Combisal

What is Combisal?

Combisal is a white inhaler with a purple lid that you use twice a day. It uses a combination of salmeterol and fluticasone to prevent asthma symptoms long-term.

Salmeterol works to keep your airways clear and fluticasone helps reduce inflammation in your lungs. Together, they combine to relieve and prevent asthmatic symptoms, such as breathlessness and wheezing, from happening.

Because Combisal is a ‘regular’ medication you take every day, you’ll still have your rescue inhaler to hand in case you get unexpected asthma symptoms or have an attack.

How does Combisal work?

Combisal contains two active ingredients: salmeterol and fluticasone. Using a Combisal inhaler can help prevent asthma attacks, and help relieve breathing difficulties in the long term when used regularly.

Salmeterol is a bronchodilator which means the muscles in the lungs are relaxed so it makes breathing easier.

Fluticasone is a corticosteroid, they reduce cells in the lung releasing cytokines. Cytokines are a chemical that causes inflammation and irritation. ^{[1] [2]}

Because salmeterol works for around 12 hours, taking your inhaler twice a day (once in the morning and once in the evening), helps provide continuous control for your symptoms. ^[3]

What doses does Combisal come in?

Combisal comes in 25mcg of salmeterol with three different fluticasone doses and after an analysis of your health, your prescriber will recommend which one will suit the severity of your asthma.

These doses are:

• 25mcg/50mcg (mild)
• 25mcg/125mcg (moderate)
• 25mcg/250mcg (moderate to severe)

All inhalers will come with 120 actuations or “puffs”.

Are Combisal and Seretide the same?

Combisal and Seretide are almost the same. They both use the same active ingredients and do the same job by preventing asthma symptoms.

Seretide, however, comes in two forms: Seretide Evohaler and Seretide Accuhaler. The Evohaler looks like most inhalers with a liquid-filled canister. An Accuhaler contains dry powder, looks like a round disc and is ‘breath-actuated’ where you just inhale.

How to use Combisal

Before using your Combisal inhaler, make sure you test that it works properly.

Preparing your inhaler for use:

Before you use your inhaler for the first time, or if you haven’t used it for a week or more, you must prepare it. Remove the mouthpiece cover, shake the inhaler well, and release two puffs into the air.

Using your inhaler:

• Shake the inhaler four or five times
• Breathe out as far as you can
• Holding the inhaler, place the mouthpiece in your mouth
• At the same time as you breathe in, press the top of the pump to release a puff
• Breathe in slowly and deeply
• Remove the inhaler from your mouth and try to hold your breath as comfortably as you can
• Wait for about 30 seconds before taking the next puff, then repeat the steps
• Afterwards, rinse your mouth out or brush your teeth to reduce the side effects of thrush and a hoarse voice

The standard dose for all strengths is two puffs, twice a day. If you’re using your inhaler more often or think you need to adjust your dose, speak to your clinician for advice.

How effective is Combisal?

Using a combination inhaler like Combisal is part of preventative treatment for asthma. Fluticasone is the preventer part and helps to build protection over time so you should notice improvement after a few days.

If you take Combisal regularly, fluticasone will notably reduce the inflammation in your lungs. After a few weeks, you will see the benefits such as minor trigger reactions, sleeping better, and breathing easier. ^[1]

What happens if I use too much?

If you use too much of your Combisal inhaler, tell your doctor. Larger doses may reduce the amount of steroid hormones produced by the adrenal gland and this can cause a faster, irregular heartbeat and dizziness.

If you forget to use your inhaler, just take your next puffs at the usual time.

Do not reduce your dose or stop taking Combisal suddenly without speaking to your doctor first.