Each metered dose of Aerivio Spiromax contains 50 microgram salmeterol and 500 microgram fluticasone propionate, the same as Seretide 500 Accuhaler. Each delivered dose provides 45 microgram salmeterol and 465 microgram fluticasone propionate.
Aerivio Spiromax is indicated in the regular treatment of severe asthma where use of a combination product (inhaled corticosteroid and long-acting β2 agonist) is appropriate, in patients who are either:
- not adequately controlled on a lower-strength corticosteroid combination product, or
- already controlled on a high-dose inhaled corticosteroid and a long-acting β2 agonist.
The product should not be prescribed as the first salmeterol/fluticasone combination inhaler in patients naive to such therapy.
In COPD, Aerivio Spiromax can be prescribed for adults with a pre-bronchodilator FEV1 less than 60% of the predicted normal and a history of exacerbations, who remain significantly symptomatic despite regular bronchodilator therapy.
The recommended dose in both asthma and COPD is one inhalation twice daily.
Dry powder inhaler
The Spiromax device, which is also available as DuoResp Spiromax (formoterol/budesonide, indicated in asthma and COPD), is a breath-actuated dry powder inhaler that has a design similar to that of pressurised metered-dose inhalers.
There are three steps to using the Spiromax inhaler: open, breathe and close. No priming is required. Dose confirmation is provided by a 'click' sound, lactose taste and a dose indicator.
When prescribing Aerivio Spiromax, healthcare professionals must ensure patients are trained in the use of the device including instruction on the need to inhale forcefully. Patients should be advised to not shake the inhaler before use or block the air vent when preparing the ‘breathe’ step.