The Seretide 500 Accuhaler is a fixed combination preventer. GlaxoSmithKline UK makes it. Each dose delivers two active ingredients. Firstly, fluticasone propionate 500 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 500 Accuhaler Summary of Product Characteristics confirms the ingredients and doses.
Why the dry powder design matters
The Accuhaler is a dry powder inhaler, not a pressurised aerosol. Meanwhile, the medicine sits in pre-loaded blisters on a foil strip inside the device. As a result, no propellant is used. Additionally, your own airflow pulls the powder out when you breathe in. Furthermore, this suits patients who struggle with press-and-breathe technique on the Evohaler.
Licensed for asthma and COPD
Notably, the Seretide 500 Accuhaler is the only Seretide strength with a COPD licence in the UK. Firstly, it’s licensed for asthma in adults and adolescents from 12 years. Additionally, it’s licensed for adults with COPD, an FEV1 below 60% of predicted normal, and repeated flare-ups. As a result, this makes it a dual-purpose combination inhaler. NICE NG115 recognises fluticasone-salmeterol as an option in eligible COPD patients.
Key features and specifications
Active ingredients per pre-dispensed dose: fluticasone propionate 500 micrograms and salmeterol xinafoate 50 micrograms
Delivered dose (leaving the mouthpiece): 460 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 high-strength dry powder preventer for severe asthma and COPD
If your asthma isn’t holding on a lower-strength combination, or you have COPD with repeated flare-ups, the Seretide 500 Accuhaler is often the next move. Firstly, it delivers 500 micrograms of fluticasone plus 50 micrograms of salmeterol per pre-dispensed dose. Additionally, it’s a dry powder inhaler that fires when you breathe in strongly. Meanwhile, at 2 doses a day it counts as a high adult ICS dose. At Courier Pharmacy, we help you make sense of whether this high-strength option fits your control needs.
Five key takeaways
The Seretide 500 Accuhaler is a fixed combination of fluticasone 500 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 with asthma, and for adults with COPD.
At 2 doses a day, it delivers a high adult ICS dose of 1,000 micrograms of fluticasone daily.
The Seretide 500 Accuhaler is a Prescription Only Medicine. A UK-qualified prescriber reviews every request at courierpharmacy.co.uk.
Treatment dosage Seretide 500 Accuhaler
Adult and adolescent dose for asthma
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 1,000 micrograms of fluticasone and 100 micrograms of salmeterol daily. The BNF and Seretide 500 Accuhaler Summary of Product Characteristics confirm these figures.
Adult dose for COPD
For adults with COPD, the dose is the same: 1 inhalation twice daily. In particular, this is only for patients with FEV1 below 60% of predicted normal and repeated flare-ups. Additionally, it’s for patients with significant symptoms despite regular bronchodilator therapy. NICE guideline NG115 covers this in detail.
Stepping up or down
Your prescriber may step you down once your control has been stable for a while. In particular, this may mean switching to Seretide 250 Accuhaler or another combination. Furthermore, any step-down should be planned. Meanwhile, never stop your preventer suddenly. As a result, disclose any recent changes during consultation.
What is Seretide 500 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 and for adults with COPD.
Made by GlaxoSmithKline UK, and one of the most-studied combination inhalers in COPD trials.
Prescription only, and the highest-strength option in the Seretide Accuhaler range.
Why some patients prefer the Accuhaler
The Accuhaler exists because not everyone gets on with a pMDI. Firstly, some patients struggle with the press-and-breathe timing. Additionally, others prefer a device that fires when they breathe in. Meanwhile, the Accuhaler is breath-actuated, so the timing is automatic. As a result, technique becomes simpler for many patients.
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 500 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 500 microgram version delivers a high adult ICS daily dose. Furthermore, only the 500 strength has a COPD licence in the UK.
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 500 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 500 Accuhaler (Prescription Only) from Courier Pharmacy
The Seretide 500 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 500 Accuhaler
Fluticasone at a glance
Fluticasone propionate is an inhaled steroid. Firstly, each Accuhaler dose delivers 500 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 500 Accuhaler for?
Licensed for severe asthma
The Seretide 500 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 high-dose combination. Above all, this is a preventer, taken every day even when you feel well.
Licensed for COPD
Notably, the 500 strength Accuhaler is licensed for adults with COPD. In particular, it suits patients with an FEV1 below 60% of predicted normal. Additionally, patients must have a history of repeated flare-ups. Furthermore, they must have significant symptoms despite regular bronchodilator therapy. The NHS covers COPD treatment options in detail.
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 500 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 500 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. In particular, mouth care matters more at higher steroid strengths. Furthermore, store the Accuhaler below 30 degrees Celsius.
Warnings and precautions for Seretide 500 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.
Pneumonia risk in COPD
Notably, inhaled steroid combinations have been linked to a higher rate of pneumonia in COPD patients. Furthermore, older patients, those with a lower BMI, and those with more severe COPD are at higher risk. Meanwhile, contact your prescriber urgently for a new cough, fever, or worsening breathlessness. As a result, this risk needs balancing against the benefits.
Steroid effects at high doses
Inhaled steroids can affect the body's natural steroid production. In particular, this matters at the high doses delivered by Seretide 500. As a result, patients on Seretide 500 usually need a steroid safety card. Above all, tell any healthcare team you're on Seretide, especially before surgery. Furthermore, don't stop suddenly without medical advice.
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 500 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 500 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, muscle cramps are also common. Above all, in COPD patients, pneumonia has been reported as common. Most other effects settle with good technique.
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 high-dose 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, high-dose users need periodic review for these effects.
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. Furthermore, in COPD patients, contact your prescriber urgently for new cough, fever, or increased sputum production.
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 500 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, this matters more at the 500 microgram strength than at lower doses. Furthermore, disclose any of these during your consultation.
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 500 Accuhaler
How quickly does the Seretide 500 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 500 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.
Is Seretide 500 Accuhaler licensed for COPD?
Yes. Notably, only the 500 strength Accuhaler has a UK COPD licence. In particular, it's for adults with an FEV1 below 60% of predicted and repeated flare-ups. Additionally, patients must have significant symptoms despite regular bronchodilator therapy. Discuss suitability with your prescriber.
Is 500 micrograms a high dose?
Yes. At 2 doses a day, Seretide 500 delivers 1,000 micrograms of fluticasone daily. In particular, this counts as a high adult ICS dose. As a result, patients on this strength usually need a steroid safety card. Additionally, regular reviews with your prescriber matter more at this dose.
Do I need a steroid safety card with Seretide 500 Accuhaler?
Yes. Steroid safety cards are required for patients on high daily inhaled steroid doses like the Seretide 500 Accuhaler. Additionally, they alert healthcare teams that you may need extra steroid cover in illness or surgery. Above all, ask your prescriber about getting a card if you're on this strength.
Can I use Seretide 500 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.
Why is pneumonia a concern with Seretide 500 in COPD?
Studies have shown a higher rate of pneumonia in COPD patients on inhaled steroid combinations. Additionally, older patients, those with lower BMI, and those with more severe COPD are at higher risk. Meanwhile, contact your prescriber urgently for new cough, fever, or worsening breathlessness.
Can I stop Seretide 500 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. Additionally, sudden stops after high-dose steroid use can affect adrenal function. Above all, speak to your prescriber before any change.
Does the Seretide 500 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 500 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.
Will Seretide 500 Accuhaler affect my adrenal function?
At high daily doses, inhaled steroids can affect the body's natural steroid production. In particular, this matters with Seretide 500. Meanwhile, your prescriber may monitor this if you're on the 500 strength long-term. As a result, don't stop suddenly without medical advice.
Can Seretide 500 Accuhaler make me hoarse?
Yes. Hoarseness is a common side effect of inhaled steroids. Additionally, the risk rises with higher steroid strengths. Above all, it usually settles as your voice adjusts. Rinsing your mouth after each dose reduces the risk.
Can I use Seretide 500 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. Additionally, high-dose use raises the level of caution. As a result, if you're pregnant or breastfeeding, tell your prescriber.
Can Seretide 500 Accuhaler be used in children?
It's licensed for adolescents aged 12 and over in asthma. However, the 500 microgram strength usually suits adults with more severe disease. As a result, ask your prescriber about the right strength for younger patients. Above all, dosing decisions in children need careful specialist input.
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 500 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 500 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 500, mention this in the consultation.
What if Seretide 500 Accuhaler isn't right for me?
Sometimes another Seretide strength suits better. In other cases, a different combination or add-on therapy is the answer. 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
