When This Medicine Should Not Be Used:
You should not use this medicine if you have had an allergic reaction to salmeterol. Do not use this medicine during an asthma attack or an acute COPD flare-up.

How to Use This Medicine:
Powder Under Pressure, Disk

• Your doctor will tell you how much medicine to use. Do not use more than directed.
• This medicine should come with a Medication Guide. Ask your pharmacist for a copy if you do not have one.
• Read and follow the patient instructions that come with this medicine. Talk to your doctor or pharmacist if you have any questions.
• Serevent® Diskus® is a powder that is used with its own special inhaler device. Individually measured doses of the powder are held in a foil blister package that is placed into the Diskus®. The Diskus® pierces each blister one at a time to load the correct dose into the chamber when you are ready to use the medicine. Do not use the Diskus® with a spacer.
• Keep the Diskus® inhaler closed when you are not using it. Keep the inhaler dry at all times. Do not blow into it.
• Before inhaling your dose, breathe out fully, trying to get as much air out of the lungs as possible. Hold the Diskus® level and away from your mouth.
• Open your mouth and breathe in quickly and deeply through the Diskus®. Do not breathe in through your nose.
• Remove the Diskus® from your mouth. Hold your breath for about 10 seconds or as long as possible, then breathe out slowly.

Drugs and Foods to Avoid:
Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• This medicine should not be used together with similar inhaled medicines such as arformoterol (Brovana™), budesonide/formoterol (Symbicort®), formoterol (Foradil®, Perforomist™), or salmeterol/fluticasone (Advair®).
• Make sure your doctor knows if you have used medicine for depression (such as amitriptyline, doxepin, nortriptyline, Elavil®, Pamelor®, or Sinequan®) or an MAO inhibitor (such as Eldepryl®, Marplan®, Nardil®, or Parnate®) within the past 2 weeks.
• Tell your doctor if you are using medicine to treat depression (such as nefazodone or Serzone®), medicine to treat an infection (such as clarithromycin, itraconazole, ketoconazole, telithromycin, Biaxin®, Ketek®, Nizoral® or Sporanox®), or medicine to treat HIV or AIDS (such as atazanavir, indinavir, nelfinavir, ritonavir, saquinavir, Crixivan®, Fortovase®, Invirase®, Norvir®, Reyataz®, or Viracept®).
• Make sure your doctor knows if you are also using any diuretics or "water pills" (such as furosemide, hydrochlorothiazide [HCTZ], torsemide, Demadex®, or Lasix®) or blood pressure medicines (such as atenolol, metoprolol, propranolol, Inderal®, Tenormin®, or Toprol®).

Warnings While Using This Medicine:

• Make sure your doctor knows if you are pregnant or breastfeeding, or if you have liver disease, heart or blood vessel disease, heart rhythm problems, high blood pressure, diabetes, epilepsy or seizures, thyroid problems, or low potassium in the blood.
• If you use a corticosteroid medicine to control your asthma, keep using it as instructed by your doctor. Take all of your COPD medicines as your doctor ordered. Do not change your doses or stop using your medicines without asking your doctor.
• This should not be the first and only medicine you use for asthma or COPD. This medicine will not stop an asthma or COPD attack that has already started. Your doctor may prescribe another medicine for you or your child to use in case of an acute asthma attack or an acute COPD flare-up. If the other medicine does not work as well, or if you have used more than four puffs daily for 2 days in a row, tell your doctor right away.
• If any of your asthma medicines do not seem to be working as well as usual, call your doctor right away. Do not change your doses or stop using your medicines without asking your doctor.
• This medicine may cause paradoxical bronchospasm, which means your breathing or wheezing will get worse. Paradoxical bronchospasm may be life-threatening. Stop using this medicine and check with your doctor right away if you or your child have coughing, difficulty breathing, shortness of breath, or wheezing after using this medicine.
• If you or your child develop a skin rash, hives, or any allergic reaction to this medicine, stop using the medicine and check with your doctor as soon as possible.
• Check with your doctor right away if you or your child have chest pain, a fast heartbeat, nervousness, shaking of the hands or feet, noisy breathing, a feeling of choking, or tightness or irritation of the throat while using this medicine.
• Call your doctor if your symptoms do not improve or if they get worse.
• Your doctor will check your progress and the effects of this medicine at regular visits. Keep all appointments.

Possible Side Effects While Using This Medicine:
Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Chest pain or shortness of breath.
• Cough, fever, chills, sore throat, runny or stuffy nose, and body aches.
• Difficulty with swallowing.
• Dry mouth, increased thirst, muscle cramps, nausea, or vomiting.
• Fast, pounding, or uneven heartbeat.
• Increased asthma attacks or other breathing problems.
• Lightheadedness, dizziness, or fainting.
• Seizures or tremors.
• Troubled breathing.
• Unusual tiredness or weakness.

If you notice these less serious side effects, talk with your doctor:

• Headache.
• Muscle or bone pain.
• Nausea, vomiting, or upset stomach.
• Numbness or tingling in hands or feet.
• Skin rash.

If you notice other side effects that you think are caused by this medicine, tell your doctor.
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088