Odd seretide dosage

[Farnsfield]

Has anyone seen seretide used three times a day? Got a script for this last week, surgery told me it was recommended by specialist respiratory nurse. GP rang her to check it but I was busy with a patient when he rang back to confirm so didn't have chance to get any more details. I suppose I could ring him again or try to speak to the nurse direct but I just wondered if anyone else had experience of this. Common sense to me would just be to increase twice daily dose if needed.

[Sir_Dispensalot]

i was under the impression that because salmeterol is a long acting beta2 agonist it should only be given in a bd dosage. It wouldn't be too dangerous to give it tds but the patient is at risk of developing ventricular arrhythmia or prolonged QT interval as the risk of side effects is increased. It might be wise to speak to the resp. nurse about it if possible to see the clinical reasoning behind it and why the patient isn't simply being switched to a different treatment regimen if bd salmeterol isn't enough.

[SolomonQ]

i would have thought the best action would have been to increase the strenght of the seretide or if at max. the addition of Atrovent or nebulisers etc....

also consider the increased complications due to higher intake of the steroid because of the tds dose.

[Steve G]

Does the patient have COPD or asthma? It would make more sense to add in extra treatment, rather than increasing the seretide to tds (and what strength of seretide are they on?)