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.

If you take more than one inhaled medicine, make sure you know which is which and when you should use them.

1. Make sure that this medicine is suitable for you (or your child) (see "Before using your inhaler" below).
2. 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.
3. 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.
4. DO NOT inhale more doses or use your inhaler more often than you were told.
5. 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.
6. If you are told to stop using this medicine, return any unused Serevent Inhaler to your pharmacist.
7. Keep this medicine OUT OF THE REACH OF CHILDREN for whom it is not intended.
8. This medicine is NOT usually recommended for children below 4 years of age.
9. If you have problems after taking this medicine you will find help in this leaflet.

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".

• 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.

• Tell your doctor or pharmacist as soon as possible if you have not already done so.

• Make sure that your doctor knows what other medicines you are taking.

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.

For children over 4 years of age; the usual dose is 2 puffs (2 x 25 micrograms) twice daily.

6. 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.
7. If you are to take another puff keep the inhaler upright and wait about half a minute before repeating steps 2 to 6.
8. After use always replace the mouthpiece cover to keep out dust and fluff.

Do not rush Stages 3, 4 and 5. It is important that you start to breathe in as slowly as possible just before operating your inhaler. Practice in front of a mirror for the first few times. If you see "mist" coming from the top of the inhaler or the sides of your mouth you should start again from Stage 2.

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.

Your inhaler should be cleaned at least once a week.

1. Pull the metal canister out of the plastic body of the inhaler and remove the mouthpiece cover.
2. Rinse the plastic body and mouthpiece cover in warm water.
3. Leave to dry in a warm place. Avoid excessive heat.
4. Replace the canister and mouthpiece cover.

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). Then rinse thoroughly with clean water before drying. Do not put the metal canister into water.

• If you notice a sudden worsening of your shortness of breath and wheeze shortly after using your inhaler, tell your doctor as soon as possible.

• 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.

• If you feel unwell or have any symptoms that you don’t understand you should tell your doctor as soon as possible.

• 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.

• There have been occasional reports of skin rashes, muscle cramps, local irritation, aching joints and non-specific chest pain.

• 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.

• 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.

• 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.

• 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.

• Protect from frost and direct sunlight. Store below 30°C (86°F).

• Do not use this inhaler after the date shown as ‘Exp’ on the metal canister and carton.

• 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.

• WARNING – The metal canister is pressurised. Do not puncture it or burn even when empty.

Serevent Inhaler contains 25 micrograms salmeterol (as salmeterol xinafoate) in each puff. Each canister provides 60 puffs.

Your inhaler also contains Lecithin, Dichlorodifluoromethane and Trichlorofluoromethane.

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.

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.

You will be able to find more information about prescribed medicines from books which may be found in the public libraries.

You may want to read this leaflet again. Please DO NOT THROW IT AWAY until you have finished your medicine.

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.