Page 29 - P4304.1-V109_PS Magazine - May 2025 (print)

Prescription Charges – not your problem?
Or are they?

PSUK is pleased to offer a 40% discount

on Sereflo pMDIs for dispensing practices (If you are in Wales or Scotland, where all prescriptions

are free from charge, this article is not for you!)
Product NHS List price 1 PSUK discount Saving

Sereflo pMDI 40% £5.99
25/125mcg £14.99
It is so important that you understand
Sereflo pMDI £19.99 40% £7.99 how a prescription makes you money, as without
25/250mcg this information you will struggle to see profits in
the dispensary. You should understand that both
Sereflo pMDI can offer a 25mcg salmeterol with 125 or 250mcg fluticasone the dispensing fee and the item reimbursement are
combination more cost-effectively than the market-leading competitors, important, and each can offer you that all important
Seretide® and Sirdupla® (salmeterol/fluticasone). Plus, you can take positive financial margin if you keep your eye on the
1-3
advantage of significant additional savings with the PSUK discount.
ball. (If this is news to you then can I suggest you
come to a study day – soon!)

Sereflo pMDI is indicated for use in adults with asthma 18 years of age and older only. 4,5 However, those important margins
Sereflo pMDI is indicated in the regular treatment of patients with moderate to severe asthma can all go down the proverbial drain if
where use of a combination product (long-acting β2 agonist and inhaled corticosteroid) your prescription forms are not being
is appropriate:
- patients not adequately controlled on a lower strength corticosteroid combination product 4,5 handled correctly and accurately. I
or would encourage you to read on here
- patients already adequately controlled on an inhaled corticosteroid in a mid or as the results of poor prescription
high strength and a long-acting β2 agonist. 4,5 management can be extremely
Seretide is a trademark of GSK. Sirdupla is a registered trademark of Mylan. detrimental to your profits.
pMDI = pressurised metered dose inhaler.

®
Sereflo Metered Dose Inhaler (salmeterol xinafoate/fluticasone with caution in patients with severe cardiovascular disorders or heart rhythm abnormalities and in
propionate) patients with diabetes mellitus, thyrotoxicosis, uncorrected hypokalaemia or with a predisposition to
low levels of serum potassium. Prescribers should also be aware of the risk of adrenal suppression
Prescribing Information and acute adrenal crisis which may occur in patients on prolonged treatment with high doses of Caroline Pond
Please consult the full Summary of Product Characteristics (SmPC) before prescribing
Sereflo 25 microgram (μg) salmeterol xinafoate /125 μg or 250 μg fluticasone propionate per actuation inhaled corticosteroids. Systemic effects may occur with any inhaled corticosteroid and it is important
therefore, that the patient is reviewed regularly and the dose of inhaled corticosteroid is reduced to the
pressurised inhalation, suspension. For both dose strengths the equivalent delivered dose per
actuation is 21 μg of salmeterol and the delivered fluticasone propionate is 110 μg, for 125 μg dose lowest dose at which effective control of asthma is maintained. Visual disturbances may be reported
strength and 220 μg, for 250 μg dose strength. INDICATIONS: For use in adults with asthma 18 years with steroid use. Patients presenting with blurred vision or other visual disturbances should be
of age and older only. Sereflo is indicated in the regular treatment of patients with moderate to severe considered for referral to an ophthalmologist. Drug Interactions: Concomitant use should be avoided
asthma where use of a combination product (long-acting β2 agonist and inhaled corticosteroid) is with; non-selective and selective β blockers, ritonavir and other potent/moderate CYP3A inhibitors,
appropriate: patients not adequately controlled on a lower strength corticosteroid combination product unless potential benefit outweighs the risk. Particular caution is advised in acute severe asthma
or patients already adequately controlled on an inhaled corticosteroid in a mid or high strength and as hypokalaemia may be potentiated by concomitant treatment with xanthine derivatives, steroids
a long-acting β2 agonist. POSOLOGY AND ADMINISTRATION: Patients should be instructed and diuretics. See the SmPC for further information on contraindications and precautions.
in the proper use of their inhaler (see SmPC and patient information leaflet). Recommended PREGNANCY AND LACTATION: Balance risks against benefits. UNDESIRABLE EFFECTS:
doses in adults 18 years and older - Two inhalations of 25μg salmeterol and 125 μg or 250 μg Adverse events which have been associated with salmeterol/fluticasone propionate include: Very
fluticasone propionate twice daily. A short-term trial of salmeterol and fluticasone propionate may be common; nasopharyngitis and headache; Common; candidiasis of the mouth and throat, pneumonia,
considered as initial maintenance therapy in adults with moderate persistent asthma for whom rapid bronchitis, hypokalaemia, throat irritation, hoarseness/dysphonia, sinusitis, contusions, muscle
control of asthma is essential. In these cases, the recommended initial dose is two inhalations of 25 cramps, traumatic fractures, arthralgia and myalgia. For other adverse events please consult the full NHS prescription charges
μg salmeterol and 50 μg fluticasone propionate twice daily. Note: Sereflo is not available in a lower SmPC. MARKETING AUTHORISATION HOLDER & PL NUMBERS: Cipla (EU) Ltd. Dixcart House,
strength product containing salmeterol 25 μg and fluticasone propionate 50 μg. Therefore, when Addlestone Road, Bourne Business Park, Addlestone, Surrey KT15 2LE. PL 36390/0237 and PL
initiating therapy, or when it is appropriate to titrate down to a dose below 125 μg, an alternative 36390/0238. Legal category: POM. NHS Cost 25 μg/125 μg 1x 120 dose MDI £14.99 and 25 μg/250
fixed-dose combination of salmeterol and fluticasone propionate containing a lower dose of the μg 1x 120 doses MDI £19.99. Date of last revision: April 2020. When we dispense a prescription for a patient on the NHS, the medications or
inhaled corticosteroid is required. Use of a spacer device; where required in those with difficulties in
coordinating actuation of the inhaler with inspiration of breath, it is recommended ONLY for higher appliances and cost of dispensing are to all intent and purpose free-of-charge to the
strength Sereflo containing salmeterol 25 μg and fluticasone propionate 250 μg. Patients should Adverse events should be reported. Reporting forms and information can
continue to use the same make of spacer device (Volumatic or the AeroChamber Plus) as switching be found at www.mhra.gov.uk/yellowcard or search for MHRA Yellowcard patient, but some patients are required to pay a nominal prescription charge if they do
between spacer devices can result in changes in the dose delivered to the lungs. See the SmPC
for further information on initiation, titration down and spacer use. CONTRAINDICATIONS: in the Google Play or Apple App Store. Adverse events should also be not qualify for one of the many exemptions listed on the reverse of the prescription form.
Hypersensitivity to the active substances or to any of the excipients. SPECIAL WARNINGS AND reported Cipla (EU) Ltd on 0800 0472144, drugsafety@cipla.com
PRECAUTIONS: Sereflo should not be used to treat acute asthma symptoms for which a fast- and As of March 2025, when I am writing this article, in England, certain groups are exempt
short-acting bronchodilator is required. Patients should be advised to have their inhaler to be used
for relief in an acute asthma attack available at all times. Patients should not be initiated on Sereflo References. from NHS prescription charges. The standard prescription charge is £9.90 per item.
during an exacerbation, or significantly worsening or acutely deteriorating asthma. Serious asthma- 1. Dictionary of medicines and devices (dm+d), available at https://www.nhsbsa.nhs.uk/pharmacies-gp-
related adverse events and exacerbations may occur with Sereflo. Patients should be asked to practices-and-appliance-contractors/dictionary-medicines-and-devices-dmd (accessed August 2022).
continue treatment but to seek medical advice if asthma symptoms remain uncontrolled or worsen 2. British National Formulary, Medicinal forms, available at
after initiation. Treatment should not be stopped abruptly due to risk of exacerbation. Therapy should https://bnf.nice.org.uk/medicinal-forms/fluticasone-with-salmeterol.html (accessed August 2022).
be down-titrated under physician supervision. All inhaled medication containing corticosteroids 3. MIMS.co.uk (accessed August 2022).
should be administered with caution in patients with active or quiescent pulmonary tuberculosis and 4. Sereflo 25 microgram/125 microgram. Summary of Product Characteristics.
fungal, viral or other infections of the airway. Salmeterol and fluticasone propionate should be used 5. Sereflo 25 microgram/250 microgram. Summary of Product Characteristics.
August 2022 CIPSER20220021
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