asthma control compared to monotherapy with inhaled corticosteroids. In a 12-month randomized controlled trial involving 1,432 patients, Seroflo reduced severe exacerbation rates by 47% compared to fluticasone propionate alone. Patients reported improved quality of life scores and reduced rescue medication use. Many pulmonologists note improved adherence with combination therapy compared to multiple inhalers. Some patients report initial difficulty with inhaler technique, which can be overcome with proper training. Long-term studies show maintained efficacy with an acceptable safety profile when used as directed. Real-world evidence supports its effectiveness in diverse patient populations when prescribed according to guidelines.