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What are the Side Effects of Salmeterol Xinafoate?

By Mary Lou Derksen
Updated Feb 25, 2024
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Salmeterol xinafoate is a long-acting beta agonist (LABA) used daily as a bronchodilator for controlling asthma symptoms. As does any medication, salmeterol xinafoate has side effects. Some — sinus or nasal congestion, runny or stuffy nose, short-term throat irritation, mild headaches, and tremors or nervousness — are considered minor and generally of no great concern. Serious side effects include hives or a rash; breathing difficulty, choking, or wheezing; swelling anywhere on the face or in the mouth or throat; fever; unusual thirst, hunger, urination or drowsiness, and other symptoms of high blood sugar.

The most serious, though rare, side effect of salmeterol xinafoate is an intensification of asthma symptoms, sometimes causing death. This potential problem has led the U.S. Food and Drug Administration (FDA) to say that LABA medications should always be used in conjunction with an asthma controller medication such as inhaled corticosteroids. Two-in-one medications — a LABA plus an asthma controller — are encouraged to aid in compliance with some of these recommendations. According to the FDA, salmeterol and other LABAs should not be used for a long period of time if a patient’s asthma can be controlled sufficiently with an asthma controller medication. They should be used only long enough to bring asthma symptoms under control.

Other possible side effects of salmeterol xinafoate include severe itching, dizziness, irregular or fast heartbeat, chest pain or tightness, continuous or severe cramps or muscle pain, confusion and excitement. The potential consequences of some of these side effects mean patients should contact their doctor immediately whenever they experience any of these severe side effects. A doctor also should be contacted if side effects not mentioned here are experienced.

There are several medical conditions for which salmeterol xinafoate is prescribed. Asthma bronchospasms is the most common. It is sometimes used long-term for chronic obstructive pulmonary disease (COPD) bronchospasms if the COPD is moderate to severe. The third most common use is to prevent bronchospasms caused by exercise. It is generally prescribed for use once or twice a day.

Salmeterol xinafoate is not to be used by patients who have asthma that can be adequately controlled by other means. These include inhalers with occasional-use, short-acting beta2-adrenergic agonists, or a combination of the beta2 agonist and inhaled corticosteroids. It should never be the first medication used to treat asthma or COPD. Drugs that can have negative interactions with salmeterol xinafoate include strong inhibitors of CYP 3A4, diuretics that are nonpotassium-sparing, and two types of antidepressants — tricyclic and monoamine oxidase (MAO) inhibitors.

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