The Seretide 250 Accuhaler is a fixed combination preventer. GlaxoSmithKline UK makes it. Each dose delivers two active ingredients. Firstly, fluticasone propionate 250 micrograms is an inhaled steroid. Additionally, salmeterol 50 micrograms is a long-acting reliever. As a result, one twice-daily dose covers both the swelling and the airway tightening. The Seretide 250 Accuhaler Summary of Product Characteristics confirms the ingredients and doses.
Why the medium strength matters
The 250 microgram strength sits in the middle of the Seretide Accuhaler range. Meanwhile, the range also includes 100 and 500 microgram versions. In particular, the 250 microgram version suits patients whose asthma needs more than a low steroid dose. Additionally, at 2 doses a day this counts as a medium adult ICS dose. Furthermore, this makes it a common step-up option in adult asthma.
Why some patients prefer a dry powder inhaler
The Accuhaler is a dry powder inhaler, not a pressurised aerosol. Firstly, no propellant is used. Additionally, your own airflow pulls the powder from the pre-loaded foil blister. Meanwhile, this removes the need for press-and-breathe coordination. As a result, some patients get more consistent technique with an Accuhaler than with an Evohaler.
Key features and specifications
Active ingredients per pre-dispensed dose: fluticasone propionate 250 micrograms and salmeterol xinafoate 50 micrograms
Delivered dose (leaving the mouthpiece): 231 micrograms fluticasone and 47 micrograms salmeterol
Form: inhalation powder in a pre-loaded foil strip inside a plastic Accuhaler device
Pack size: 28 or 60 doses per Accuhaler (60 usually supplied)
A medium-strength dry powder combination preventer for asthma
If your asthma isn’t holding on a lower-strength combination, or your prescriber is switching you from a pMDI to a dry powder device, the Seretide 250 Accuhaler is a well-established next step. Firstly, it delivers 250 micrograms of fluticasone plus 50 micrograms of salmeterol per pre-dispensed dose. Additionally, it’s a breath-actuated dry powder inhaler with a built-in dose counter. Meanwhile, at 2 doses a day it counts as a medium adult ICS dose. At Courier Pharmacy, we help you make sense of whether this combination fits your control needs.
Five key takeaways
The Seretide 250 Accuhaler is a fixed combination of fluticasone 250 micrograms and salmeterol 50 micrograms per dose.
It’s a dry powder Accuhaler device with a pre-loaded foil strip and a built-in dose counter.
Licensed for adults and adolescents from 12 years with asthma not controlled on a steroid alone.
At 2 doses a day, it delivers a medium adult ICS dose of 500 micrograms of fluticasone daily.
The Seretide 250 Accuhaler is a Prescription Only Medicine. A UK-qualified prescriber reviews every request at courierpharmacy.co.uk.
Treatment dosage Seretide 250 Accuhaler
Adult and adolescent dose
For adults and adolescents aged 12 and over, the usual dose is 1 inhalation twice daily. As a result, that’s 2 doses a day in total. Additionally, doses are usually taken 12 hours apart. Furthermore, this delivers 500 micrograms of fluticasone and 100 micrograms of salmeterol daily. The BNF and Seretide 250 Accuhaler Summary of Product Characteristics confirm these figures.
When your reliever use signals a problem
Above all, needing your rescue reliever more than 3 times a week is a signal. Firstly, it usually means your control isn’t holding. Additionally, it flags that a review is due. In fact, NICE NG245 links heavy reliever use to worse asthma outcomes. Rather than reaching for more Seretide, contact your prescriber.
Stepping up or down
Your prescriber may step you up to Seretide 500 Accuhaler if control needs more. Alternatively, they may step you down to Seretide 100 Accuhaler once your control has been stable. Furthermore, any step-change should be planned. Meanwhile, never stop your preventer suddenly.
What is Seretide 250 Accuhaler: overview
A twice-daily combination preventer containing fluticasone (a steroid) and salmeterol (a long-acting reliever).
A breath-actuated dry powder inhaler with a foil strip of pre-loaded doses and a dose counter.
Licensed for asthma in adults and adolescents from 12 years.
Made by GlaxoSmithKline UK, and part of one of the most-used combination inhaler ranges in the UK.
Prescription only, and the middle-strength option in the Seretide Accuhaler range.
Why combination inhalers exist
Combination inhalers answer a practical problem. Before they existed, patients on both an inhaled steroid and a long-acting reliever used two separate devices. As a result, adherence often suffered. Additionally, technique varied between devices. However, a single device delivers both medicines together. Meanwhile, this improves consistency and simplifies the daily routine.
Fluticasone and salmeterol together
Seretide combines two well-established medicines. Firstly, fluticasone propionate has been used in inhaled form since the 1990s. Additionally, salmeterol was one of the first long-acting relievers introduced. As a result, this combination has decades of clinical experience behind it. Furthermore, twice-daily dosing keeps steady cover across each 24 hours.
The Accuhaler device
The Accuhaler is a purple disc-shaped device. Meanwhile, it holds a foil strip with 28 or 60 pre-loaded doses. Additionally, sliding the lever exposes and prepares the next dose. Furthermore, the built-in counter shows how many doses remain. As a result, you always know when to reorder.
Where the 250 strength fits
The Seretide Accuhaler range includes 100, 250, and 500 microgram strengths of fluticasone. Meanwhile, all three contain 50 micrograms of salmeterol per dose. In particular, the 250 microgram version delivers a medium adult ICS daily dose. Furthermore, it suits patients who need more steroid than Seretide 100 Accuhaler offers.
A note on lactose
Notably, each dose contains up to 12.5 mg of lactose monohydrate. In particular, this matters for anyone with severe lactose intolerance. Similarly, patients with a confirmed milk protein allergy should be cautious. Small traces of milk protein can be present in inhalation-grade lactose. Mention any dairy allergies during your consultation.
Why choose Courier Pharmacy for your Seretide 250 Accuhaler
Registered, independent, and patient-led
Courier Pharmacy is a UK-registered independent pharmacy. The General Pharmaceutical Council regulates us. Firstly, respiratory disease looks different for every patient. Additionally, your triggers, history, and device preferences all matter. As a result, our prescribers ask about those things. Getting your combination inhaler right is about the fit.
Dr Ada Jex-Cori, our brand pharmacist
Our brand pharmacist is Dr Ada Jex-Cori. She represents the spirit of what we do. Named for Ada Lovelace, Sophia Jex-Blake, and Gerty Cori, she stands for evidence-led, unafraid-of-questions medicine. Her message is straightforward. You’re not broken. The system is. We’re here to change that.
Care that keeps showing up
We don’t disappear after we’ve dispensed. Furthermore, if your control shifts, we’re here. Additionally, if a side effect appears, we help you make sense of it. For patients navigating MCAS, chronic fatigue, or fibromyalgia alongside respiratory care, that continuity matters. Care that fits you means care that keeps showing up.
Buy Seretide 250 Accuhaler (Prescription Only) from Courier Pharmacy
The Seretide 250 Accuhaler is a Prescription Only Medicine. You can request it at courierpharmacy.co.uk. Firstly, complete an online consultation. Then, a UK-qualified prescriber reviews your answers. If approved, we dispense and deliver discreetly.
Complete a quick online consultation
A UK prescriber reviews your answers
If approved, a prescription is issued
We dispense and deliver discreetly to your door
If it isn’t suitable for you, we’ll explain why and suggest the next best option.
Active ingredients in Seretide 250 Accuhaler
Fluticasone at a glance
Fluticasone propionate is an inhaled steroid. Firstly, each Accuhaler dose delivers 250 micrograms. In particular, it binds to steroid receptors in airway cells. As a result, it switches off the genes that produce inflammatory chemicals. Additionally, airway swelling reduces over 1 to 2 weeks. Peer-reviewed studies have shown fluticasone reduces asthma flare-ups significantly.
Salmeterol at a glance
Salmeterol xinafoate is a long-acting beta-2 agonist. Meanwhile, each dose delivers 50 micrograms. Additionally, it activates beta-2 receptors on airway smooth muscle. As a result, the muscle relaxes and airways stay open for about 12 hours. However, salmeterol has a slow onset of around 10 to 20 minutes. Furthermore, this is why it cannot be used for rescue.
Lactose and milk protein
Additionally, each dose contains up to 12.5 mg of lactose monohydrate as a carrier. Furthermore, the lactose helps disperse the medicines as you breathe in. Notably, small traces of milk protein can be present in inhalation-grade lactose. As a result, patients with severe milk protein allergy should discuss the risk. For most people, this isn't a concern.
What is Seretide 250 Accuhaler for?
Licensed for asthma maintenance
The Seretide 250 Accuhaler is licensed for the regular treatment of asthma. In particular, it suits patients not adequately controlled on inhaled steroids and short-acting relievers. Additionally, it suits patients already stable on a similar combination. Above all, this is a preventer, taken every day even when you feel well.
Where it fits in the treatment ladder
In practical terms, Seretide 250 Accuhaler is a step up from lower-strength combinations. If your Seretide 100 Accuhaler isn't holding, this is one route forward. Furthermore, NICE NG245 recognises combination inhalers as appropriate when steroids alone aren't enough. However, the 250 strength does not carry a COPD licence in the UK.
When you'll still need a reliever
Above all, always keep a short-acting reliever with you. Meanwhile, salmeterol is a slow-onset long-acting reliever, so it cannot be used for rescue. As a result, ask your prescriber about salbutamol or terbutaline as your rescue medicine. If you're using your rescue reliever more than 3 times a week, contact your prescriber.
How does Seretide 250 Accuhaler work?
Fluticasone calms the swelling
Fluticasone binds to steroid receptors in airway cells. Firstly, this switches off the genes that produce inflammatory chemicals. As a result, airway swelling reduces over 1 to 2 weeks. Additionally, the airways become less twitchy. Think of it as turning down the alarm system in your airways.
Salmeterol keeps the airways open
Salmeterol activates beta-2 receptors on airway smooth muscle. Meanwhile, the signal tells the muscle to relax. As a result, the airways stay open for around 12 hours. However, salmeterol has a slow onset compared to formoterol. Additionally, this is why it cannot be used for rescue relief.
How the Accuhaler device fires
In a pMDI, a propellant pushes the medicine out as a spray. However, the Accuhaler has no propellant. Meanwhile, your own airflow draws the powder from the foil blister. As a result, the device only works well with a firm, steady inhalation. Patients with very reduced inspiratory flow may need a different device.
How long until you feel the full effect
You may notice some airway opening from salmeterol within the first day. However, the full anti-inflammatory benefit takes 1 to 2 weeks. Furthermore, maximum control usually shows within 4 to 6 weeks. As a result, sticking with twice-daily use matters. Above all, take it even when you feel well.
How to use Seretide 250 Accuhaler
Step-by-step technique
Firstly, hold the Accuhaler in one hand and push the thumb grip until it clicks. Then, slide the lever away from you until it clicks. That loads one dose. Next, breathe out gently, away from the mouthpiece. Now put the mouthpiece to your lips and breathe in as hard and deep as you can. Hold your breath for 10 seconds if you can. The NHS provides an inhaler technique guide for reference.
Between doses and moisture care
Close the Accuhaler by sliding the thumb grip back until it clicks. Additionally, keep the device dry and away from steamy bathrooms. Above all, don't breathe out into the mouthpiece. Moisture can affect the powder. Furthermore, don't wash the mouthpiece with water. Wipe it with a dry tissue if needed.
Mouth care and storage
Rinse your mouth and spit afterwards, or brush your teeth. Additionally, inhaled steroids can cause oral thrush or a hoarse voice. Meanwhile, rinsing removes any medicine that hasn't reached your lungs. Furthermore, store the Accuhaler below 30 degrees Celsius. Keep it in a dry place at all times.
Warnings and precautions for Seretide 250 Accuhaler
Who should not use it
Firstly, don't use Seretide if you're allergic to fluticasone or salmeterol. Additionally, tell your prescriber about heart disease, irregular heartbeat, or high blood pressure. Similarly, mention diabetes, thyroid problems, tuberculosis, or any lung infection. As a result, these conditions need extra care with Seretide.
Steroid effects at medium and higher doses
Inhaled steroids can affect the body's natural steroid production. In particular, this matters at medium to high doses used for a long time. As a result, patients on Seretide 250 Accuhaler may need a steroid safety card. Above all, tell any healthcare team you're on Seretide, especially before surgery.
Cardiovascular considerations
Salmeterol can slightly raise heart rate and blood pressure. However, palpitations are uncommon. Meanwhile, patients with existing heart disease need extra care. Additionally, potassium can drop at high doses. As a result, mention any cardiac history during consultation.
Lactose and milk protein allergy
Notably, the Seretide 250 Accuhaler contains lactose. In particular, this includes small traces of milk protein. As a result, patients with severe milk protein allergy should discuss the risk. For most people with mild lactose intolerance, the small amount is not a concern. However, disclose any dairy allergies during consultation.
Paradoxical bronchospasm
Very rarely, inhalers cause paradoxical bronchospasm. This is when airways tighten straight after use. Firstly, if this happens, stop Seretide and use your reliever. Additionally, contact your prescriber urgently. Above all, don't continue with the same inhaler until reviewed.
Pregnancy and breastfeeding
Both fluticasone and salmeterol have been used in pregnancy. However, data is more limited than for older ICS medicines. Meanwhile, both pass into breast milk in small amounts. As a result, if you're pregnant, planning pregnancy, or breastfeeding, mention it during your consultation.
Side effects of Seretide 250 Accuhaler
Common side effects
The most common side effects affect up to 1 in 10 people. These include sore throat, hoarse voice, headache, and oral thrush. Additionally, palpitations and tremor can occur. Meanwhile, some patients notice muscle cramps. Most are manageable with good technique and mouth care.
Uncommon side effects
Uncommon side effects (up to 1 in 100) include skin rashes and dizziness. Furthermore, sleep problems and irritability can occur. Additionally, cataract has been reported with long-term use. Your prescriber may monitor these during regular reviews.
Rare and very rare side effects
Rare side effects (up to 1 in 1,000) include irregular heartbeat and behavioural changes. Very rare side effects (up to 1 in 10,000) include serious allergic reactions and adrenal effects. Additionally, glaucoma has been reported very rarely. Above all, any of these need urgent attention.
When to seek urgent help
Seek urgent help for sudden worsening breathlessness after a dose. Similarly, seek help for facial swelling or difficulty breathing. Additionally, get help for severe chest pain or an irregular heartbeat. Meanwhile, any widespread rash needs immediate attention.
Yellow Card reporting
You can report any suspected side effects directly via the MHRA Yellow Card Scheme at https://yellowcard.mhra.gov.uk. Reporting side effects helps provide more information on the safety of this medicine.
Drug interactions with Seretide 250 Accuhaler
Beta-blockers
Firstly, beta-blockers can reduce or block the effect of salmeterol. This includes non-selective ones like propranolol. Additionally, cardioselective beta-blockers can interact to a lesser extent. Meanwhile, some glaucoma eye drops contain beta-blockers. Tell your prescriber about any of these.
CYP3A4 inhibitors
Meanwhile, strong CYP3A4 inhibitors can raise blood levels of fluticasone. In particular, ritonavir and cobicistat matter most. Additionally, ketoconazole, itraconazole, and clarithromycin also count. As a result, disclose any of these during your consultation. Furthermore, your prescriber will monitor for systemic steroid effects if you must take them together.
Other airway medicines and diuretics
Additionally, other beta-2 agonists can add up to more side effects. Similarly, xanthines like theophylline deserve mention. In particular, diuretics that lower potassium can interact with salmeterol. Furthermore, digoxin and other steroids need discussion. Above all, tell your prescriber about every medicine you take.
Frequently asked questions about Seretide 250 Accuhaler
How quickly does the Seretide 250 Accuhaler start working?
Salmeterol opens your airways within 10 to 20 minutes of the first dose. However, the full anti-inflammatory benefit from fluticasone takes 1 to 2 weeks. Furthermore, maximum control usually shows within 4 to 6 weeks. Stick with it every day, even when you feel well.
Can I use Seretide 250 Accuhaler as a rescue inhaler?
No. Seretide is a maintenance preventer only. In particular, salmeterol has a slow onset and cannot be used for rescue. As a result, always keep a separate short-acting reliever with you. If you're using your reliever more than 3 times a week, contact your prescriber.
What's the difference between the Accuhaler and the Evohaler?
The Accuhaler is a dry powder inhaler that fires when you breathe in. Meanwhile, the Evohaler is a pressurised aerosol you press to release the dose. Additionally, the Accuhaler contains lactose while the Evohaler doesn't. As a result, the two devices suit different patient preferences.
What's the difference between Seretide 100, 250, and 500 Accuhaler?
All three contain the same 50 micrograms of salmeterol per dose. However, they differ in fluticasone. Firstly, Seretide 100 gives 100 micrograms. Additionally, Seretide 250 gives 250 and Seretide 500 gives 500. As a result, the 250 sits in the middle of the range.
Is Seretide 250 Accuhaler licensed for COPD?
No. Only the 500 strength Accuhaler carries a UK COPD licence. Meanwhile, the 250 strength is licensed for asthma in adults and adolescents. As a result, if you have COPD, ask your prescriber about the 500 strength instead.
Do I need a steroid safety card with Seretide 250 Accuhaler?
Possibly. Steroid safety cards are usually recommended for patients on medium or higher daily inhaled steroid doses. Additionally, they alert healthcare teams that you may need extra steroid cover in illness or surgery. Above all, ask your prescriber whether you need one on your dose.
Does Seretide 250 Accuhaler contain lactose?
Yes. Each dose contains up to 12.5 mg of lactose monohydrate. Notably, small traces of milk protein can be present. As a result, patients with severe milk protein allergy should discuss the risk. For most people with mild lactose intolerance, the small amount is not a concern.
Can I use Seretide 250 Accuhaler with a spacer?
No. Spacers only work with pressurised inhalers. The Accuhaler is a dry powder device. It relies on you breathing in strongly through the mouthpiece. As a result, a spacer would prevent it from working correctly.
Can I stop Seretide 250 Accuhaler if I feel well?
No. Seretide is a preventer, and it works because you take it every day. As a result, stopping it lets airway swelling come back. Speak to your prescriber before any change. Any step-down should be planned, not sudden.
Does the Seretide 250 Accuhaler have a dose counter?
Yes. The Accuhaler has a built-in dose counter. Additionally, the counter shows how many doses remain out of the 60 doses supplied. As a result, you always know when to reorder. Meanwhile, numbers 5 to 0 appear in red to warn you the device is nearly empty.
Will Seretide 250 Accuhaler affect my heart?
Salmeterol can slightly raise heart rate and blood pressure. Meanwhile, palpitations are uncommon. However, existing heart disease needs discussion before starting. Above all, contact your prescriber urgently for new chest pain or an irregular heartbeat.
Can Seretide 250 Accuhaler make me hoarse?
Yes. Hoarseness is a common side effect of inhaled steroids. Above all, it usually settles as your voice adjusts. Additionally, rinsing your mouth after each dose reduces the risk. If it persists, tell your prescriber.
Can I use Seretide 250 Accuhaler during pregnancy?
Only after careful discussion. Firstly, both ingredients have been used in pregnancy but with less data than older ICS medicines. Meanwhile, both pass into breast milk in small amounts. As a result, if you're pregnant, planning pregnancy, or breastfeeding, tell your prescriber.
Can Seretide 250 Accuhaler be used in children?
It's licensed for adolescents aged 12 and over in asthma. However, the Seretide 100 Accuhaler is used for younger children from 4 years upward. As a result, ask your prescriber about the right strength for children under 12. Above all, dosing decisions in children need careful specialist input.
What if Seretide 250 Accuhaler isn't controlling my asthma?
If Seretide 250 Accuhaler doesn't hold your control at 2 doses a day, your prescriber may step you up. In particular, Seretide 500 Accuhaler delivers a higher steroid dose. Furthermore, this is a considered clinical decision. Discuss any ongoing symptoms with your prescriber.
Will Seretide 250 Accuhaler affect my blood sugar?
Salmeterol can raise blood sugar slightly. Additionally, this matters most for people with diabetes. Meanwhile, if you have diabetes, your monitoring may need tightening after starting Seretide. Above all, disclose any diabetes during your consultation.
What happens if I miss a dose?
Take the missed dose as soon as you remember. However, if it's nearly time for the next dose, skip it. Never double up. Consistency over weeks matters more than any single missed dose.
How should I store Seretide 250 Accuhaler?
Store below 30 degrees Celsius in a dry place. Additionally, keep it away from steamy bathrooms. Never wash the mouthpiece with water. Keep it out of the reach of children. Don't use it past the expiry date.
Will I need a prescription from Courier Pharmacy?
Yes. Seretide 250 Accuhaler is a Prescription Only Medicine. A UK-qualified prescriber must review your suitability. You can complete the consultation at courierpharmacy.co.uk. Additionally, if you're already stable on Seretide 250 Accuhaler, mention this in the consultation.
What if Seretide 250 Accuhaler isn't right for me?
Sometimes another Seretide strength suits better. In other cases, a different combination or the Evohaler version may be preferred. Whatever the situation, we'll explain why and suggest the next best option. Honesty over sales, every time.
More than a prescription: our community
Free fortnightly drop-in clinics in Derby
Healthcare shouldn't only happen when you're paying for it. Every fortnight, we run free drop-in talks at Insomnia, Derby, from 10 am to 12 pm. Anyone can come. No appointment. No cost. No pressure.
Topics we cover
We cover asthma control and inhaler technique. Additionally, we discuss weight management and hormone health. Furthermore, we cover MCAS, chronic fatigue, and more. Learn more about our community talks at courierpharmacy.co.uk.
Disclaimer
Disclaimer: This information is for education only and isn't a substitute for personal medical advice. Always follow your prescriber's instructions.
National Institute for Health and Care Excellence (2024) Asthma: diagnosis, monitoring and chronic asthma management. NICE guideline NG245. Available at: https://www.nice.org.uk/guidance/ng245
