Seretide Accuhaler & Evohaler: Uses, Dosage, Side Effects & How to Order

✓ Medically reviewed by  ·  Last reviewed: May 2026

Morgan Ellis

Pharmacy Researcher · 8 years experience

Pharmacy researcher with 8 years reviewing clinical drug information, generic formulation equivalence, and international pharmaceutical standards. Focuses on patient-facing accuracy in medication education.

If you have been prescribed a combination inhaler for asthma or COPD, there is a very good chance the originator your doctor named was Seretide. It has been the market-leading ICS/LABA combination for two decades in most countries, which means there is a well-established evidence base, clear dosing protocols, and — importantly — a mature generic supply chain that gives patients access to the same molecules at a fraction of the originator price.

This guide covers everything clinically relevant: what the two components do and why they work better together, how the Accuhaler and Evohaler devices differ (and how to use each correctly), the dose-strength selection logic, side effects to watch for, how Seretide compares to the main alternatives, and how to order without navigating a GP appointment.

What Is Seretide?

Seretide is a preventer combination inhaler — not a rescue inhaler. For acute symptom relief, see our guide to rescue inhalers (salbutamol/albuterol).

Seretide is the brand name for a fixed-dose combination of two drugs that address the two central pathological processes in asthma and COPD:

1. Fluticasone propionate (the ICS component) is a synthetic glucocorticoid that suppresses airway inflammation. In asthma, chronic eosinophilic inflammation causes mucosal oedema, goblet-cell hyperplasia, and bronchial hyper-responsiveness — the underlying biology behind wheeze, chest tightness, and exacerbations. Fluticasone acts at the level of gene transcription, downregulating pro-inflammatory cytokines (IL-4, IL-5, IL-13), reducing mast-cell density in the airway wall, and restoring normal mucosal architecture with sustained use. Unlike systemic corticosteroids, inhaled fluticasone acts predominantly locally with very low systemic absorption from the lung surface.

2. Salmeterol (the LABA component) is a long-acting beta-2 adrenoceptor agonist. It produces sustained bronchodilation (open airways) for up to 12 hours by binding beta-2 receptors on airway smooth muscle, relaxing the bronchoconstriction that restricts airflow during an attack. Critically, salmeterol is a bronchodilator — it does not treat the underlying inflammation. This is why current international guidelines (GINA for asthma; GOLD for COPD) are explicit: LABAs must only be used in conjunction with an ICS, never alone. Seretide delivers both molecules together, eliminating the risk of inadvertent LABA monotherapy.

The combination is additive rather than merely synergistic: fluticasone reduces the inflammation that makes airways hypersensitive; salmeterol keeps the airway smooth muscle relaxed. Patients who switch from an ICS alone (e.g. beclomethasone or budesonide monotherapy) to Seretide typically see improvement in FEV1, reduced exacerbation frequency, and better symptom control within 4–8 weeks of the step-up.

Seretide Accuhaler vs Seretide Evohaler

Seretide is a preventer combination inhaler — not a rescue inhaler. For acute symptom relief, see our guide to rescue inhalers (salbutamol/albuterol).

Seretide is manufactured in two distinct inhaler devices. Both deliver the same fluticasone/salmeterol molecules — the clinical difference lies in technique and handling, not pharmacology.

Clinical bottom line: if you can generate enough inspiratory flow (most adults can), the Accuhaler is simpler to use correctly — there is no timing to coordinate. If you struggle with forceful inhalation or already use a spacer device, the Evohaler with a spacer delivers better lung deposition.

Seretide Dose Strengths Explained

Seretide is a preventer combination inhaler — not a rescue inhaler. For acute symptom relief, see our guide to rescue inhalers (salbutamol/albuterol).

Seretide comes in three strengths, denoted by the fluticasone dose (the ICS component). The salmeterol component is fixed at 50 µg per dose across all strengths.

Standard dosing is one inhalation twice daily (morning and evening, roughly 12 hours apart). Total daily fluticasone doses are therefore 200 µg, 500 µg, or 1,000 µg depending on the strength. Daily doses above 800–1,000 µg of inhaled fluticasone warrant monitoring for systemic corticosteroid effects.

Who Should Use Seretide?

Seretide is a preventer combination inhaler — not a rescue inhaler. For acute symptom relief, see our guide to rescue inhalers (salbutamol/albuterol).

For asthma: Seretide is indicated at GINA steps 3–5 — when asthma is not adequately controlled with a low-dose ICS alone. Before stepping up, it is worth confirming that poor control reflects genuine inadequate treatment (rather than poor inhaler technique or low adherence). If technique and adherence are confirmed, stepping up to Seretide 250/50 µg bd is the standard evidence-based move.

For COPD: Seretide 500/50 µg is licensed for symptomatic COPD management in patients with FEV1 <60% predicted and two or more exacerbations per year. In COPD, the primary goal is reducing exacerbation frequency; inhaled corticosteroids have a more modest effect on airflow than in asthma, but the combination with salmeterol improves quality-of-life scores and reduces exacerbation rate in the target population.

Seretide is not appropriate for: acute bronchospasm (it is a maintenance inhaler — use a short-acting bronchodilator such as Asthalin (salbutamol) as your rescue inhaler). Patients on Seretide still need a separate reliever inhaler for breakthrough symptoms.

How to Use a Seretide Accuhaler Correctly

Seretide is a preventer combination inhaler — not a rescue inhaler. For acute symptom relief, see our guide to rescue inhalers (salbutamol/albuterol).

Incorrect technique is the single biggest cause of treatment failure with dry-powder inhalers. Approximately 70% of patients use their DPI incorrectly. The steps below follow the GlaxoSmithKline patient technique guide:

1. Open the Accuhaler. Hold the outer case in one hand, place the thumb of the other hand in the thumb grip, and slide away from you until a click is heard. The mouthpiece is now exposed.
2. Load a dose. Hold the Accuhaler horizontally with the mouthpiece facing you. Slide the lever away from you until it clicks — this punctures the foil blister and releases one dose. Do not shake the device.
3. Exhale gently — away from the device. Do not breathe out into the mouthpiece; moisture degrades the dry powder.
4. Inhale steadily and deeply. Place the mouthpiece in your mouth, seal your lips around it, and inhale as steadily and as deeply as you can. The dose is carried in on your inspiratory flow — a faster, deeper breath delivers more drug to the lungs.
5. Hold your breath for 5–10 seconds. This allows powder to settle onto the airway surface rather than being exhaled immediately.
6. Close the device. Slide the thumb grip back toward you until it clicks shut — the dose counter will advance.
7. Rinse your mouth with water and spit. This removes any fluticasone deposited in the oropharynx, preventing oral thrush (candidiasis), the most common local side effect of ICS inhalers.

How to Use a Seretide Evohaler Correctly

Seretide is a preventer combination inhaler — not a rescue inhaler. For acute symptom relief, see our guide to rescue inhalers (salbutamol/albuterol).

The Evohaler is a standard pressurised MDI. The key skill is timing: the canister must be pressed at the moment you begin to inhale — not before, not after.

1. Shake the inhaler vigorously for 5 seconds. This is critical — the suspension must be fully mixed.
2. Remove the mouthpiece cap and check for debris. For a new inhaler or one unused for more than 5 days, prime by releasing 2 test actuations into the air away from your face.
3. Breathe out gently — away from the inhaler.
4. Seal your lips around the mouthpiece and start to breathe in slowly (aim for a 4–5 second inhalation). Press the canister firmly downward at the start of inhalation — not before.
5. Continue inhaling slowly to the end of breath. Remove the inhaler from your mouth.
6. Hold your breath for 5–10 seconds.
7. Wait 30 seconds before taking a second inhalation if prescribed (two puffs per dose).
8. Replace the mouthpiece cap. Rinse your mouth and spit.

Side Effects of Seretide

Seretide is a preventer combination inhaler — not a rescue inhaler. For acute symptom relief, see our guide to rescue inhalers (salbutamol/albuterol).

Common (oropharyngeal/local):

• Oral candidiasis (thrush) — white patches in the mouth or throat; caused by local deposition of fluticasone. Prevented almost entirely by rinsing after every dose. If it occurs, topical antifungal (nystatin or clotrimazole lozenge) clears it within 2 weeks; Seretide does not usually need to be stopped.
• Hoarseness or dysphonia — voice change from corticosteroid effect on laryngeal muscles. Generally mild; usually resolves with continued therapy or dose reduction.
• Throat irritation — more common with DPIs. Rinsing and using a spacer (Evohaler) reduce frequency.

Common (systemic — salmeterol component):

• Tremor — fine skeletal muscle tremor; a class effect of beta-2 agonists. Usually transient and more pronounced after initiation.
• Palpitations or increased heart rate — mild tachycardia, also a beta-2 agonist effect. Monitor in patients with pre-existing cardiac arrhythmia.
• Headache

Uncommon but important to monitor:

• Adrenal suppression — at high doses of inhaled fluticasone (>1,000 µg/day) taken long-term, some degree of HPA axis suppression is possible, especially in children. Monitor growth in paediatric patients. Adults on long-term 500/50 µg bd should have periodic review.
• Paradoxical bronchospasm — a rare but recognised response to inhaled drugs, including Seretide. If symptoms worsen immediately after inhalation, stop the inhaler and use a short-acting bronchodilator.
• Decreased bone mineral density — with prolonged high-dose ICS use. Calcium and vitamin D supplementation is often recommended for high-dose long-term ICS users.

Seretide vs Alternatives — Which Combination Inhaler?

Seretide is a preventer combination inhaler — not a rescue inhaler. For acute symptom relief, see our guide to rescue inhalers (salbutamol/albuterol).

Switching from Seretide to Seroflo is straightforward for most patients — same molecule, same strength options. Seroflo is available at MedsBase at significantly lower cost than the Seretide originator price, which matters for patients self-funding treatment. The generic’s WHO-GMP certification means the same quality controls apply.

Ordering Seretide Without a Prescription

Seretide is a preventer combination inhaler — not a rescue inhaler. For acute symptom relief, see our guide to rescue inhalers (salbutamol/albuterol).

Seretide is available at MedsBase’s asthma and COPD treatment category without a prescription. Both the Accuhaler and the Evohaler are stocked across all three dose strengths (100/50, 250/50, and 500/50 µg).

If you are looking for the most cost-effective equivalent, Seroflo (fluticasone/salmeterol) contains identical active molecules, is manufactured by a WHO-GMP-certified pharmaceutical company, and is available at a lower price point. Clinically experienced patients switching from Seretide brand to Seroflo generic typically report no difference in effect.

Before ordering, confirm you are ordering the correct device (Accuhaler if you use a dry-powder device; Evohaler if you prefer a pMDI or use a spacer) and the correct dose strength. If you are using 250/50 µg twice daily for asthma, order the Seretide Accuhaler 250/50 µg — the most commonly ordered strength.

Worldwide Shipping is available. Orders are dispatched in plain, unmarked packaging.

Every order is covered by MedsBase Reshipment Assurance — if your parcel doesn’t arrive within the expected window, we re-ship at no cost to you.

Frequently Asked Questions

Seretide is a preventer combination inhaler — not a rescue inhaler. For acute symptom relief, see our guide to rescue inhalers (salbutamol/albuterol).

What is the difference between Seretide Accuhaler and Evohaler?

Both deliver the same drug combination (fluticasone + salmeterol) in the same dose strengths. The Accuhaler is a dry-powder inhaler that is breath-activated — you don’t need to coordinate pressing and inhaling. The Evohaler is a pressurised MDI that requires coordinating the press with your inhalation. The Evohaler can be used with a spacer to improve lung delivery; the Accuhaler cannot. For most adults with adequate inspiratory flow, the Accuhaler is easier to use correctly.

Can I use Seretide as a reliever inhaler during an asthma attack?

No. Seretide is a maintenance (preventer) inhaler — it is designed for regular twice-daily use to prevent symptoms, not to reverse acute bronchospasm. For breakthrough symptoms or acute attacks, use a short-acting bronchodilator such as salbutamol (e.g. Asthalin). If you are having a severe asthma attack, seek emergency medical care immediately.

How long does it take for Seretide to work?

The salmeterol component produces bronchodilation within 10–20 minutes of inhalation. However, the full anti-inflammatory benefit of the fluticasone component builds over weeks of regular use — most patients notice improved symptom control at 4–8 weeks, and maximum benefit by 3 months. This is why regular twice-daily dosing (even when asymptomatic) is essential and is not the same as “on-demand” use.

What should I do if I miss a dose of Seretide?

If you remember within a few hours, take the missed dose. If it is closer to your next scheduled dose, skip the missed dose and resume your normal schedule. Do not double-dose. Seretide’s effect is maintained over the dose interval, so a single missed dose typically has only a minor impact on symptom control — but regularly missing doses substantially reduces the anti-inflammatory benefit.

Is there a generic version of Seretide available?

Yes. Seroflo (manufactured by Cipla) is the principal WHO-GMP-certified generic containing identical fluticasone propionate and salmeterol at the same dose strengths as Seretide. It is available significantly below the branded Seretide price. Other generics including Serobid are also available in some markets.

Can I use Seretide if I have heart disease?

The salmeterol component is a beta-2 agonist, which can cause mild tachycardia and, rarely, palpitations. In patients with stable, well-controlled coronary artery disease or heart failure, inhaled LABAs at standard doses are generally considered safe, but this should be discussed with your cardiologist before starting or continuing treatment. Seretide is contraindicated in patients with significantly compromised cardiac function.

Does Seretide cause weight gain?

Unlike oral corticosteroids, inhaled fluticasone at standard doses is not associated with clinically meaningful weight gain. The vast majority of fluticasone at therapeutic doses acts locally in the lungs with minimal systemic absorption. Only at high doses over long periods (1,000 µg+/day) do measurable systemic effects accumulate.

Written by

Sophie Chen

Pharmaceutical Content Researcher · 8 years experience

Sophie Chen is a pharmaceutical content researcher with 8 years covering generic medication access and clinical pharmacology. She specialises in international regulatory frameworks, bioequivalence standards, and patient-facing education on therapeutic drug classes. She is not a clinician.