Salmeterol
- Class: Long-acting beta-2 agonist (LABA)
- Used for: asthma and COPD maintenance
- Say it: sal-MEE-ter-ol
- Forms: inhaler
SALMETEROL runs a long METER — twelve full hours — but it is slow off the line, so it can never rescue.
Slow onset is the critical half. Used alone in asthma it holds the airway open while the inflammation underneath worsens, which is why it must always be paired with a steroid.
A long-acting beta-2 agonist keeps the airway open for about twelve hours but does nothing about the inflammation underneath. Used alone in asthma it masks worsening disease and raises the risk of death — it must always be paired with an inhaled steroid.
Side effects
Common: headache, tremor, palpitations
Serious: asthma death if used without a steroid
Typical dose
50 micrograms twice daily inhaled
One inhalation twice daily, twelve hours apart. Increasing the dose does not increase the benefit.
Check yourself
Why must salmeterol never be used alone in asthma?
- It relieves symptoms while leaving the underlying inflammation untreated and worsening
- It causes dangerous potassium rises
- It is too short-acting to help
- It blocks the effect of inhaled steroids
Show answer
A. It relieves symptoms while leaving the underlying inflammation untreated and worsening
Asthma is an inflammatory disease. A LABA opens the airway without touching that inflammation, so the patient feels well while the disease progresses underneath — and the first sign can be a severe attack.
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