Seroflo Rotacaps 500 Mcg

Description

About Seroflo Rotacaps 500 mcg

Seroflo Rotacaps 500 mcg are prescription dry-powder capsules containing salmeterol 50 mcg and fluticasone propionate 500 mcg, made by Cipla Limited, used for maintenance treatment of severe asthma in adults and adolescents aged 12 and over, and for COPD where a specialist prescribes it. It is the highest-strength Seroflo capsule, delivering a high daily dose of inhaled corticosteroid (1,000 mcg of fluticasone a day at the standard dose), and is inhaled through a Rotahaler or Revolizer.

How does it work?

The large fluticasone dose suppresses stubborn airway inflammation, including eosinophils, mucus and swelling, in asthma that has not responded to medium doses. Salmeterol relaxes bronchial muscle for about 12 hours to keep the airways open between doses. The combination is a controller: it reduces symptoms and attacks over time but does not relieve breathlessness instantly.

When is the 500 mcg strength used?

• Severe asthma: when the 250 strength does not give control, after inhaler technique and adherence have been checked.
• COPD: UK and European labeling use this strength for COPD with frequent exacerbations, while US labeling stops at the 250/50 dose for COPD because higher steroid doses did not add benefit there. Your doctor will choose based on your history.

Because the steroid dose is high, guidelines advise using it for the shortest time needed and stepping down once asthma is stable.

How to use Seroflo Rotacaps 500 mcg

1. Take one capsule out only when you are ready for the dose, with dry hands.
2. Load it into your capsule device and open it according to the device instructions.
3. Exhale fully away from the device, then inhale rapidly and as deeply as you can.
4. Hold the breath for a slow count of ten, then check that no powder remains.
5. Rinse your mouth, gargle and spit out the water; this matters even more at high steroid doses.

The dose is one capsule twice daily, about 12 hours apart, and never more than two capsules a day. Do not use it to treat an attack; keep a reliever inhaler such as Asthalin Inhaler with you.

High-dose steroid safety

At this dose, more fluticasone reaches the bloodstream, so the doctor will watch for effects beyond the lungs:

• Adrenal suppression: long-term high doses can reduce the body’s own cortisol. Do not stop suddenly, and tell any doctor treating you for surgery, injury or serious illness that you use a high-dose inhaled steroid. In the UK, people on this dose are generally given a steroid emergency card; ask whether you should carry a similar alert.
• Bones and eyes: lower bone density, cataracts and glaucoma; regular eye checks are sensible.
• Blood sugar: may rise in people with diabetes.
• Pneumonia: a higher risk in people with COPD.

What are the side effects?

Thrush in the mouth, a croaky voice, throat irritation, headache, easy bruising, tremor and palpitations. Seek urgent care for breathing that worsens after a dose, chest pain, an irregular heartbeat, severe weakness or dizziness, or allergic swelling.

Interactions and cautions

Ritonavir and cobicistat-boosted HIV medicines, ketoconazole, itraconazole and clarithromycin can raise fluticasone levels enough to cause Cushing’s syndrome and adrenal suppression, and they increase salmeterol’s effects on the heart. Beta-blockers, diuretics, MAO inhibitors and tricyclic antidepressants need review. Do not add any other long-acting beta-agonist. The capsules contain lactose. Discuss pregnancy and breastfeeding with your doctor.

Pack sizes and storage

Packs of 30, 60 or 90 Rotacaps, from $11; 30 capsules last 15 days at the standard dose. Store below 77°F (25°C), in a dry place, with the bottle closed.

Frequently asked questions

Will I stay on 500 mcg permanently?

Not necessarily. Once asthma is stable, many people step down to Seroflo Rotacaps 250 mcg.

Is there an option without capsules?

The Seroflo Multihaler comes in a 500 strength too; check the strength on the device.

Where can I see other asthma treatments?

Visit the asthma category.

This page is for general information and is not personal medical advice. Seroflo Rotacaps 500 mcg are a high-dose prescription medicine; your doctor should review the dose regularly.