Seroxyn HFA 25/125

Indications

Seroxyn is indicated for the regular treatment of asthma in the following cases:

• Patients not adequately controlled with inhaled corticosteroids and “as needed” inhaled short-acting β2-agonists.
• Patients already adequately controlled on both inhaled corticosteroids and long-acting β2-agonists.

Pharmacology

Salmeterol Xinafoate is a long-acting β2-adrenoceptor agonist used to treat asthma and obstructive airway diseases, providing bronchodilation over 12 hours.
Fluticasone Propionate is a corticosteroid with potent glucocorticoid activity, which reduces inflammation in the lungs and prevents exacerbations of asthma without significant systemic effects at usual doses.

Dosage

• Inhaler:
  • Adults & adolescents (12 years and older): 2 puffs of Salmeterol 25 µg and Fluticasone 50 µg, 125 µg, or 250 µg twice daily.
  • Children (4–12 years): 2 puffs of Salmeterol 25 µg and Fluticasone 50 µg twice daily.
• Inhalation Capsule:
  • Adults & adolescents (12 years and older): Salmeterol 50 µg & Fluticasone 100 µg or 250 µg twice daily.
  • Children (4–11 years): For asthma, Salmeterol 50 µg & Fluticasone 100 µg twice daily.
• Maxhaler for Asthma:
  • Adults & adolescents (12 years and older): One inhalation of 50/100, 50/250, or 50/500 twice daily.
  • Children (4 years and older): One inhalation of 50/100 twice daily.
• Maxhaler for COPD: One inhalation twice daily.

Administration

1. Shake inhaler well before use.
2. Exhale fully, place the mouthpiece between the teeth, and inhale deeply while pressing the canister.
3. Hold breath for 10 seconds.
4. Rinse mouth after use.
5. Clean the inhaler weekly.

Interaction

• Avoid non-selective β-blockers in asthma patients.
• Use caution with strong CYP3A4 inhibitors (e.g., ketoconazole, ritonavir), as they may increase systemic exposure to Fluticasone Propionate.

Contraindications

• Hypersensitivity to any ingredient.
• Not for the primary treatment of acute asthma attacks.

Side Effects

• Salmeterol: Tremor, palpitations, headache, muscle cramps, arrhythmia, hypersensitivity reactions, and oropharyngeal irritation.
• Fluticasone Propionate: Hoarseness, oral thrush, skin hypersensitivity, and rare facial edema.

Pregnancy & Lactation

• Pregnancy: Use only if benefits outweigh the risks.
• Lactation: Consider benefits over risks; concentrations in breast milk are low.

Precautions & Warnings

• Not to be initiated during acute asthma exacerbations.
• Can cause paradoxical bronchospasm (immediate wheezing). Treat with a short-acting bronchodilator.
• COPD patients may be at increased risk for pneumonia.
• Monitor for systemic effects of corticosteroids, including growth retardation, cataract, glaucoma, and adrenal suppression, especially with long-term use.

Overdose Effects

• Salmeterol Overdose: May cause seizures, tachycardia, arrhythmias, tremors, headache, and palpitations.
• Fluticasone Propionate Overdose: Excessive doses may temporarily suppress adrenal function.