Seretide Accuhaler

Seretide is a combination inhaler containing fluticasone propionate (an inhaled corticosteroid preventer) and salmeterol (a long-acting bronchodilator — the same drug in Serevent). It's used as a daily maintenance treatment for asthma and COPD, delivering both medicines together so the steroid and the LABA are always taken as a pair.

Fluticasone calms the underlying airway inflammation; salmeterol keeps the airways open for around 12 hours per dose. Combining them in a single device makes it impossible to take the LABA without the steroid — which, as covered under Serevent above, is a meaningful safety advantage.

The two are similar in concept — both combine a steroid with a long-acting bronchodilator — but they behave differently because of the LABA each one uses. Symbicort contains formoterol, which acts within minutes, so it can be used as both a maintenance and a reliever inhaler in MART regimens. Seretide contains salmeterol, which takes around 30 minutes to work, so it's used as maintenance only. If you're on Seretide, you'll always have a separate fast-acting reliever (such as Ventolin or Bricanyl) for sudden symptoms.

No. Because of the slower onset of salmeterol, Seretide isn't suitable for relieving sudden symptoms or treating an asthma attack. Always use your separately prescribed fast-acting reliever in those situations.

Seretide comes in two main forms. The Accuhaler is a dry powder inhaler — you slide the lever to load a dose, breathe out gently away from the mouthpiece, then breathe in fast and deeply through it, hold your breath for ten seconds, and breathe out gently. The Evohaler is a pressurised metered-dose inhaler used much like Ventolin — shake, breathe out, seal lips, breathe in slowly while pressing the canister, hold your breath, breathe out. A spacer is recommended with the Evohaler. Either way, rinse, gargle, and spit with water afterwards to reduce the risk of oral thrush and hoarse voice.

Hoarse voice, oral thrush, throat irritation, tremor, headache, and occasional palpitations are the most commonly reported. Mouth care after each dose substantially reduces the local steroid effects.

The bronchodilator effect of salmeterol builds over the first few doses; the full anti-inflammatory effect of fluticasone develops over four to six weeks, in line with other inhaled steroids.

Switching between combination inhalers — for example from Seretide to Symbicort, or from Seretide to a newer combination — isn't a simple like-for-like swap, because the doses, devices, and intended regimens differ. A prescriber should always handle the switch and review symptom control after a few weeks, both because steroid doses aren't directly equivalent across different inhalers and because the role of the LABA changes (especially if MART becomes a possibility on a Symbicort-style regimen).