Salmeterol

What salmeterol is and how it works

Salmeterol is a long-acting beta agonist (LABA) inhaled medicine that relaxes and opens air passages in the lungs. It is used for maintenance control of asthma in people also using an inhaled corticosteroid, for prevention of exercise-induced bronchospasm, and for maintenance treatment of chronic obstructive pulmonary disease (COPD). (1) (2) (3)

Salmeterol is not a rescue inhaler and is not used alone for asthma. Approved uses, minimum age, device, and product availability differ by country. A prescriber must confirm eligibility, inhaler technique, and whether the person has a short-acting rescue medicine.

Mechanism of action: how salmeterol works

Salmeterol is a long-acting beta agonist (LABA). It works by relaxing and opening air passages in the lungs, making it easier to breathe. (2) (1) (3)

What is Salmeterol used for?

Before taking salmeterol

Do not take / not appropriate for

• Do not use salmeterol alone for asthma. US label: use of salmeterol without a concomitant inhaled corticosteroid is contraindicated. (asthma) (2)
• Do not use salmeterol to treat sudden asthma attacks, acute bronchospasm, status asthmaticus, or acute episodes of asthma or COPD requiring intensive measures. It is not a rescue medicine. (all indications) (2) (1)
• Do not use salmeterol if you have severe hypersensitivity to milk proteins or known hypersensitivity to salmeterol or any of the product ingredients. (all products) (2)

Tell your clinician about

• Any allergy to salmeterol, other medicines, milk protein, or any food.
• Whether you use another long-acting beta agonist, such as arformoterol, formoterol, indacaterol, olodaterol, vilanterol, or a fluticasone/salmeterol combination product, because additional LABA medicines should not be used with salmeterol.
• Any current or recent use, within the past two weeks, of tricyclic antidepressants or monoamine oxidase inhibitors.
• Any history of irregular heartbeat, high blood pressure, QT prolongation, seizures, thyroid disease, diabetes, or ketoacidosis.
• All prescription and non-prescription medicines, vitamins, supplements, and herbal products.
• Pregnancy, plans for pregnancy, or breastfeeding.

Salmeterol dosage and how to take it

• Salmeterol is for oral inhalation only, using the dry-powder inhaler exactly as prescribed.
• US label for asthma and COPD: 1 inhalation twice daily, morning and evening, about 12 hours apart. For prevention of exercise-induced bronchospasm: 1 inhalation at least 30 minutes before exercise, not more often than once every 12 hours. If already using salmeterol twice daily, do not use another dose before exercise.
• Do not use more or less salmeterol or use it more often than prescribed.
• Do not use salmeterol to treat sudden breathing problems. Use the prescribed short-acting beta agonist rescue inhaler for sudden symptoms.
• Do not change the way you use any asthma or COPD medicine, including an inhaled corticosteroid or rescue inhaler, without advice from the prescriber.
• Before first use, ask the doctor, pharmacist, or respiratory therapist to show and watch your inhaler technique.

Procedures and treatment changes

Tell the treating team before surgery, procedures, or any medicine change. Do not alter treatment without the responsible clinician. (1) (2) (3)

Missed dose

Gap in supplied research notes: MedlinePlus includes a missed-dose heading for salmeterol, but the specific instruction was not captured. Contact the prescriber or pharmacist for the exact next-step instruction.

Overdose

US FDA label: overdose can cause excessive beta-adrenergic stimulation or exaggeration of beta-agonist effects, including seizures, angina, hypertension or hypotension, tachycardia with rates up to 200 beats/min, arrhythmias, nervousness, headache, tremor, muscle cramps, dry mouth, palpitation, nausea, dizziness, fatigue, malaise, insomnia, hyperglycemia, hypokalemia, metabolic acidosis, QTc prolongation, ventricular arrhythmias, and possibly cardiac arrest or death. Seek emergency medical attention immediately. Treatment is clinician-managed: discontinuation of salmeterol together with appropriate symptomatic therapy may be needed. A cardioselective beta-receptor blocker may be considered by clinicians, but such medicine can produce bronchospasm. Cardiac monitoring is recommended. There is insufficient evidence to determine if dialysis is beneficial. (2)

Salmeterol side effects

Salmeterol can cause beta-agonist effects such as palpitations, chest pain, rapid heart rate, tremor, or nervousness. Immediate hypersensitivity reactions, including anaphylaxis, may occur after administration.

Serious warnings

Interactions

Pregnancy, breastfeeding, kidney/liver function, age

Monitoring

Before starting

• Confirm the exact diagnosis, age, indication, and that asthma treatment includes an inhaled corticosteroid.
• Ask about allergy to salmeterol, milk protein, or product ingredients, and any previous immediate hypersensitivity reaction.
• Review use of other long-acting beta agonists, tricyclic antidepressants, MAO inhibitors, and the full medication list.
• Assess cardiovascular disorders, irregular heartbeat, high blood pressure, QT prolongation, seizures, thyrotoxicosis, diabetes, ketoacidosis, and hepatic impairment.
• Ensure the person has a prescribed short-acting beta agonist rescue inhaler and understands when to use it.
• Teach and observe inhaler technique before first use.

During treatment

• Monitor asthma control, COPD symptoms, rescue-inhaler use, and lung function.
• Seek medical advice immediately if a previously effective salmeterol dose fails to provide the usual response, because this may signal destabilization.
• Reassess whether continued salmeterol is still needed; once asthma is controlled, the prescriber may stop salmeterol while continuing the other asthma medicine.
• Watch for beta-agonist adverse effects, hypokalemia, hyperglycemia, paradoxical bronchospasm, and signs of increased drug exposure in hepatic impairment.
• Check inhaler technique, dose counter, storage, and the patient's understanding of not using salmeterol for acute symptoms.

Storage

AU label: store below 30 degrees Celsius in a dry place; shelf lifetime is 2 years. Keep the inhaler dry. Do not exhale into the inhaler, take it apart, or wash the mouthpiece or any part of the inhaler. Do not use the inhaler with a spacer.

Frequently asked questions

References

1. Salmeterol: MedlinePlus Drug InformationMedlinePlus, U.S. National Library of Medicine · United States · accessed 2026-10-13 · source 1
2. SEREVENT DISKUS (salmeterol xinafoate) powder, metered - prescribing informationU.S. Food and Drug Administration (DailyMed) · United States · dated 2022 · accessed 2026-10-13 · source 2
3. SEREVENT ACCUHALER salmeterol 50 microgram/actuation powder for inhalation blister pack - Consumer Medicine Informationhealthdirect Australia · Australia · accessed 2026-10-13 · source 3

Brand names by country

Single-ingredient salmeterol names are shown separately by country. Product availability, strengths, and supply rules can change; combination products are not included here.

Priority countries