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<DOCUMENT author="perl program" datec=020199 title="leaflet" book="ABPI" edition="1996-97" section="company">
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WHAT YOU SHOULD KNOW ABOUT SEREVENT INHALER    
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Please read this leaflet carefully before you (or your child) start to take this medicine.  This leaflet provides a summary only: for further information or advice ask your doctor or pharmacist.
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SEREVENT INHALER SHOULD BE USED TWICE A DAY
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It is very important that you use Serevent every day, twice a day, in the morning and again in the evening.  This will help to keep you free of symptoms both throughout the day and during the night.
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SEREVENT INHALER SHOULD NOT BE USED AS A &quot;RELIEVER&quot;
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Serevent should not be used for a sudden attack of wheeze or breathlessness.
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<BLOCK>
If you get a sudden attack of wheezing or breathlessness, you should take one or two puffs from a quick acting reliever inhaler which your doctor may already have given you.  If you feel you are getting breathless or wheezy more often than normal, or you are using your short-acting reliever more often you should go and see your doctor.
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If you take more than one inhaled medicine, make sure you know which is which and when you should use them.
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OTHER IMPORTANT POINTS TO REMEMBER
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Make sure that this medicine is suitable for you (or your child) (see "Before using your inhaler" below).
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You should inhale each dose as your doctor has advised.  The directions should be given on the label: if not, or you are not sure, ask your doctor or pharmacist.
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Use your inhaler every day twice a day.  DO NOT STOP treatment even if you feel better unless told to do so by your doctor.
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DO NOT inhale more doses or use your inhaler more often than you were told.
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You or your child should continue to take any other asthma medication prescribed by the doctor in the same way as before, unless he/she tells you otherwise.  EVEN IF YOU FEEL MUCH BETTER.
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If you are told to stop using this medicine, return any unused Serevent Inhaler to your pharmacist.
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Keep this medicine OUT OF THE REACH OF CHILDREN for whom it is not intended.
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This medicine is NOT usually recommended for children below 4 years of age.
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If you have problems after taking this medicine you will find help in this leaflet.
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HOW YOUR INHALER WORKS
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The active ingredient in Serevent Inhaler is called salmeterol xinafoate.  Serevent has a "bronchodilating" action.  When taken regularly, it enables the small air passages of the lungs to remain relaxed and open.  This makes it easier for air to get in and out of the lungs, and so helps to ease breathing problems in asthma.  The effect of Serevent lasts 12 hours, so it should be taken each morning and each evening to help ensure that the benefits continue throughout the day and night..  Serevent does NOT act quickly enough to be used as a "reliever".
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BEFORE USING YOUR INHALER
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If you are pregnant you MUST tell your doctor before starting to use this inhaler.  If you become pregnant, or are intending to become pregnant or if you are breast feeding a baby, tell your doctor as soon as possible in case your treatment needs to be changed.
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If you are pregnant you MUST tell your doctor before starting to use this inhaler.  If you become pregnant, or are intending to become pregnant or if you are breast feeding a baby, tell your doctor as soon as possible in case your treatment needs to be changed.
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If you are having treatment for a thyroid gland problem; If you are having treatment for raised blood pressure or a heart problem; If you ever have had to stop taking another medicine for this illness because you were allergic to it or it did not suit you.
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If you are having treatment for a thyroid gland problem; If you are having treatment for raised blood pressure or a heart problem; If you ever have had to stop taking another medicine for this illness because you were allergic to it or it did not suit you.
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Tell your doctor or pharmacist as soon as possible if you have not already done so.
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Tell your doctor or pharmacist as soon as possible if you have not already done so.
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Make sure that your doctor knows what other medicines you are taking.
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Make sure that your doctor knows what other medicines you are taking.
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DOSE
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For adults; the usual dose is 2 puffs (2 x 25 micrograms) twice daily.  Your doctor may advise you to increase this dose to 4 puffs (4 x 25 micrograms) twice daily.
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For children over 4 years of age; the usual dose is 2 puffs (2 x 25 micrograms) twice daily.
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HOW TO USE YOUR INHALER   
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To remove the mouthpiece cover, hold between the thumb and forefinger, squeeze gently and pull apart as shown. Check inside and outside to make sure that the mouthpiece is clean.
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TESTING YOUR INHALER
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If your inhaler has not been used for a week or more, release one puff into the air | to make sure that it works.
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Shake the inhaler well.
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Hold the inhaler upright as shown above with your thumb on the base, below the mouthpiece.  Breathe out as far as is comfortable and then....
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Place the mouthpiece in your mouth between your teeth and close your lips firmly around it 
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but do not bite it.
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Just after starting to breathe in 
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through your mouth
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 press down on the top of the inhaler to release Serevent while still breathing in 
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steadily and deeply.
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Hold your breath, take the inhaler from your mouth and your finger from the top of the inhaler.  Continue holding your breath for as long as is comfortable.
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If you are to take another puff 
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keep the inhaler upright
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 and wait about half a minute before repeating steps 2 to 6.
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After use always replace the mouthpiece cover to keep out dust and fluff.
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IMPORTANT 
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<BLOCK>
Do not rush Stages 3, 4 and 5.  It is important that you start to breathe in as 
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slowly
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 as possible just before operating your inhaler.  Practice in front of a mirror for the first few times.  If you see &quot;mist&quot; coming from the top of the inhaler or the sides of your mouth you should start again from Stage 2.
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If your doctor or the nurse has given you different instructions for using your inhaler, please follow them carefully.  Tell them if you have any difficulties.
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Cleaning
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<BLOCK>
Your inhaler should be cleaned at least once a week.
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Pull the metal canister out of the plastic body of the inhaler and remove the mouthpiece cover. 
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Rinse the plastic body and mouthpiece cover in warm water.
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Leave to dry in a warm place.  Avoid excessive heat.
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Replace the canister and mouthpiece cover.
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A mild detergent or a solution of the type used to clean babies feeding bottles may be added to the water (your pharmacist will advise you).  
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Then rinse thoroughly with clean water before drying.
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  Do not put the metal canister into water.
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AFTER USING YOUR INHALER
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If you notice 
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a sudden worsening of your shortness of breath and wheeze shortly after using your inhaler,
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 tell your doctor as soon as possible.
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If the RELIEF OF WHEEZING OR CHEST TIGHTNESS IS NOT AS GOOD AS USUAL OR DOES NOT LAST FOR AS LONG AS USUAL TELL YOUR DOCTOR AS SOON AS POSSIBLE.  IT MAY BE THAT YOUR CHEST PROBLEMS ARE GETTING WORSE AND PERHAPS YOUR DOCTOR MAY WISH TO ADD ANOTHER KIND OF MEDICINE TO YOUR TREATMENT.
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If you feel unwell or have any symptoms that you don’t understand you should tell your doctor as soon as possible.
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SIDE EFFECTS
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Occasionally some people feel a little shaky or have a headache or notice that their heart is beating a little faster than usual but these effects usually wear off as treatment continues.  Tell your doctor but do not stop using Serevent Inhaler unless told to do so.
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There have been occasional reports of skin rashes, muscle cramps, local irritation, aching joints and non-specific chest pain.
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IF YOU TAKE TOO MUCH
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If you accidentally take a LARGER DOSE THAN RECOMMENDED you may notice that your heart is beating faster than usual and that you feel shaky.  You may also have a headache.  Tell your doctor as soon as possible.
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If the dose you have taken was very much larger than usual and if you feel ill or are worried you should phone your doctor AT ONCE or go to your local hospital casualty department.  If possible go with a friend and DON’T DRIVE yourself there.
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IF YOU MISS A DOSE
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If you forget a dose do not worry, inhale a dose when you remember BUT if it is near to the time for the next dose, wait until this is due.  DO NOT TAKE A DOUBLE DOSE. Then go on as before.
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STORING YOUR INHALER
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<ITEM>

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Keep your inhaler in a safe place where it cannot be reached by children for whom it is not prescribed and those who need adult help in using it.
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(Your medicine may harm those for whom it is not prescribed.)
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<ITEM>

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Protect from frost and direct sunlight.  Store below 30°C (86°F).
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Do not use this inhaler after the date shown as ‘Exp’ on the metal canister and carton.
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If the inhaler becomes very cold, remove the metal canister and warm IN YOUR HAND for a few minutes before use.  NEVER use other forms of heat.
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WARNING – The metal canister is pressurised.  Do not puncture it or burn even when empty.
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WHAT’S IN YOUR INHALER
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<BLOCK>
Serevent Inhaler contains 25 micrograms salmeterol (as salmeterol xinafoate) in each puff. Each canister provides 60 puffs.
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Your inhaler also contains Lecithin, Dichlorodifluoromethane and Trichlorofluoromethane.
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REMEMBER: This medicine should only be taken by the person for whom it is prescribed.  Only a doctor can prescribe it.  Never give it to someone else.  It may harm them even if their symptoms are similar.
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FURTHER INFORMATION
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<BLOCK>
This leaflet does not contain the complete information about your medicine.  If you have any questions or are not sure about anything, then you should ask your doctor or the pharmacist.
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You will be able to find more information about prescribed medicines from books which may be found in the public libraries.
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You may want to read this leaflet again.  Please DO NOT THROW IT AWAY until you have finished your medicine.
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This leaflet has been prepared in accordance with guidance from the Association of the British Pharmaceutical Industry.  The information given only applies to Serevent Inhaler.
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FOR CHILDREN If you are a child with asthma: read this
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Use Serevent every day, in the morning and at night before you go to bed.
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The usual dose is two puffs in the morning and two puffs at night, before you go to bed.
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If you get wheezy don t use Serevent to stop your wheeze.  You should use your &quot;reliever&quot; puffer, just like you did before.
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If you are using other puffers, you should carry on using these like you did before you started Serevent.
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It is important to keep taking your &quot;preventers&quot; even if you feel better.  Don’t stop your &quot;preventers&quot; or take less of them unless your doctor has told you to.
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<BLOCK>
If you start getting more wheezy than you usually do, get your mum or dad to take you to see the doctor.
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You should take your Serevent like your doctor said.  If you don t know how ask your doctor or chemist.
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Don’t stop taking your Serevent even if you feel better, unless your doctor said.
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Don’t take more of your Serevent than your doctor said.
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Don’t let your friends use your Serevent.  It is only for you.
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If you don’t feel well after taking Serevent, tell your mum or dad.
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It is important that your mum or dad reads the rest of this leaflet.
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Serevent is a trade mark of the Glaxo Group of Companies.
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Product Licence held by Glaxo Pharmaceuticals UK Limited,
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Stockley Park, UB11 1BT, England.
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Manufactured by Glaxo Pharmaceuticals UK Limited,
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Speke, Liverpool, L24 9JD, England.
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