Seroxyn HFA 25/250

Indications

Seroxyn is used for the regular treatment of asthma, particularly in the following situations:

1. Patients inadequately controlled with inhaled corticosteroids and short-acting β2-agonists.
2. Patients adequately controlled on both inhaled corticosteroids and long-acting β2-agonists.

Note: Always use as per the advice of a registered physician.

Pharmacology

Seroxyn combines two active ingredients:

• Salmeterol Xinafoate: A long-acting beta-2 agonist (12-hour duration) that helps alleviate symptoms of asthma and airway obstruction.
• Fluticasone Propionate: A potent glucocorticoid corticosteroid that acts locally on the lungs to reduce inflammation and improve lung function without systemic side effects at typical doses.

Together, these medications protect against symptoms and prevent asthma exacerbations by improving lung function.

Mechanisms of Action:

• Salmeterol: Binds to the exo-site of the β2-receptor and has a long-lasting bronchodilator effect.
• Fluticasone Propionate: Reduces inflammation in the lungs, improving asthma symptoms and reducing exacerbations.

Dosage

Inhaler:

• Adults and Adolescents (12 years and older):
  • 2 puffs of 25 µg Salmeterol and 50 µg Fluticasone twice daily.
  • Optionally, increase to 125 µg or 250 µg Fluticasone depending on severity.
• Children (4-12 years):
  • 2 puffs of 25 µg Salmeterol and 50 µg Fluticasone twice daily.

Inhalation Capsule (for asthma):

• Adults and Adolescents (12 years and older):
  • Salmeterol 50 µg & Fluticasone 100 µg or 250 µg twice daily.
  • Maximum: 500 µg Fluticasone twice daily.
• Children (4-11 years):
  • Salmeterol 50 µg & Fluticasone 100 µg twice daily.

Maxhaler (for Asthma & COPD):

• Adults and Adolescents (12 years and older):
  • 50/100, 50/250, or 50/500 inhalers: One inhalation twice daily.
• Children (4 years and older):
  • 50/100 inhaler: One inhalation twice daily.

Note: Rinse the mouth after each inhalation to reduce the risk of oral thrush.

Administration

1. Remove the inhaler cap and shake it well before use.
2. Exhale fully, hold the inhaler upright, and place the mouthpiece between your lips.
3. Inhale deeply and slowly, pressing down firmly on the inhaler to release the medicine.
4. Hold your breath for 10 seconds, then exhale slowly.
5. If multiple inhalations are prescribed, wait 1 minute between puffs.

Interactions

• β-blockers (non-selective and selective) should be avoided unless necessary.
• Strong CYP3A4 inhibitors (e.g., ketoconazole, ritonavir) can increase the systemic exposure to Fluticasone Propionate, so caution is advised.

Contraindications

• Hypersensitivity to Salmeterol, Fluticasone, or any excipient.
• Not intended for treating acute asthma exacerbations (e.g., status asthmaticus).

Side Effects

• Salmeterol: Tremors, palpitations, headaches, arrhythmias, muscle cramps, and oropharyngeal irritation.
• Fluticasone Propionate: Hoarseness, oral thrush, cutaneous hypersensitivity, facial oropharyngeal edema.

Pregnancy & Lactation

• Pregnancy: Use only if the benefit outweighs the risk to the fetus, as there is limited human data.
• Lactation: Caution is advised during breastfeeding, as both Salmeterol and Fluticasone are present in low concentrations in breast milk.

Precautions & Warnings

• Asthma Exacerbations: Do not initiate during acute or unstable asthma episodes.
• Paradoxical Bronchospasm: Immediate cessation if wheezing increases after inhalation.
• COPD: Watch for signs of pneumonia, as patients with COPD may be at a higher risk.

Overdose Effects

• Salmeterol: Symptoms may include tachycardia, arrhythmias, tremor, and hyperglycemia. Treatment includes discontinuation and, if necessary, cardioselective beta-blockers.
• Fluticasone Propionate: Acute overdose may suppress adrenal function, but it generally recovers without emergency treatment.