Sirdupla

• Sirdupla is a preventer inhaler used to keep the symptoms of asthma under control and reduce the risk of asthma attacks (exacerbations of asthma)
• Sirdupla contains a steroid called fluticasone and a bronchodilator called salmeterol
• Sirdupla reduces the inflammation within the airways making it easier to breathe, as well as controlling other asthma symptoms including wheeze and cough
• You are likely to also require a reliever inhaler to be taken in case of an asthma attack 
• It is important to read the patient leaflet for a full list of side effects and cautions.

Sirdupla is an inhaler that contains two medications. The first drug is a steroid called fluticasone. Fluticasone helps to reduce the swelling within the airways. It does this by dampening down the actions of inflammatory cells in the airways, including mast cells and white blood cells. With the swelling minimised, it is easier to draw air into the lungs via the airways. Inhaled steroids such as fluticasone help to reduce wheezing and make your breathing feel less restricted.

Sirdupla also contains the long acting bronchodilator salmeterol. Salmeterol relaxes the muscles around the airways, helping to open the passageways so that it feels easier to breathe.

Some people feel an improvement soon after taking their inhaler. However, it can take up to two weeks before you notice the full benefit of taking Sirdupla inhaler. At this point, it is important to continue using your inhaler every day as prescribed. Stopping your inhaler is likely to lead to your symptoms of asthma recurring.

You may also need a “reliever” inhaler in case of a sudden flare up of symptoms including breathlessness, wheezing, coughing, or an asthma attack.

Sirdupla inhaler should be taken every day to keep your symptoms under control. It is important to read the manufacturer’s instructions to ensure you get the full dose of the medications.

The following may help you understand how to take your inhaler.

1. Sit or stand up straight to take your inhaler.
2. Check the dose counter to be sure that the inhaler isn’t empty.
3. Remove the cover and check there is nothing inside the mouthpiece.
4. Shake the inhaler well.
5. Breathe out away from the inhaler.
6. Put the mouthpiece into your mouth and close your lips around it to form a good seal. Do not bite the inhaler.
7. Push the top of the canister down firmly and breathe in quickly and deeply. This will help to draw the medication into the lungs.
8. Take your finger off the canister and remove the inhaler from your mouth, then keep your mouth closed.
9. Hold your breath for 10 seconds, or for as long as is comfortable.
10. Breathe out slowly.
11. If you are prescribed a second dose, repeat steps 4 to 10.
12. Replace the cap of the inhaler.

Some people find it easier to take their Sirdupla inhaler with a spacer device. Speak to your doctor if you think you might benefit from using a spacer.

You should rinse your mouth with water after taking Sirdupla inhaler, as this will help to minimise the risk of mouth infections.

Sirdupla inhalers come in two different strengths:

• The 25/125 inhaler contains 25 micrograms of salmeterol and 125 micrograms of fluticasone per dose
• The 25/250 inhaler contains 25 micrograms of salmeterol and 250 micrograms of fluticasone per dose.

Sirdupla is only prescribed for adults, and your doctor will prescribe the correct dose for you based on the severity of your asthma symptoms. 

It is common to start by taking two puffs of the 25/125 inhaler twice daily. 

Like all medications, Sirdupla can have some side effects. The most common side effects include:

• Headache
• Inflammation or infection of the nose or throat
• Candida of the mouth (a fungal infection in the mouth)
• Chest infections
• Irritation of the throat
• Hoarse voice
• Sinusitis
• Skin bruising more easily
• Muscle cramps
• Aches and pains
• Low potassium level on blood testing.

These side effects are likely to settle down, but if they persist or become troublesome you should speak to your doctor for further advice. If you think you have an infection, contact your doctor as antimicrobial treatment may be required.

The risk of developing a fungal infection in the mouth can be reduced by rinsing your mouth with water or brushing your teeth after taking the inhaler. 

More serious side effects are rare. They are more likely if you have been taking Sirdupla or another steroid inhaler or tablet for a long time. The side effects include:

• Signs of an infection including high temperature, cough with phlegm or mucus, pain on passing urine (peeing), or mouth sores
• A round puffy face known as ‘moon face’ – this can be a sign of Cushing’s Syndrome
• Diarrhoea and vomiting, loss of appetite, weight loss, tiredness, and dizziness – these can be signs of adrenal problems
• Blurred vision due to glaucoma or cataracts.

Serious allergic reactions happen very rarely. If you have a severe allergic reaction (anaphylaxis) including breathlessness, lip swelling or tongue swelling, call 999 immediately.

Sirdupla inhaler may not be suitable for everyone. You should tell your prescriber if you:

• Have an allergy to any of the ingredients in Sirdupla
• Have ever had an allergic reaction to any other medication
• Have a heart rhythm abnormality
• Have thyroid disease
• Have low potassium levels on blood testing
• Have diabetes
• Are pregnant, trying to conceive, or breastfeeding – this is because it is important that your asthma is well controlled at this time.

Your prescriber can then advise whether Sirdupla is a suitable medication for you.

Occasionally, using a new inhaler can lead to worsening of your symptoms. If you notice shortness of breath, wheeze, or a persistent cough after taking Sirdupla inhaler, use your reliever inhaler and contact your doctor straight away.

Some medications can interact with Sirdupla. You may be advised that Sirdupla will not suit you if you already take:

• Beta blockers
• Antifungal medications 
• Some antibiotics
• Medications for HIV or AIDS.

Because Sirdupla may not suit everyone, we will complete a Consultation with you including a health questionnaire. This will ensure that the medication will be suitable for you.

A qualified prescriber will review your current medications, including any herbal remedies or supplements, to ensure that Sirdupla will not interact with them. 

Once prescribed, Sirdupla will be ordered on your behalf via electronic prescription. Sirdupla will then be conveniently dispatched from one of our partner pharmacies.