Following are some precautions and warnings to be aware of with salmeterol:
In some studies, people taking salmeterol were more likely to have very severe asthma attacks. Some of these very severe asthma attacks have resulted in deaths. It is not entirely clear if salmeterol caused these problems or not. The medication should not be started in people whose asthma is significantly worsening (or in emergency situations), as this may increase the risk of death. Let your healthcare provider known immediately if your asthma symptoms become worse during treatment with salmeterol.
Salmeterol is not a fast-acting asthma medication and cannot replace fast-acting rescue inhalers. Do not use salmeterol to treat an asthma attack. Everyone taking salmeterol should also have a rescue medication available at all times. Let your healthcare provider know if you need to use your rescue inhaler more frequently than usual, as this may be a sign of worsening asthma.
Salmeterol cannot replace steroids for asthma. If you take a steroid asthma medication, your healthcare provider should not stop or reduce the dose of your steroid medication when you start salmeterol.
Do not take salmeterol more frequently than prescribed, as this may increase your risk of side effects.
Salmeterol can have a stimulatory effect on the heart and blood pressure. A fast heart rate (tachycardia), high blood pressure (hypertension), and irregular heart rhythms (arrhythmias) may occur -- though low blood pressure (hypotension) is also possible. If you have heart disease or high blood pressure, make sure your healthcare provider is aware of it. He or she may wish to use particular caution when recommending salmeterol for your situation.
People with an overactive thyroid (hyperthyroidism), diabetes, or epilepsy should use caution when using salmeterol, as the drug may worsen these conditions or increase the risk of side effects.
Salmeterol is considered a pregnancy Category C medication. This means that it may not be safe to use during pregnancy. Talk with your healthcare provider about the risks and benefits of using salmeterol during pregnancy (see Serevent and Pregnancy for more information).
It is not known if salmeterol passes through breast milk. Therefore, if you are breastfeeding or plan to start breastfeeding, be sure to talk with your healthcare provider about using salmeterol (see Serevent and Breastfeeding for more information).
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